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New practical training on pureed – dysphagia – diets by dietitians

We recently read about a course that focused on creating pureed diets produced by Dietitian, Rachael Masters. Passionate about nutrition and a keen interest in dysphagia, Rachael wanted to provide a course that provides useful information and practical advice for caterers and people living at home 

We therefore wanted to share what she has done and this is what Rachael has to say about it…

Preparing pureed or altered consistency diets can seem overwhelming, making sure it is a safe consistency to eat, appealing and packed with nutrition. Focus on Undernutrition have launched new practical online training to support cooks and carers to develop pureed and altered consistency diets, previously delivered face to face to over 700 cooks. Endorsed by the British Dietetic Association and developed by a Consultant Dietitian, supported by a Speech Therapist and expert dysphagia chefs. 

This accessible training includes masterclasses, practical catering demonstrations for over 20 pureed recipes, before and after confidence and knowledge surveys and course evaluation. The training incorporates downloadable resources, including activity sheets, all the training materials, recipe books with over 30 level 4 pureed recipes. 

The training includes:

  • What is dysphagia
  • What is IDDSI
  • Which foods are suitable for different IDDSI levels
  • Adapting meals to be suitable for each IDDSI level
  • Developing nutritionally balanced menu  
  • Practical videos on over 20 level 4 pureed recipes, including main course, desserts, snacks such as biscuits, scones, sandwiches, afternoon tea.

To find out more details on Focus on Undernutrition Online training watch https://youtu.be/Hzf8z_pu54w. To purchase the training, email info@focusonundernutrition.co.uk for a registration form to complete.

For further information visit www.focusonundernutrition.co.uk or email info@focusonundernutrition.co.uk

In the meantime, please remember, these meals can be supplemented by our Slõ Milkshakes+ oral nutritional supplement.

A powdered pre-thickened supplement they will boost nutritional intake with a minimum of 23g of protein, 330+ calories and a mix of 25 essential vitamins and minerals.

They also taste good too. Not too sweet and no metallic aftertaste, they also taste fresh made with cold whole milk from the fridge. If you want to use them, they can be bought from our website www.slodrinks.com/shop

Posted on

New practical training on pureed – dysphagia – diets by dietitians

We recently read about a course that focused on creating pureed diets produced by Dietitian, Rachael Masters. Passionate about nutrition and a keen interest in dysphagia, Rachael wanted to provide a course that provides useful information and practical advice for caterers and people living at home.

We therefore wanted to share what she has done and this is what Rachael has to say about it…

“Preparing pureed or altered consistency diets can seem overwhelming, making sure it is a safe consistency to eat, appealing and packed with nutrition. Focus on Undernutrition have launched new practical online training to support cooks and carers to develop pureed and altered consistency diets, previously delivered face to face to over 700 cooks. Endorsed by the British Dietetic Association and developed by a Consultant Dietitian, supported by a Speech Therapist and expert dysphagia chefs.

Delivered as two modules, this accessible training includes masterclasses, practical catering demonstrations for over 20 pureed recipes; before and after confidence and knowledge surveys and course evaluation. The training incorporates downloadable resources, including activity sheets, all the training materials, recipe books with over 30 level 4 pureed recipes, coursework and certificate. Both practical and written coursework is required for this course which is uploaded onto the training platform and marked by a dietitian. If completed by a family carer, the coursework can be excluded on request.

The training includes:

  • What is dysphagia
  • What is IDDSI
  • Which foods are suitable for different IDDSI levels
  • Adapting meals to be suitable for each IDDSI level
  • Developing nutritionally balanced menu cycles for level 4 and level 6 diets
  • Completing IDDSI testing
  • Thickening fluids and completing IDDSI flow tests
  • Catering equipment for altered consistency diets (ACD)
  • Practical guidance and demonstrations on preparing ACD and IDDSI testing
  • Practical videos on over 20 level 4 pureed recipes, including main course, desserts, snacks such as biscuits, scones, sandwiches, afternoon tea.
  • Coursework in adapting a menu cycle for level 4 and level 6 diets.

The training is part of the Focus on Undernutrition Catering Course, a six-module course covering menu planning, diabetes, fortified (high calorie/protein) diets, dysphagia, dementia and constipation. The dysphagia modules can be completed as standalone for £100, or part of the whole course for £250.”

