Making safe to swallow drinks for those with dysphagia is difficult. Making puree meals, that are safe; nutritious and palatable is even harder and stressful for caregivers.
We therefore wanted to share this site with you. www.essentialpuree.com
It contains a puree recipe book Essential Puree: The A to Z Guidebook. Written by Diane it contains some of the recipes she created to care for her mum.
We liked it and so asked Diane to share her story….
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I am a home chef from a family of talented cooks. In taking care of my mother, I had been cooking for her. I had already developed a repertoire of dishes that were family favorites, recipes handed down for generations, done in an updated and healthy manner, according to the latest trends in nutritional healing.
I am an author who gave up the writing life in the big city to return to the family and take care of my mother. I am an experienced researcher. I did what I always do. I kicked into high gear and began reporting my story. The result was Essential Puree: The A to Z Guidebook.
To begin with, I ordered every cookbook for dysphagia that was available and began reading all of them. I spoke to healthcare professionals. I have a regular household kitchen. I started there. One by one, I discovered new appliances that saved labor, time and clean-up. I shopped like a maniac and wrote down my consumer reports on kitchen appliances (these are available on the Essential Puree website).
I looked for ready to eat food, and found nothing in the freezer departments and very little vacuum packed or canned on the shelves or online. I found out that what was commercially available could only be classified as horrible. In an online blog, one son who was his mother’s caregiver characterized the commercially packaged food products as dog food. He felt guilty feeding such things to his mother.
As an eldest daughter, I fell into the role of principal caregiver and embarked upon the journey of preserving my mother’s quality of life. I was on my own, as most of those who have been diagnosed are. This is emotional. It is a huge change. There was no emergency response manual that addressed the problem of converting to a puree kitchen.
One had to go by trial and error. Most of the works available on the market were clinical. They did not suit my palate. My mother had taught me how to cook from the time I was a little girl. She was renowned for her own table.
So I worked at it. Even the aides who helped me take care of my mother liked the food. They asked for the recipes. So I wrote the book that I wish that I had when my mother was diagnosed. Besides that, dealing with my mom was like dealing with Scarlett O’Hara in old age. She was used to living well and she was used to getting her way. She had high standards. I had been a rebellious daughter. She had been a headstrong mom. The act of cooking for her mended our relationship. It proved that I loved her. I was not gallivanting all over the world, writing my stories. I was there. I was on deck. We worked it out. The work opened new emotional experiences for me and I found that my writing deepened. It was an amazing revelation!
In my role as principal caregiver, I soon realized that making great pureed food at home turned out to be healthier, cheaper and more delicious than buying what was commercially available.
In solving the problem, I realized that my primary tools were the blender and the mini-food processor. I became the Queen of the Buzz. I wrote it all down in the recipes. I wrote the book I wanted, so that others could have the benefit of my experience. The patient, in this case my mother, did not have to lose one of life’s greatest pleasures, that of eating well.
I discovered that if I organized batch cooking, four to six servings at a time, I did not have to be chained to the kitchen. I froze meals in individual portions. If I needed a break and my mother’s physician told me that I did need breaks, I did not have to worry. I did not have to get caregiver burnout. A great meal was always on hand. Any member of the family could warm it up and serve it properly. As one of America’s greatest chefs, Wolfgang Puck says, “When you make it yourself, you know what’s in it.”
Essential Puree: The A to Z Guidebook is not simply a book of recipes. It presents a system for setup and organization of the puree kitchen: the pantry, the refrigerator and the freezer. It tells how to select ingredients for nutritional healing. It tells how to organize a cooking schedule. It tells how to cook in batches, label food and store food. It tells how to keep track of what is on hand at any given time. It discusses ingredients. It offers tips, tricks, tools and techniques.
The condition of dysphagia is life-threatening because with the swallowing difficulty comes coughing and the aspiration of food into the lungs. The danger is that the patient may contract bacterial pneumonia. This requires hospitalization and is more difficult to cure than regular viral pneumonia. Sometimes if the dysphagia patient cannot eat, they must take in their nutrition with a feeding tube.
(There are approximately forty medical reasons for the condition of dysphagia. Swallowing difficulties affect the elderly, those who suffer from strokes, dementia or Alzheimer’s, but this is not a disorder that affects only older people. It affects many others, people of all ages, including children and the young. There are the terrible occurrences in life, such as accidents, in cars, boats, motorcycles, or on the job. There are those who are victims of paralysis, and those who are wounded in war. These are people with permanent difficulties. There are those with temporary difficulties, such as those caused by the treatment of cancer. Those having oral surgery, cosmetic or plastic surgery and even those having surgery for reasons of weight loss have a need for puree.)
The one condition most overlooked is war injuries. I had a letter from a serviceman returning from a war zone. He had been shot in the neck and could not eat solid food. He ordered a copy of the Guidebook and was happy.
