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alternatives to pureed food for elderly lady
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alternatives to pureed food for elderly lady

Hi, my mom is currently in a nursing home and is on pureed food.  She hates it.  I'm there at meal time and she just says "oh no" and cringes when she sees the pureed plate of food come.  I help her eat some of it, but she eats very little of it saying she can't stand it. The pureed food I have to admit looks, smells horrible.  If the regular food is pork chops those on pureed get ground pork with gravy, it's usually a type of instant potatoes which my mom hates.  Usually I can get her to eat some of the pureed vegetables but only some meat (like at most a teaspoon) if I hide it in with the veggies.  They don't use any seasonings in the pureed food, no salt, or anyting.  I've tried using a little salt and pepper.  I've even tried bringing my own pureed food in that I thought she would like but that hasn't worked either.  Today, I even tried baby food, but she didn't like that either.  She will drink the meal replacement drinks, she loves them but sometimes it bothers her stomach, I think it can be too rich for her.  Any ideas, of what I could bring her or try would be greatful.  I'm worried she's not getting enough nutrician.  I've talked with the nurses, dietician, and the kitchen but they haven't been too helpful.
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144586_tn?1284669764
There are unanswered questions.

People are placed on pureed food because they have dysphagia - swallowing problems.

Bland food is contraindicated. It does not stimulate the swallow reflex. Hot sauce helps, as does lemon and pepper. Thus the dietician in the nursing home is not understanding what is going on.

If they will allow get her a little refrigerator and a microwave and pre-prepare meals for her.

Tilapia makes an excellent taste treat for someone with swallowing difficulties. It can be prepared in many different ways and will melt in her mouth. I used to feed the 105 year old (she's still around and a happy-pie) I cared for on soft-cooked fish every day.

Eggs are also nice.

And organic mashed potatoes in various flavors with loots of butter.

Soft pancakes ala McDonalds with maple syrup.

Papaya.

And drinks in small quantities in several flavors.
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144586_tn?1284669764
Heres a good Tilapia Recipe for those with a pureed food diet:

Buy a nice fresh bone-free piece and soak overnight in lime juice with a bit of mashed garlic.

In the morning beat an egg, *** a teaspoon of milk, take the fish from the lime, pat it, then cover with egg mixture and then press against bread crumbs on both sides.

In an iron frying pan, sizzle-hot put on each side for ten seconds.

Then into a microwave for four minutes.

Now you can store it in a refrigerator.

When ready to serve, back in the microwave and put on three pats of organic butter.

As al alternative meal flavor, instead of the butter use mustard. And fresh lemon juice.

Each pat of butter is about 70 calories.
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144586_tn?1284669764
Hard-boiled eggs, with salt and pepper are also ideal. You can bring them in  an insulated container. They keep best underwater in a little refrigerator.

In addition properly prepared scrambled eggs with different toppings. Maple syrup, blueberry syrup. Strawberry syrup. Peach juice (from canned peaches). But never honey.

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Avatar_f_tn
Thanks, I'll try some of your suggestions.  They actually puree fish and hard boiled eggs for the residents.  But I will try some Tilapia for her and try some different flavorings for her other pureed food.  Thanks.
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144586_tn?1284669764
McDonalds pancakes are also a treat. They make them extra-fluffy and soft.
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Avatar_f_tn
That would be great if we had a McDonalds here...lol..small town.  
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144586_tn?1284669764
When I cooked the Tilapia I used plenty of liquid (the lime juice, or lemon juice). I reheated it so the total cooking time was about five minutes. You need the moisture. Sometimes I would cook it in chicken broth.

Fluffy pancakes were always a hit with my little one. McDonald's was almost downstairs and they made them so perfectly. I just substituted natural maple syrup.

Other fish (deboned) can be cooked to be extremely soft (to literally melt in the mouth)without pureeing.

I would flavor organic mashed potatoes with a bouloin cube, either chicken or beef and use lots of butter. I would also serve the mashed ocasionally tinted with a drop of food dye (she liked orange) with a half dozen different types of cream gravys. She liked the chicken gravy and the mushroom gravy the best. Sometimes I would have two small scoops of mashed potato with different gravy on each one.

Another winner for those with swallowing difficulties are very hearty soups, particuliarly split-pea, slow cooked with an organic tomato, fresh carrot juice, a slice of ham, a dash of milk, a bit of chicken broth, crushed garlic, butter (added at the end), a bit of onion and a dash of hot sauce. Blend in the blender well. She loved that!

In many cases the problem is that people with dysphagia have to eat very slowly (maybe a small spoon every four or five minutes), and the nursing homes don't have the patience to do this.

Another problem they don't recognize is that swalling in the very elderly is often cicardian in nature.