To find out more details on Focus on Undernutrition Online training watch https://youtu.be/Hzf8z_pu54w. To purchase the training, email info@focusonundernutrition.co.uk for a registration form to complete.

For further information visit www.focusonundernutrition.co.uk or email info@focusonundernutrition.co.uk

In the meantime, please remember, these meals can be supplemented by our Slõ Milkshakes+ ONS.

A powdered pre-thickened ONS, they will boost nutritional intake with a minimum of 23g of protein, 330+ calories and a mix of 25 essential vitamins and minerals.

They also taste good too. Not too sweet and no metallic aftertaste, they also taste fresh made with cold whole milk from the fridge.

Here in the UK, they are available to prescribe and pip codes are available from the Clinicians Library: www.slodrinks.com/clinicians-library

They can also be bought on our website www.slodrinks.com/shop

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Finding Dysphagia in Four: A simple swallow screen

The signs and symptoms of dysphagia are familiar to Speech and Language Therapists/ Pathologists and Dietitians that see dysphagia patients daily.

However, as you know, outside this sphere there are a huge number of health care professionals that are not. They may be unaware of how dysphagia can impact a patient’s recovery care plan. As a result, a patient may not be receiving the most suitable care.

As you know, dysphagia affects the elderly and with an increasingly elderly population, the incidence of dysphagia will only increase. It would therefore be a good idea to create a simple way to find dysphagia, for those on Acute wards and working in Surgeries and Health centres.

This is something highlighted in a paper we recently read: A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems?

You can read the full paper here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151188/ but to summarize…

“Screening for dysphagia is considered good practice on a stroke ward and for stroke care. However, despite it occurring at the same frequency in frail older adults on an Acute ward, it isn’t screened for.

When you consider that, in addition to strokes, there are 126 conditions that can present with dysphagia as a secondary symptom in older, frail patients, many may have a swallowing difficulty undiagnosed.

There is, therefore, a need to empower frontline medical and nursing staff to screen prior to referral rather than assess peoples’ ability to swallow when they are on the ward.

Consequently, the Paper’s authors reviewed the available literature on screening, other assessment techniques (EAT-10) and conducted a study to develop a shorter swallow screen, the 4 Question Test. (4QT).

This Swallow Screen is highly sensitive but not a specific swallow screen.

It does not replace a Speech and Language Therapists/Pathologists Assessment and does not aim to identify the nature or etiology of any dysphagia present.

Instead, it provides an effortless way for medical and nursing staff, without prior training, to identify people who may have difficulty swallowing and then, if necessary, refer them for a full swallow assessment.

There is the added advantage that, in clinically busy settings and out of hours, there is no need to look for a teaspoon or to establish the time taken to swallow a fixed volume of water.

This Swallow Screen is simple and effective. It does not pretend to be conclusive in identifying the presence of dysphagia. It empowers healthcare professionals to look for it before referring to a Speech Therapy Department.”

We think this is so important and could have a such a huge positive impact on helping dysphagia patients we have sponsored the printing of the cards you see above.

If you think it is important too and want to try them with your colleagues on the ward or in the Community, we will send you some. Just email support@slodrinks.com and let us know how many you need.

All we ask is that you let us know how useful you found them. We will then forward your comments to the authors.

In the meantime, to read the paper in full just click this link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151188/

Posted on

Finding Dysphagia in Four: A simple swallow screen

The signs and symptoms of dysphagia are familiar to Speech and Language Therapists/ Pathologists and Dietitians that see dysphagia patients daily.

However, as you know, outside this sphere there are a huge number of health care professionals that are not. They may be unaware of how dysphagia can impact a patient’s recovery care plan. As a result, a patient may not be receiving the most suitable care.

As you know, dysphagia affects the elderly and with an increasingly elderly population, the incidence of dysphagia will only increase. It would therefore be a good idea to create a simple way to find dysphagia, for those on Acute wards and working in Surgeries and Health centres.

This is something highlighted in a paper we recently read: A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems?

You can read the full paper here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151188/ but to summarize…

“Screening for dysphagia is considered good practice on a stroke ward and for stroke care. However, despite it occurring at the same frequency in frail older adults on an Acute ward, it isn’t screened for.

When you consider that, in addition to strokes, there are 126 conditions that can present with dysphagia as a secondary symptom in older, frail patients, many may have a swallowing difficulty undiagnosed.

There is, therefore, a need to empower frontline medical and nursing staff to screen prior to referral rather than assess peoples’ ability to swallow when they are on the ward.

