Individuals with severe swallowing problems (dysphagia) are often advised to modify their diet to a smooth, puree consistency (think mashed potatoes). Now, while you may love your mother’s mashed potatoes, when you imagine everything you eat reduced to that consistency, mealtime may not seem so appealing.
Shortly before my father’s death in 2001, he was hospitalized and underwent bowel surgery. Prior to his hospitalization, he had already physically declined from Parkinsonism, and also had some signs and symptoms of dysphagia. As a speech-language pathologist, I recognized my father’s swallowing symptoms of: drooling, occasional “wet voice,” when speaking or eating, and occasional “coughing” when eating , but he was free of any upper respiratory infections and none of his symptoms were significant enough to recommend a change to his diet consistency. That is, until his hospitalization, when he was placed on a puree diet. Since I was living out of state from my parents, I received information from my mother who reported that my father was refusing to eat. In a phone conversation with him, the very last, I might add, in the midst of my lecturing him about eating, he proclaimed: “it’s slop!”
I couldn’t disagree with him. Having worked in hospitals at that point for over 20 years, I knew that the puree meal that arrived at the patient’s bedside was often an unpleasant palate of bland colors slowly moving towards one another on a plate, and even the nurse or CNA’s would curl up their noses as they lie the meal before a patient.
So, needless to say, many patients refuse to accept a puree diet recommendation. And, many carepartners express overwhelm as to what to cook and how to serve puree food that is palatable and pleasant to look at.
For these reasons, anyone with dysphagia, who must eat a puree diet, owes it to themselves to visit the website of local puree culinary expert, Diane Wolff. The impetus for Diane’s fore into puree was when a puree diet was recommended for her own mother, who suffered from Alzheimers.
Overwhelmed initially like most people, Diane soon learned that patients with dysphagia:
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Often lose interest in eating when there’s no flavor or visual appeal to the food they are served.
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May be at higher risk for weight loss and the ability to fight off infections, such as aspiration pneumonia.
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May lose the ability to swallow or get inadequate nutrition from an oral diet alone, and eventually require a feeding tube.
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May refuse to eat or drink an adequate amount, and lacking proper nutrition, in time, lose vitality and strength.
Determined not to let this happen to her mother, Diane set off on a journey of discovery and experimenting that would eventually manifest into a cookbook, Essential Puree. Basically, Diane has become the Betty Crocker of puree cooking. The Essential Puree is available as a paperback or e-reader, and on her blog, Diane brings puree to the Holiday party, and even includes information on how to re-configure holiday cocktails.
Visit Diane’s website for ordering information or for some of her free holiday meal suggestions. Bon Appetite! https://essentialpuree.com/
NFOSD (National Foundation for Swallowing Disorders) is an excellent resource for anyone wanting to learn more about swallowing disorders, current research, and treatments. Resources include: support group listings, webinars, articles, and an online forum.https://swallowingdisorderfoundation.com/
My Mission
To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower.
Mary Spremulli, MA, CCC-SLP
Michael thank you so much for your comments. The key to managing swallowing problems in Parkinson’s is being proactive (where have you heard that before?). Options for palatable puree is always desirable and I hope you’ll share more about your daughter’s work.
Great topic Mary! Loved the suggestions from Dianne and may try some myself. I continue to experience swallowing issues in spite of my daily (almost daily) vocal exercises. Okay, so I am not a regular participant. I am a growing fan of the puree scene thanks to my daughter LuLaura who never misses an opportunity to introduce her latest recipe.
Diane, I am always in awe of your energy and all that you are doing, and your work is the greatest tribute you could give your mom. I know the information you provide is helping many many people who can be overwhelmed when faced with the prospect of preparing puree foods and being served them.
Fabulousity. Thank you, Mary. Of course, you long ago gave me encouragement, and gave me a quote for the front of my book.
I have just returned from California, where I shot the video for the preparation of the Holiday Meal for the loved one with dysphagia. I used both store bought items such as Cranberry Sauce and steamed garlic green beans from Whole Foods (with the addition to the latter of caramelized onions to take the place of the crisp fried onions that are traditional and are no good for the safe swallow), and homemade items, such as turkey breast.
The webinar should be posted ont heir website very soon, as they were editing when I left. I had a lot of fun doing it, and I did it in memory of my mom, the late great Cathie G.
XO to you for the holidays.