Easier Swallowing Texture D
Consistencies You have been found to have difficulties with eating and drinking. It has been recommended that you follow a consistency modified diet and the one that has been recommended for you is Texture D. Reproduced with the kind permission of Birmingham Speech and Language Therapy Dysphagia Service for people with Adult Learning Disabilities Texture D Potato Mince gravy Broccoli Carrot 1
So what does that mean for you? Finely mashed Food should be soft and moist and may have some variation in texture. It does not need to be puréed or sieved. Avoid solids and liquids together, examples include stew served with a thin gravy and scotch broth. Suitable examples include flaked fish in thick sauce, macaroni cheese, shepherd s pie or stewed apple. You should be able to easily mash the food with a fork. Food should require very little chewing. Avoid foods which are dry or crisp as they may cause choking e.g. baked pasta dishes can sometimes have hard crusts. Remember to avoid high risk foods see the leaflet An Introduction to Easier Swallowing for a list of these foods. 2
Sample meal pattern suitable for Texture D All food must be cooked until it is soft and moist. It should be easily mashed with a fork. All your drinks should be thickened to consistency... Breakfast Mashed fruit or fruit juice Cooked porridge made with milk, Oatso Simple (not apple), Ready Brek or Weetabix Mid-morning See ideas for snacks Lunch Soup Sandwiches crusts removed and bread prepared in a soaking solution (see page 7) Tender roast meat*, finely chopped in thick gravy, tender meat* casserole, mince, fish in sauce, egg or cheese dish Creamed potato, pasta in sauce or rice in sauce or gravy Mashed vegetables e.g. carrots AVOID coarse vegetables and stalks. Mid-afternoon See ideas for snacks Evening Meal Tender roast meat* in thick gravy, tender meat* casserole, mince, fish in sauce, egg or cheese dish Creamed potato or pasta in sauce Mashed vegetables e.g. baked beans AVOID coarse vegetables and stalks. Milk pudding, smooth yoghurt, mousse or whip with stewed fruit or soft fresh or tinned fruit. Bedtime Milky drinks such as Horlicks, Ovaltine, hot chocolate. Fruit juice, fruit purée or smoothie. Foods may need to be fortified your dietitian will advise. *Some meat may need to be processed to achieve a finely mashed consistency your dietitian/speech and language therapist will provide further guidance 3
Ideas for meals Texture D Remember that any foods you eat should be soft and moist. They should also be easily mashed with a fork. All your drinks should be thickened to consistency... Fish Fish in a sauce Fish pie (potato) Fish cakes and sauce Tuna in mayonnaise and mashed potatoes Vegetarian Macaroni cheese Baked egg custard/scrambled egg Cheese and potato pie (no pastry) Cauliflower cheese Boiled egg mashed with butter Soft omelette Haricot bean casserole Lentil casserole Pasta and tomato sauce Potato waffle and baked beans Root vegetable curry and potato Soups All varieties (some may need to be puréed e.g. scotch broth) 4
Meat/chicken When cooking rice, ensure it is soft and well cooked and mixed with sauce or gravy. Corned beef hash/stovies Shepherd s pie/mince and potatoes Casseroled meat* finely chopped served with thick gravy Spaghetti bolognaise Tender roast meats* finely chopped, served with thick gravy Meat/chicken curry and rice meat* should be tender and moist served with the curry sauce Black pudding (skin removed) and baked beans Vegetables and fruits Tinned chopped tomatoes Carrots Turnip Broccoli tops - no stalks Cauliflower tops - no stalks Baked beans Mushy peas Banana Melon Tinned pears/peaches/apricots Stewed apples/rhubarb Strawberries/raspberries/kiwi-fruit Desserts Ice cream Smooth yoghurt Smooth fromage frais Trifle with soft fruit Custard Rice pudding and seedless jam Flaked rice *Some meat may need to be processed to achieve a finely mashed consistency your dietitian/speech and language therapist will provide further guidance 5
Semolina Mousse or whip Crème caramel Plain sponge and custard Cheesecake and cream (no base) Jelly Ideas for snacks Texture D Mousse Instant whip Yoghurt Ice cream Fruit Biscuits Cake Crackers Bread Any flavour. Made to appropriate consistency. Soft fruit yoghurt or fromage frais. If you require thickened fluids, allow ice cream to melt at room temperature, thicken with appropriate thickener to a pudding consistency. Add pouring ice cream sauces for example strawberry or chocolate. Stewed fruit, for example apple, rhubarb or soft tinned fruits. These may require a soaking solution (see page 7). Use plain biscuits (avoid chocolate covered biscuits or biscuits containing nuts or dried fruits). Some people may be able to manage cake with custard or cream. It may need to be prepared using a soaking solution (see page 7). You can use fruit juice in place of water. Use soaking solution (see page 7), made with water, Oxo, Bovril, or stock cubes. Some people may be able to manage soft, moist sandwiches. The bread may need to be prepared using a soaking solution made with water, Oxo, Bovril or stock cubes. 6
Meat paste Meat paste can be piped/spread on to bread or crackers. Sandwich fillings These should be soft and moist e.g. tuna or egg mayonnaise, meat spreads or smooth pâté. Soaking solution A soaking solution is made by blending food thickener with water, fruit juice, Oxo, Bovril, or stock cubes, according to the manufacturers instructions. The resulting solution can then be used to soak foods such as bread (crusts removed), cakes, crackers and biscuits to alter their consistency without puréeing. Foods are immersed or covered in the liquid and then put in the fridge to allow the food to absorb the solution and become soft and moist. 7
8 Notes
Contact numbers Dietitian s name: Dietitian s number: Speech and Language Therapist s name: Speech and Language Therapist s number: Useful addresses This information has been produced for SNDRi by State Registered Dietitians and other relevant health professionals. At the time of publication the information contained within the leaflet was, to the best of our knowledge, correct and up to date. Always consult a suitably qualified Dietitian and/or your GP on health problems. SNDRi cannot be held responsible for how clients/patients interpret and use the information within this resource. Hosted by Glasgow Caledonian University and funded by the Scottish Government. A Registered Dietitians project, in partnership with other agencies. To re-order visit www.caledonian.ac.uk/sndri and follow instructions Ref: 9354 12/05 (03/10) SNDRI