Issue 143 Dysphagia: IDDSI implementation

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SOCIAL CARE

DYSPHAGIA: IDDSI IMPLEMENTATION IN HIGHLAND CARE HOMES Delivering safe, nutritious and appetising mealtimes is essential for care home residents, especially those who suffer from dysphagia. This article looks at how this is being successfully managed in The Highlands. Since the 1st of April 2019, NHS Highland has fully implemented the new texture classifications across all health and social care settings. The International Dysphagia Diet Standardisation Initiative (IDDSI)1 describes texture modified food and thickened liquids used for individuals of all ages, living with dysphagia. The framework allows for consistent management, production and adherence to a texture modified diet (see Figure 1 overleaf). WHAT IS IDDSI?

IDDSI is a global standardised framework that provides terminology and definitions for texture modified foods and thickened liquids. It consists of a continuum of eight level (0-7) and provides an easy-touse colour-coded model. It includes descriptors, testing methods and evidence for both drink thickness and food texture levels. FOCUSING ON SUPPORT FOR CARE STAFF

Increasing numbers of care home residents are living longer with conditions such as dementia, stroke, Parkinson’s disease and other neurological conditions. All have an increased propensity for developing dysphagia, where symptoms increase in tandem with disease progression. It is our duty, as health and social care professionals, to support these vulnerable people to access safe enjoyable nutritious meals and drinks. This requires a greater awareness

and understanding of both carers and cooks about how they can deliver this practically, in a way that ensures food is varied, tasty and well presented. Gone are the days (I hope) when a diet for swallowing problems was a liquidised, unrecognisable brown/grey mass of whatever composite meal was on offer that day. Equally, attempts at presenting food well in the kitchen were often thwarted by carers who then proceeded to mix everything together on the plate. In the Highlands, we have focused a great deal of effort on supporting care staff and cooks to deliver high quality, safe and nutritious food and fluids for people who have an identified swallowing difficulty. Support includes: • extensive opportunities for learning and development; • one-to-one support for care chefs.; • access to online and printed resources, recipes and professional expertise. Unfortunately, not all cooks have had the experience of previously working in care homes, never mind preparing texture modified diets. So, in Highland, we are currently working with the University of Highlands and Islands (UHI) to deliver a new SVQ course, which supports care cookery as a career. Investment in care chefs is also championed by the National Association of Care Caterers (NACC),2 while the Care Inspectorate Food, Fluid and Nutrition hub 3 offers practical information, YouTube demonstrations and web links for anyone looking for evidence-based information and advice.

Evelyn Newman Nutrition and dietetics advisor: care homes NHS Highland Award winning dietitian, Evelyn Newman, is well known throughout the profession for her writing, volunteering with the BDA and innovative work. She currently holds a unique role in The Highlands. @evelynnewman17

REFERENCES Please visit the Subscriber zone at NHDmag.com

www.NHDmag.com April 2019 - Issue 143

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