My mother’s condition of dysphagia was related to aging and it was permanent. The more I did this work, the more people I met and they told me their stories. I soon realized that the need for pureed foods may be temporary and it may be for people of many different ages, for many different reasons. The designer in the print shop that I use to make my letterhead told me that a stepson had been in a motorcycle accident and had an injury that required him to eat pureed foods. She bought the young man a copy of the Guidebook for him, hot off the presses.
The manager of my favorite whole foods store recommended the cookbook to someone who had gastric bypass surgery as a means of getting control of obesity. He used the cookbook to get him through the post-op period.
This same manager told me that many people with digestive issues seem to have an easier time with pureed foods. But here is an amazing fact. There are perfectly healthy people who have a temporary need or are trying to improve their health. My chiropractor told me that his wife had gastroparesis, a condition diagnosed by her gastroenterologist. She needed pureed food.
My mother’s physical therapist had extensive oral surgery in his fifties. He couldn’t eat solid food. He had been drinking fruit juices and he was starving. I had given him an autographed copy of the book. He had tasted the food I cooked for my mom over the years and he knew it was tasty. He adopted the technique and made a pureed version of his mother’s Hungarian goulash.
My banker saw a copy of the book and told me he wanted to lose weight. He wanted to escape the fast food and vending machines at his bank, a branch in the suburbs. He liked the fact that the calorie and nutrition count per serving were provided. He made the food at home and brought it to work. He heated up the meals in the microwave in the bank’s break room. Two days ago, he told me proudly that he had lost ten pounds. He wanted to stay in good shape because he had young children and he wanted to be there for them. He looks fantastic.
One of the aides who took care of my mother had a daughter who was on her high school track team. The mother smelled my minestrone cooking, tasted it and thought it was delicious. She asked for the recipe and took it home and made it for her daughter. The daughter liked it so much that she started making it and taking it to school for her carb load for competitive sports. The daughter went on to win a state championship in track and a full scholarship to college. I like to think my minestrone played a small part in the young woman’s success.
A friend of mine had a plastic surgery procedure, a facelift, and could not eat solid food for several weeks. She got the Guidebook, she made the pureed food and drank it through a straw. It got her through the post-op recovery period.
Another friend of mine is a mother with children in grade school. She is always on the run. She thinks of the blended meal as a smoothie of rocket fuel. She can take it with her and sip it in the car. It beats the fast food joints. She can even take it to the gym, so she has a protein supply after a workout. She thinks this is better than downing a protein sports shake that solves the protein problem but is unsatisfying to her.
An investment banker friend of mine is always taking a plane to some far corner of the world. He was tired of eating airplane food, airport meals, and take-out sandwiches. He wanted to take good food with him in a portable container and eat it as a puree. He found out that if he packed it in clear containers of 3.4 ounces and put it in a plastic bag, he would conform to the TSA requirement and could take the food on the plane.
The portable containers did not open in his briefcase. For the road warrior, the pureed meal is liberty and salvation.
A good meal on the go saved him mental energy—he did not have to think about getting food in airports. It saved time. It made him feel good. It was high quality, clean eating.
As the noted speech language pathologist David Fagen, the head SLP at Fawcett Memorial Hospital in Florida, states, “Nutrition is an area that is often overlooked.”
I created the diet for my mom because I wanted her to have what was familiar and delicious. My mother thrived on these recipes for three years. Her physician was pleased. The nurses were impressed. My mom ate with pleasure and she enjoyed her food. It took some experimentation, but I got it right. .
My friend Heidi Pines, whom I have known since high school, has worked in the healthcare industry in Florida for a long time. Heidi specializes in long term care and works for a major insurance company. She had experience in meeting with people who had the opposite experience of my mom. Call it patient boredom. They did not want to eat. Heidi gave me a quote for the back of the guidebook: “As a geriatric licensed clinical social worker working in healthcare institutions for twenty years, I can tell you that one of the biggest complaints that I hear is about the limited diet of tasteless food. This book is wonderful! Great idea!”
So there you have it. The medical professionals like having educational materials to recommend to patients. Using this book, the families and caregivers can find their way to the best ingredients and convenience foods that are time-saving but nutritionally healing. I post new recipes on the Essential Puree website, along with tips, tricks, tools and techniques. I see it as a go-to source for patients, families and caregivers, a site that is well-researched and vetted by healthcare professionals.
I do this work in my mother’s memory. I hope that what was created for my mom may be of benefit to others. I think my mother would have loved it.
As my friend Dr. Dee says—a remarkable woman who is both a nutritionist and graduate of a prestigious culinary school, “The healing power of food created with love cannot be overestimated.”
Diane Wolff is the author of three books about Chinese history and cultures. She is a widely published journalist. This is her first cookbook. For additional recipes and tips and tricks on setting up and running a dysphagia kitchen, go to www.essentialpuree.com.
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