CONDITIONS & DISORDERS
DYSPHAGIA: PUREE DIET WEEK CATEGORY C CHALLENGE Lucy Blackstone, Rourke Thomas, Janette Banks, Sophie Johnston Band 5 Dietitians, Salford Royal NHS Foundation Trust The Team see a wide range of patients from elderly care to trauma across both the hospital and the community setting. They are all enthusiastic about seeing things from a different perspective and enjoy a challenge; what better way to learn about a puree diet than to fully immerse themselves in the experience, all in the name of charity.
As dietitians working across a variety of areas within the hospital, we all experience a vast number of patients on a modified consistency diet and, aside from tasting sessions, none of us had ever eaten a full puree meal, let alone followed a pureed diet. So, for one week in October, we decided to follow a puree diet to raise money for the Motor Neuron Disease association.
We also wanted to develop our knowledge and understanding of the difficulties faced by this patient group. Four dietitians committed to the challenge, including two vegetarians and one working Mum, and we all made it through to the end. The following questions cover what we feel to be the most important lessons learnt. WHAT WAS THE MOST DIFFICULT PART OF THE PUREE CHALLENGE?
S: The weekends and seeing friends in
the evenings was the most difficult time for me. Eating is such a social activity and it felt quite isolating to be the one in the corner eating a pureed ready meal whilst others were enjoying my favourite pizza takeaway. This really affected my mood and I found myself opting out of social activities if I knew food would be involved. I can see how this could result in social isolation over a longer period. Snacking was also difficult, as it had to be pre-planned; there was no grabbing a slice of cake from the weekly baking rota in the office!
L: I agree, as someone who doesn’t like The Authors would like to thank Wiltshire Farm Foods and Simply Puree for donating ready meals for the pureed diet challenge.
yoghurt, I found it particularly hard to find anything I liked, and the lack of savoury snack options was difficult. Similarly to Sophie, I also struggled with social situations, I took a ready meal to a friend’s birthday party and when some of the guests couldn’t even look at my meal, it made me feel a bit embarrassed. Eventually, I just avoided social situations where food was involved.
R: For me, it was the constant craving for
a little more bite! Just because a healthcare professional has advised that you follow a texture-modified diet doesn’t mean it’s going to be easy. For many patients, breaking the routine of their usual meal plans, not being able to just grab a quick snack on the way out of the house or being able to eat without thinking “Can I have this? Is this the right consistency?” could be a real burden psychologically. It’s not like becoming vegetarian, vegan or even going gluten-free, it’s not a case of restriction, it’s total reconstruction of your diet. It’s like changing all rules on something that’s second nature.
J: Fitting the diet into family life - cooking
one meal for the family and blending mine down - had time implications for a busy working mum. Blending my daughter’s apple crumble cooked at school led to cries of ‘you’re ruining it’. Blending a family one-pot meal, like fish pie, led to one big bowl of grey amorphous mush. I found the lack of crunch and variety of texture difficult for someone who doesn't like soggy cereal. This food soon became boring and so I tended to rely on yoghurts and smoothies for breakfast. IF YOU COULD GIVE PATIENTS ON A PUREE DIET ONE TIP WHAT WOULD IT BE?
S: I enjoyed mealtimes much more
when others were eating pureed foods too, which was easy for us, as the four of us were doing it together and I had continuous support. I would www.NHDmag.com May 2017 - Issue 124
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