That is to say that a patient that cannot swallow in the morning may be able to swallow reasonably well at night. My little one had such a cycle and meals at nine or ten P.M. were the way to solve it. Of course in a nursing home the residents adapt to the staff's schedule.
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Avatar_m_tn
My dear wife died a year ago after over 50 years with MS and I was her primary carer.
She was 82 when she died and lived in our home until 3 weeks before her death.
There were times during her life when she needed short term hospital or respite care and I observed the care she got which I guess was 'minimal adequate' and her last days she was given pureed food at the suggestion of the hospital they said 'she could not swallow' ......... she hated it and I took her fresh water melon, mangoes and bananas and similar which she relished.
After she died I started to look after my own sadly neglected health and this year has seen me in several hospitals and rehab facilities to fix up chronic leg ulcers,a total left knee replacement an hydropneumothorax and a few other odds and ends to the point where I am reasonably well.
This long term hospital visitation has enlightened me greatly with how patients are treated.
To get to the point ............ yesterday (Christmas day) my brother in law Mark was brought to visit me along with the rest of my family for Christmas get together.Mark is 81 and has long standing Parkinson's disease and cant communicate except for an alphabet board.
He is in a nursing home and they feed him PUREED FOOD ............ he hates it.
When he saw the spread of food we had he almost jumped out of his wheelchair motioning for hot rolls and butter and sausages,cheese and other before the main meal was ready which when it arrived he devoured with great relish.
I asked why he was given PUREED FOOD at the nursing home and they said that he could not swallow.
As a result I am following this up on his behalf as I sincerely believe that the PUREED FOOD choice for him was made by the nursing home to simplify the nursing home's task of feeding him cut up solid food which to them is time consuming.
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144586_tn?1284669764
While I am not a fan of nursing homes in general, the provision of pureed food is not generally a decision based on "cutting up solid food".

The fact is that dysphagia, or difficulty in swallowing, can be fatal. The pureed food is provided to prevent death.

Parkinson's disease is characterized by periods when one swallows normally and periods when one may not be able to swallow. If the initial evaluation is performed when there is swallowing difficulty, then an inappropriate diet may be prescribed.

It is not a matter of "cutting up food".

Even cut-up food can provoke a laranygospasm and complete airway obstruction in a Parkinson's patient.

It is difficult to "Monday morning quarterback" in regards to a specific individual, but in dysphagia there may be a circardian cycle. For example my "little one", now 105 going on 106, could swallow fairly normally at night and be unable to swallow without choking during most of the day. It is diffifult, in a poorly staffed nursing home to make a decision prior to every meal as to the swallowing status of a patient. In that respect, one could say that the pureed food is a "matter of convenience" for the home. But I would not characterize the decision as necessarily reflecting uncaring or neglect,

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Avatar_f_tn
My mother has a swallowing disorder and can only eat nectar consistency pureed foods. She's at home with me, so I make a lot of her meals she also get's FiberSource shakes via a feeding tube, when needed.

I season her foods with:
1. Mrs. Dash salt-free seasonings
2. Garlic powder
3. Onion powder
4. Cinnamon, nutmet brown sugar
4. Low sodium chicken, beef and vegetable broths
5. Brummel and Brown low fat spread (B&B)
6 Low sodium canned soups

Her favorite pureed meals are:
1. Sweet potatoes with cinnamon, nutmeg and butter.  I use canned sweet potatoes to save time.

2. Mixed vegetables. I buy frozen and microwave them to save time. I then puree them with vegetable broth and B&B.
3. Mashed potatoes with sour cream and B&B
4. Mashed rutabega with B&B and Mrs. Dash seasoning
5. Pureed chicken, broccolli and whole grain noodle casserole. I use cream of mushroom or celery soup.  
6. High protein yogurts
7. Cottage cheese with pureed mixed fruit
8. Pureed apple pie
9. Fruit flavored jello
10. All kinds of puddings

I hope this helps.
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Avatar_n_tn
have you tried tofu?  I use the Chinese way of cooking it.  First mince the pork, marinate it with salt, sugar, and low sodium soy sauce, toe very 8 ounces of meat, I add 1-1/2 table spoon of corn starch, 3 table spoon of water.  The corn starch and water is to make the pork more most and smooth.  Then I stir fry the meat, add chicken stock to cook it awhile to soften it further, stir in tofu.  

Hope it helps
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547368_tn?1332173665
Thanks for your input Suye, although this is an older post I am sure your information will be beneficial.

There are good and bad nursing homes. There truly are long term care facilities that care about their residents and do the very best they can. Staff take time to do extras for their residents and hug them when appropriate. I know as I have seen it as well as worked in such facilities.

