Food Glorious Food

 Everyone has preferences when it comes to food textures and there are obvious cases of when different textures and softness of food is given, common sense suggests that babies without teeth will have liquidised and then pureeed food before moving on to solids but is this the same for adults?  What about those with disabilities/illnesses/conditions where it affects the ability to chew and swallow?

The International Dysphagia Diet Standardisation Initiative {IDDSI} have created levels of dysphagi that allow carers and everyone in general to understand what level people are at with their chewing/biting/swallowing without differing opinons becoming a problem.  Remember this is not used with babies who don't have Dysphagia.

Dysphagia is where an individual has difficulty with swallowing.

The levels are:

7- Regular easy to chew food...a mixture of textures and soft/hardness that when bitten and chewed can be swallowed by everyone.  

6- Soft and Bite Sized...foods will be cooked or as chefs may refer to it over cooked to make it softer and it will be cut into bite sized portions so that it's easier to consume, bite and chew.

5- Minced and Moist...all food regardless of if it's meat, fruit, vegetables will be minced so it resembles the size/texture of mincemeat and will be eaten mixed with sauces/gravies/fruit/vegetable purees.

4- Thick Puree...I have a background in childcare so I liken this to the second stage of weaning, you've done the liquid puree and now it's on to thick with the odd lump in it of puree...the consitancy of pipped icing on cake...like a buttercream.

3- Liquidised:  Moderately Thick - so it's not really a liquid but it's not a puree either I think of this as smoothie consistancy. 

2- Liquidised: Mildly Thick - I liken this to milkshake that contains ice cream, so it's still got body but it's not so thick it has texture.

1- Liquidised: Slightly Thick -  this reminds me of glace or water icing sometimes called lemon icing if you using lemon instead of water.  It's runny and generally used for dipping or on things 

In addition to dealing with soft palates there is also the possibilities of allergies.  Allergies always make meals complicated as the need to avoid cross contamination is really important.  It also means that often your making two meals.  

Here I have several allergies to contend with:

:~  Citric Acid

:~  Cows Dairy

:~  Pistachios

:~  Rice, Rice Flour, Rice Starch, Rice Milk, Rice Cream

:~  Potato, Potato Starch

It sure makes life REALLY tricky when cooking.  Although not actually allergic to corn starch I try to limit it in the hope it doesn't become a problem.  I've made the following substitutions: 

Potatoes with Celeriac and Turnips.

Gravy which requires stocks which require thickening with starch with sauces...tomato based, butternut or alternative squash based, bechemel based.  My favourite is the squash based ones.

I've increased vegetables and removed carbs in the form of most pasta and rice from dishes.  Pasta can contain rice flour as an alternative so it's proceed with extreme caution.

Cows Dairy with Goats Dairy

Citric Acid.....it's impossible to completely remove it as it's in such a lot of things but where I can I balance with honey to neutralise the acid.

Pistachios...I just minimise nut usage to prevent the risk of cross contamination and because peanuts have rice flour on them to preserve them those are out too.  It's easier to just not have nuts.

At the moment I'm cooking to level 6 on the IDDSI scale.  I've found some easy ways to help this by:

:~  Mostly cooking chicken and limiting red meat

:~  Steaming both meat and vegetables...this makes them less soggy than boiled so they are soft but not yet pureed.  

:~  Using sauces helps to make food softer.

:~  Cooking two meals won't put you off eating your own meal.

That brings me neatly to my next major issue.  I'm excellent at being the person who doesn't eat, who skips meals and has the mantra running in her head "your fat you shouldn't be eating anything".  I've noticed that this is more likely when others are pushing the virtues of diets and losing weight so I try really hard to avoid that.

Part of the probelm is I don't have a sweet tooth but also I prefer crispy/crunchy foods but at the same time really hate grease and oil.  So steaming allows me to keep control of my vegetables a little more than boiling and they can be crunchy.  I also eat a lot of raw vegetables.  This is where making two meals is the only solution.  

The only real problem with making two dishes is of course the washing up.  That is a nightmare but there's not a lot that can be done about it other just getting on with it.

I've also got a few tips to aid with eating:

:~ Sit whereever is most comfortable for your caree, if that's in front the tv with an over bed table and arm chair or the dinning table formally set go for it, I promise being comfortable when eating will make the meal go much smoother.

:~ If things need cutting up do so before the meal starts it allows for independence, especially if you have other people around.

:~ I use picnic plates because they have an excellent rim for scopping things up against.  I also have hyperacusis and I feel itching or scratching of my ears when cutlery sounds on plates and I want to scratch and rip my ears off...it took me years to work out that it's the sound of cutlery on plates because I can't hear the noise but now I know the picnic plates are a major relief.

:~ A fork and spoon for precut meals works really well and are easier to grip for arthritic hands than a knife.

:~ In our house the TV has multiple benefits, 

1} It stops me gulping meals 

2} it provides a distraction so you eat rather than push it aside because your worried about the length of time it takes 

3} your less likley to notice your caree takes 90mins {or any time} because your watching the TV. 

4} it makes a great break in the day for you to sit, eat and take a rest.  

I tend to chose an episodal programme, either dvd or recording and you watch up to 90mins worth of episodes.  It means its eaasier to stop and get back up and go clean those pesky dishes.

I think that's possibly all my tips on food for the moment but as blogger lost my original post I can't be certain.  So I shall post and if I think of anything else I'll do another post and try to remember to link back to this one.