Consequently, the Paper’s authors reviewed the available literature on screening, other assessment techniques (EAT-10) and conducted a study to develop a shorter swallow screen, the 4 Question Test. (4QT).

This Swallow Screen is highly sensitive but not a specific swallow screen.

It does not replace a Speech and Language Therapists/Pathologists Assessment and does not aim to identify the nature or etiology of any dysphagia present.

Instead, it provides an effortless way for medical and nursing staff, without prior training, to identify people who may have difficulty swallowing and then, if necessary, refer them for a full swallow assessment.

There is the added advantage that, in clinically busy settings and out of hours, there is no need to look for a teaspoon or to establish the time taken to swallow a fixed volume of water.

This Swallow Screen is simple and effective. It does not pretend to be conclusive in identifying the presence of dysphagia. It empowers healthcare professionals to look for it before referring to a Speech Therapy Department.”

We think this is so important and could have a such a huge positive impact on helping dysphagia patients we have sponsored the printing of the cards you see above.

If you think it is important too and want to try them with your colleagues on the ward or in the Community, we will send you some. Just email support@slodrinks.com and let us know how many you need.

All we ask is that you let us know how useful you found them. We will then forward your comments to the authors.

In the meantime, to read the paper in full just click this link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151188/

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The perfect thickened drink

Is a milkshake the perfect thickened drink?

As you know, it’s difficult to stay hydrated with dysphagia. There’s lots of reasons for it, but the main one is people don’t like the texture of thickened drinks.

A glass of juice, a cup of tea or coffee with thickener is strange because it’s not what people expect.

We thought the best way to overcome this was to provide a drink that’s easy to accept. One that is known to be thick – like a milkshake.

Everyone knows milkshakes are thick and are expected to flo slo.

Slõ Milkshakes+ are therefore easy to accept because they are a familiar thickened texture. But they are safer to swallow because they are thickened to IDDSI Levels 1, 2 and 3.

That means you can use them to stay hydrated. They are made with milk which is 87% water.

Plus, they provided much needed nutrition. The + stands for + proteins (min 23g), + calories (399 max) and + vitamins and minerals (25).

Better still, they are enjoyable to drink. The chocolate uses a rich cocoa powder, the strawberry – real strawberry and banana – real banana. They are not too sweet, don’t have a metallic aftertaste and taste fresh, rich and creamy made with whole milk from the fridge.

So could a Slõ Milkshake+ be a perfect drink for dysphagia? It’s an acceptable texture, hydrates, provides nutrition and actually tastes good!

If you would therefore like to try them, you can either buy a whole pack or a sample from us by clicking this link: https://www.slodrinks.com/shop/

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The perfect thickened drink

Is a milkshake the perfect thickened drink?

As you know, dysphagia patients struggle to stay hydrated. There’s lots of reasons for it and one of the main ones is they don’t like the texture of thickened drinks. A glass of juice, a cup of tea or coffee with thickener is strange because it’s not what they expect.

We thought the best way to overcome this was to provide a drink they will easily accept. One they know will be thick – like a milkshake.

Everyone knows milkshakes are thick and your patients expect them to flo slo.

Slõ Milkshakes+ are therefore easily accepted because they are a familiar thickened texture, but safer for your dysphagia patients because they are available at IDDSI Levels 1, 2 and 3.

Having gained acceptance, they will help hydrate your patients. They are made with milk which is 87% water.

Plus they provided much needed nutrition. The + stands for + proteins (min 23g), + calories (399 max) and + vitamins and minerals (25).

Better still, they are enjoyable to drink. The chocolate uses a rich cocoa powder, the strawberry – real strawberry and banana – real banana. They are not too sweet, don’t have a metallic aftertaste and taste fresh, rich and creamy made with whole milk from the fridge.

So could a Slõ Milkshake+ be a perfect drink for dysphagia? It’s an acceptable texture, hydrates, provides nutrition and actually tastes good?

If you would like to see what your patients think, you can prescribe Slõ Milkshakes+ and obtain the all the information you need including PIP Codes by scanning the QR code above or going to https://www.slodrinks.com/clinicians-library/

Scroll down to the Slo Milkshakes+ Data Sheet Button or, if you would like to order a sample first, using the same link scroll down to the Sample Request Button and enter your patient’s details on the encrypted online form.

