Dysphagia, a condition where patients have a difficult time swallowing food or liquids due to problems with the mouth, the throat, or the esophagus, is a prominent issue in the healthcare segment.

“Depending on the screening tool used, dysphagia impacts 24% to 47% of older adults who are hospitalized, and 54% to 59% of those residing in skilled nursing facilities,” says Dietitian and Founder of Roche Dietitians Margaret Roche.

Foodservice teams in senior living and hospitals are likely then to come across those with the condition; however, not all dysphagia patients have the same dietary requirements.

“Dysphagia is a whole umbrella term to describe different types of chewing or swallowing problems,” says Roche. “Depending on what a person’s needs are and abilities are, they would have a modification in either their food texture or their drink thickness. So, it’s a rather complex situation to be in.”

To help operators better serve those with the Dysphagia, a global initiative called the International Dysphagia Diet Standardization Initiative (IDDSI) was formed. The IDDSI framework categorizes modified foods into eight different levels of textures and thicknesses.

Depending on a patient’s severity of dysphagia, their diet will adhere to a certain IDDSI level. A patient following a level 4 IDDSI diet, for example, must make sure their food is pureed and doesn’t require chewing.

One of the biggest pain points for operators serving dysphagia-friendly diets is dealing with mixed consistency foods which contain both solids and liquids. They are not considered safe for those on IDDSI levels 4-6.

“An example [of a mixed consistency food] would be like watermelon,” says Roche. “You bite into it, and all of a sudden you have solid pieces in your mouth and you have liquid in your mouth, and that can be really complicated for people with dysphagia to manage that in their mouth, in terms of manipulating it in your mouth, but also managing to swallow.”

Certain types of soup like chicken noodle soup are another example of a mixed consistency food that is often quite popular in healthcare settings due to its association with comfort and healing, but it can be hard for those dealing with dysphagia.

Finding ways to modify mixed consistency meals to be dysphagia-friendly helps make sure those suffering from the condition are still getting enough nutrients during meals.

Foods can be pureed, minced, liquidated and more to make them safe for eating. And for things like mixed consistency soups, operators can use thickening agents to change the consistency of them to make them a safe option for dysphagia patients, says Roche, who partnered with Campbells Foodservice to test out the best ways to modify mixed consistency soups to fit into a dysphasia-friendly diet.

Her research found that operators should first blend the soups so they completely smooth and then add either a starch-based or gum-based thickener. They then should follow the IDDSI flow test to make sure they’re at the proper texture.

As healthcare operators continue to implement the IDDSI framework at their operations, Roche advises that they work with their industry partners to learn more best practices and stay on top of the latest research when it comes to caring for dysphagia patients.

“They know you cannot figure this out on your own,” she says. “Look for industry partners who have been doing these types of things, because they’re out there.”