3. Practical advice and tips for carers > Swallowing, eating and nutrition

Swallowing, eating and nutrition

3) Modified texture diets video

cup of water

Discuss with speech and language therapist, dietitian or nursing staff if there are any doubts about what the individual person should or should not be eating. Even giving ice cubes or ice chips to moisten the mouth may not be allowed until the swallow has been assessed. Check if they need to have all their fluids thickened or if  they have a strict no food or drink by mouth rule it is essential that this is followed at all times until the person has been reassessed and has been shown to have recovered a safe swallow.

Modified diets

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Pureed diet

  • This is a typical 3 course meal of soup, beef casserole, potatoes, carrots, custard and peaches.
  • We are going to demonstrate the consistency for a pureed diet. All the food should be smooth when you have finished.
  • First we are going to puree the lumps from the soup.
  • For this you can use a hand blender in the pot or a food processor /liquidiser, move it around the pan.
  • This may take a few minutes.
  • It should be free of lumps when you are done, check through it using a spoon.
  • As you can see it is lump free.
  • Some commercial soups e.g. cream of tomato will not require to be blended.

Beef

  • Now for the beef. Make sure it is well cooked to a tender consistency. Shread or break up the meat with a fork. Use an electric blender and use plenty of gravy to moisten the meat. Again it may take a few minutes to get right, and may be more difficult than soup. Add more gravy to help things along. Don’t add water. We don’t want to water down the goodness, mix with a spoon and blend further.
  • It should be a nice smooth texture like this.

Potatoes

  • For the potatoes you will need to boil them quite well so they are soft.
  • You will need a potato masher for this. Do not use an electric blender for mashed potatoes this seems to change the potato too much and it’s not pleasant to eat.
  • Try adding butter and /or cream, this helps to loosen it and make a nice consistency as well as adding extra calories and nourishment. Mash well.

Carrots

  • For the carrots you can use an electric blender.
  • These should be smooth and lump free.
  • Again this may take a few minutes –check through the carrots, do you see that lump? Blend again and recheck.
  • Presentation is important try to keep all the colours and food separate so it still looks like a normal plate of food.
  • Although it is blended down it will taste just as good.

Peaches

  • Use an electric blender for the peaches for the pudding, they may go a bit watery.
  • Your custard is already the correct texture. Thick custard like this is about the right texture. If you are making custard from a powder it should also be about this texture. Some shop bought ready made custard can be thinner and you may have to check the consistency.
  • Spoon on your blended peaches.
  • Here is the completed pureed meal.

Mashed meal

  • For a mashed diet we want to break down all the large lumps so that very little chewing is required.
  • We can do this using a fork.

Soup

  • With the soup you can see that the carrot lumps are a bit big so we need to mash these down with a fork.

Beef

  • The beef casserole can also be mashed with a fork, first break it up using a knife.
  • The beef has been well cooked until soft and you can see how the texture breaks down easily.
  • It’s a good idea to have more gravy to add.
  • The carrots can also be mashed with a fork, cutting them first will make them easier to mash.
  • The potatoes (which should have been boiled soft) can also be mashed with a fork, cutting them into smaller pieces first. You can add milk, butter or margarine to get a good texture.
  • The peaches can also be mashed up with a fork, again cutting them first with a knife helps.
  • Some textures are trickier to mash up. For example some fruits are quite stringy such as rhubarb and some meat may be tougher which will need more cooking. You may have to persevere.
  • Add the mashed peaches to the custard.
  • You can now serve the meal.
  • Some people may not like you mashing up their meal in front of them. Ask them first if it is ok. Or mash up the meal in the kitchen before you serve it, this way you can tidy up the plate.