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Swallowing Assessment Pack for Dysphagia

As you know, every dysphagia patient must have their swallowing difficulty assessed by a Speech and Language Therapist/Pathologist.

However, making thickened drinks that flo slo enough to match all the IDDSI Levels 1, 2 and 3 takes time. To complicate matters, water is preferred for assessment but some patients just don’t like the look of thickener in water or it’s texture.

To help save time and give patients another option, we’ve created an Assessment Pack with our Slõ Milkshakes+.

They are pre-thickened and powdered ONS. Containing a thickener and a flavour, you simply mix with whole milk to reconstitute them to IDDSI Levels 1, 2 or 3.

They won’t thin out or speed up. They will flo slo all day, providing plenty of time for assessment.

Better still, patients won’t see thickened being added; they expect milkshakes to be thicker and they taste good – patients can’t taste the thickener!

The reason for providing Slõ Milkshakes+ is many dysphagia patient may need nutritional supplements.

By assessing with Slõ Milkshakes+, Therapists/ Pathologists know which IDDSI Level the patient needs and the flavour they like.

That can be included in a referral to a Dietitian, shortening the time between a patient’s assessment and them receiving the oral nutritional supplements they need.

To order an Assessment Pack, click the Clinicians Library button at the top of the page. Now in the Library complete your details, request an Assessment Pack and select the flavour you want to use.

We hope you find this service helpful and if you do – please let your colleagues know.

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Dysphagia: A Geriatric Giant?

“Geriatric Giants: A term coined by geriatrician Bernard Isaacs, and the expression refers to the principal chronic disabilities of old age that impact on the physical, mental and social domains of older adults”.

Dysphagia is a big issue. Estimates suggest there are currently over 590,000,000 around the world suffering with it.

As a result, David Smithard from King’s College Hospital Foundation Trust in London (UK) argues that it should be considered a Geriatric Giant. We completely agree and so have put the Abstract and Introduction from his paper below.

We would highly recommending reading the full and original article which you can read on line by clicking this link: https://medical-clinical-reviews.imedpub.com/dysphagia-a-geriatric-giant.php?aid=8373

Abstract

With increasing age there are changes to the physiology of all aspects of swallowing. Despite these changes, the majority of older people will swallow safely. With increasing frailty the number of people presenting with dysphagia increases either in the presence of acute illness or with co morbidity; with significant number living in institutions.

The aetiology of dysphagia is multiple and is associated with increased dependency and mortality and as such dysphagia meets the criteria to be classified as a geriatric syndrome or giant. This paper presents the case for dysphagia to be recognised as a geriatric giant.

Introduction

The worldwide population is increasing, such that it is predicted that there will be 2 billion over the age of 65 years by 2050; the greatest proportional increase will be in those over the age of 85 years.

Accompanying this will be an increase In people living longer with long term conditions and a consequent increase in frail older people.

Old age is frequently accompanied by many long-term conditions that affect health. Many old people will have multiple long-term conditions (e.g. ischaemic heart disease, diabetes, dementia).

Dysphagia, difficulty in swallowing, will accompany many long term conditions and may be latent in many frail older people, and is associated with increasing dependency and death. The time has come to fully recognise dysphagia as a Geriatric Giant /Syndrome.

To be recognised as a Geriatric Syndrome/Giant dysphagia [1] has to meet accepted recognised criteria below. This short paper will outline the reasons why it should be considered thus.

Factor for Geriatric Giant Dysphagia
Age
Symptom
Cognitive Function (✓)
Functional Impairment (✓)
Common
Multifactorial
Morbidity
Outcome

You can read on line by clicking this link: https://medical-clinical-reviews.imedpub.com/dysphagia-a-geriatric-giant.php?aid=8373

Posted on

Dysphagia: A Geriatric Giant?

“Geriatric Giants: A term coined by geriatrician Bernard Isaacs, and the expression refers to the principal chronic disabilities of old age that impact on the physical, mental and social domains of older adults”.

Dysphagia is a big issue. Estimates suggest there are currently over 590,000,000 around the world suffering with it.

As a result, David Smithard from King’s College Hospital Foundation Trust in London (UK) argues that it should be considered a Geriatric Giant. We completely agree and so have put the Abstract and Introduction from his paper below.

