INSIGHTS FROM INDUSTRY
THE DYSPHAGIA DILEMMA WHY WE NEED TO IMPROVE THE OFFERING OF NUTRITIONAL, TEXTURE-MODIFIED FOODS
W
ith approximately 670,000 Australians experiencing a daily battle when it comes to swallowing food, many are missing out on the joy of mealtimes.
Known as dysphagia, the swallowing impairment is a common consequence of well-known health conditions like stroke, Motor Neurone Disease, Parkinson’s Disease, and head and neck cancer. With these conditions usually experienced among people aged 70 years and above, dysphagia is an ongoing concern for our ageing population. And it comes with a price. Recent research from Flinders University found people with Dysphagia usually have a slower recovery, staying up to three days longer in hospital and costing the healthcare system 40 per cent more than those without impaired swallowing. The reason? Malnutrition and dehydration caused by incorrect preparation and delivery of texture-modified food. As highlighted in the Aged Care Royal Commission’s final report, diet, nutrition and food are critical to the health and wellbeing of older people. Food must meet the body’s needs to maintain organs and body systems, repair injury, fight off or recover from illness or infection, and maximise physical and cognitive capacity.
interpretation. The testing design takes into account whether people can use common kitchen utensils such as spoons and forks. For kitchens to test and make food consistently seven days a week within a high staff turnover environment, combined with time pressures and hungry people to feed, things can and do get missed. In addition to a people skills problem, providers must also have the right processing equipment at hand—tough for commercial kitchens and near on impossible in domestic households. The risk of getting things wrong is high with outcomes potentially catastrophic—think choking or pneumonia (from food being ingested into the lungs). It’s easy for food to lose its shape or fill with too much fluid. This affects the sensory experience and can lead to the avoidance of food altogether. Accredited Practicing Dietitian, Linda Cumines, says, “Preventing malnutrition by having access to the right textures, with variety, along with attractive presentation is key. Any improvements to the quality of texture modified foods is welcome across the industry.”
The dysphagia dilemma
In the early 1980s, Australian dietitians and speech pathologists developed a simple and practical way to prepare Texture A, B and C foods. Later an international collaboration created a recognised IDDSI framework. This framework consists of a continuum of eight levels, where drinks are measured from Levels 0 to 4, while foods are measured from Levels 3 to 7. IDDSI testing methodology for food and beverage preparation is subjective in nature and open to Continued on page 81
80