In most Long Term Care Facilities budgets are tight and there is often a staffing shortage. It's up to the families to monitor their loved ones care. However family expectations are sometimes unrealistic. I know that statement is unpopular but our loved ones will not receive the kind of care we can provide on a one on one basis. Sadly not all of us are equipped to be Caregivers for various reasons..... so we must rely on a good facility to care for our family member.

If you family member is not in one of the better homes then search for another. They need our monitoring and love.

Diets are ordered by the physician, NOT the nursing staff. So if the physician feels that a resident's swallowing ability is impaired, even slightly a pureed diet is often ordered. OT and sometimes PT can be ordered to work with the resident on swallowing skills.  

As mentioned above there are ways to spice up the purred food.... and even make it rather tasty. If we are blessed with the ability and resources to care for our loved ones at home we can do a lot to make even a pureed diet palpable.

Thanks all for the great suggestions.
~Tuck
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1836358_tn?1318330268
Thanks for this post. Great ideas in preparing a food recipe for the elderly love ones. Their health problems give them a big impact in eating that's why it is really necessary to do a special food recipe for them. A healthy food recipe for them but delicious as well even though it may cost of a little cash advance.
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Avatar_m_tn
Hi, I am private caregiver of a Parkinson's disease patient for almost a years here in Singapore, everytime i feed my patient he always coughing...even i gave him a blended(sticky) food......but still he can't avoid himself coughing..is that a normal situation or through the food that he eat....what is the best food  in order for him to avoid coughing?
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Avatar_m_tn
Hi there,

I found your comment a real eye opener as to what health care can be like.

I am a support worker in a care home for people with dementia.
After reading your comment it definately shows how important it is to get to know your patients!!

If someone is coughing whilst eating does not mean they cannot swallow, it may mean they just need more fluids whilst eating.

Putting someone on a pureed diet when they have not properly been assessed for dysphagia or other illnesses is ridiculous. Its a shame that your experience with private care has been such a negative one in this instance.

This makes me proud to know that myself and my colleagues properly assess our residents with a doctor to determine what would be best for the residents well being!
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Avatar_m_tn
hi
i feel i need to respond to comments re-blended/pureed foods for the elderly...i have been in the catering buisness for 26 yrs and im currently a catering manager in a social work run home which houses dementia clients....i cater for a very complex range of diets which are diagnosed by medical proffesionals and then implemented by the catering team to best suit the clients nutritional needs.
purreed foods are normally a last resort after all other methods have been tried and tested and i feel the importance of maintaining nutritional needs are being forgotten here....we liason with client...proffesionals...family members or advocates of the client and do not make the decisions on food textures ourselves to suit the carers or the routine within our premises....the clients needs are our routine.
there are many aids on the market one of which we currently use which allows us to purree foods and put them in to moulds therefor take on the shape of some foods clients will recognise which lessons the anxiety for the client.
i hope this has helped to put over the other side of the coin where care homes and nutrition are concerned..ty...margaret
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Avatar_f_tn
My mom has dementia and after just coming out of hospital has started to pouch her food if there are different textures so I have had to start to purée her meals, at first I was just doing what I was eating but thought it didn't look nice even though it tasted OK, my niece is in her third year of training to be a nurse and suggested Pureed meals that are made to look like the real thing using moulds so we did a search on the internet and came up with this.  http://www.simplypuree.co.uk/  they arrived today and I gave her the beef, carrots, potato and cauliflower dish.  I had to try it first before giving it her as I wanted to see what it tasted like and it was lovely, smelled great, looked visually appealing and she ate 3 quarters of it and promptly fell asleep with a full stomach for the first time in 6 weeks.  The meal pack is 12 dishes mixed so you can try different dishes out and see what they like, think I might give her the fish dish tomorrow, yep its 36 pounds for 12 dishes but its worth it if it keeps her eating and she enjoys it.  Wiltshire foods also does a selection of meals called category C dishes, im surprised the care home does not try to do something a little more inventive to help their residents eat a little better.
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Avatar_f_tn
My mother has been staying at a nursing home almost 5 years ago due after 5th stroke.  Yet, the nursing home doctor insisted that we should agree to have feeding tube inserted.  Nursing home staff are not all good or bad.  Yet, if family members are willing to visit their loved ones often and monitor the care, they will be cared for.  I do come almost every day to see my mother and gently remind staff to do what is supposed to be done for my mother. At first she was able to eat 'mechanical-soft' foods.  Time goes by, she got aspirated a lot more and she was switched back and forth between mechanical soft and pureed foods with thickened liquids.  If mom got aspirated, staff would stop feeding her due to being afraid that it might choke her to death.  They just don't have enough time and patience to feed her slowly with small amount of food and liquids.  I just have to come at meal times and feed my mother myself and it has been working since.
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