We would highly recommending reading the full and original article which you can read on line by clicking this link: https://medical-clinical-reviews.imedpub.com/dysphagia-a-geriatric-giant.php?aid=8373

Abstract

With increasing age there are changes to the physiology of all aspects of swallowing. Despite these changes, the majority of older people will swallow safely. With increasing frailty the number of people presenting with dysphagia increases either in the presence of acute illness or with co morbidity; with significant number living in institutions.

The aetiology of dysphagia is multiple and is associated with increased dependency and mortality and as such dysphagia meets the criteria to be classified as a geriatric syndrome or giant. This paper presents the case for dysphagia to be recognised as a geriatric giant.

Introduction

The worldwide population is increasing, such that it is predicted that there will be 2 billion over the age of 65 years by 2050; the greatest proportional increase will be in those over the age of 85 years.

Accompanying this will be an increase In people living longer with long term conditions and a consequent increase in frail older people.

Old age is frequently accompanied by many long-term conditions that affect health. Many old people will have multiple long-term conditions (e.g. ischaemic heart disease, diabetes, dementia).

Dysphagia, difficulty in swallowing, will accompany many long term conditions and may be latent in many frail older people, and is associated with increasing dependency and death. The time has come to fully recognise dysphagia as a Geriatric Giant /Syndrome.

To be recognised as a Geriatric Syndrome/Giant dysphagia [1] has to meet accepted recognised criteria below. This short paper will outline the reasons why it should be considered thus.

Factor for Geriatric Giant Dysphagia
Age
Symptom
Cognitive Function (✓)
Functional Impairment (✓)
Common
Multifactorial
Morbidity
Outcome

You can read on line by clicking this link: https://medical-clinical-reviews.imedpub.com/dysphagia-a-geriatric-giant.php?aid=8373

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IDDSI Podcast

As you know the IDDSI www.iddsi.org has been adopted here in the UK. Created to simplify descriptions of thickened drinks and pureed foods, it provides a common language for patients, carers and healthcare professionals. 

Because it is so important, we invited one of the board members based here in the UK – Ben Hanson – to join us on our podcast Slõ Talk. The aim was to share with us its origins, what’s happening to raise awareness and hopes for the future.

It is for those of you who are familiar with IDDSI and those who are not?

We have found that Speech and Language Therapists, Dietitians and those working on wards are extremely comfortable using the IDDSI terminology. They also understand how that translates into preparing thickened drinks and texture modified meals.

However, outside of that sphere there are many healthcare professionals who are not dealing with dysphagia on a daily basis who need added support to understand it.

For example, we still answer questions from Doctors, Surgeries and Pharmacists. This lack of understanding has been confirmed by research by the UK branch of the IDDSI, which also adds Nursing Homes and care facilities as a large group which wants more information.

This latest Slõ Talk podcast is another tool that aims to help rectify this and so would you please pass this on to, Doctors, Surgeries, and care facilities you are working with.

More information is available from our site www.slodrinks.com and IDDSI’s www.issdi.org

In the meantime, to listen to this podcast just click here: Slõ Talk: Podcast with Ben Hanson.

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Why thickened drinks have names from the IDDSI

As you are living with dysphagia (swallowing difficulty) you will be familiar with the different level names given to thickened drinks. These have been created under something called the International Dysphagia Diet Standardization Initiative. Abbreviated to IDDSI, pronounced ID – C.

It’s aim is to simplify descriptions of thickened drinks and pureed foods. Create a common language for patients, carers and healthcare professionals to describe a thickened drink.

Before this, everyone had their own idea of describing how thick a thickened drink should be. But this was open to interpretation. The IDDSI has changed this. Now everyone knows how to describe the thickness of a thickened drink and what it should look like.

It is for those of you who are familiar with IDDSI and those who are not?

Because knowing this is so important, we invited one of the board members based here in the UK – Ben Hanson – to join us on our podcast Slõ Talk. The aim was to share with us its origins, what’s happening to raise awareness and hopes for the future.

We have found that Speech and Language Therapists, Dietitians and those working on wards are extremely comfortable using the IDDSI terminology. They also understand how that translates into preparing thickened drinks and texture modified meals.

However, outside of that sphere there are many healthcare professionals who are not dealing with dysphagia on a daily basis who need added support to understand it. That may include you.

Consequently, we wanted to share with you our latest Slõ Talk podcast which will provide you with an insight in IDDSI and we hope proves useful.

More information is available from our site www.slodrinks.com and IDDSI’s www.issdi.org

In the meantime, to listen to this podcast just click here: Slõ Talk: Podcast with Ben Hanson.