A diagnosis of dysphagia may require drastic modifications to the way you eat, drink and live. Although relatively common—roughly 1 in 25 adults in the US will be challenged by dysphagia each year—managing dysphagia at home can present unique challenges. Learn what to expect from your new diagnosis and how to best manage it at home.
What is Dysphagia?
In short, dysphagia is the overarching term for a variety of swallowing disorders. Dysphagia is common, especially in older populations—up to 40% of nursing home residents are challenged by swallowing difficulties. Dysphagia can present with a diverse range of underlying causes, and is often a symptom associated with conditions such as head and neck cancers, strokes, and dementia. Your healthcare team can diagnose dysphagia by performing a swallow study or through additional diagnostic testing.
Dysphagia can vary considerably in both severity and treatment approach. Some individuals with dysphagia may experience difficulty swallowing thin liquids while others may exhibit more extreme swallowing impairments.
Managing Your New Diet
Treatment for dysphagia depends on the underlying cause and may include prescribed exercises, medications, and/or diet changes. In many cases, diet modifications, requiring foods and liquids to be thickened, are necessary. Texture modifications can make food and liquids easier to swallow and can help to decrease the risk of aspiration. Aspiration occurs when food, drinks or foreign bodies end up in your airway or lungs and can lead to respiratory issues such as pneumonia or lung infections.
In 2013, the International Dysphagia Diet Standardization Initiative (IDDSI) was created as a global initiative to help improve the lives of people living with dysphagia. The IDDSI framework consists of 8 levels, where drinks fall into levels 0-4, and foods are in levels 3-7. The higher the level, the thicker the food or drink. Your healthcare team will prescribe which levels of foods and drinks you’re able to safely consume.
While altering the consistencies of what you eat and drink may sound daunting at first, there are some easy ways to make sure that you have safe, flavorful options that can give you a sense of normalcy in your diet.
Thickening Foods and Drinks at Home
Thickening foods and liquids at home typically involves the use of a thickening product, which, when mixed directly into the food or drink, changes the consistency to help meet your unique needs. The labels on these thickeners normally describe how to create specific IDDSI levels. Typically, there are two subsets of thickeners; starch-based and gum-based.
Starch-based thickeners are easy to mix, but can be prone to changing consistencies, especially if a product is refrigerated after being thickened. Each type of thickener can have advantages for different types of foods and drinks. Gum-based thickeners usually provide a more consistent degree of thickness for your food or drink, and will remain at a more stable consistency. Hormel Health Labs offers product solutions for both types of thickeners; our Thick & Easy® Instant Food & Beverage Thickener is starch-based, while our Thick & Easy® Clear Food & Beverage Thickener is made using xanthan gum.
To ensure foods and liquids are thickened to the proper consistency, it’s essential to test them. There are a couple of different tests that can be completed with items in your own home:
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- Fork Drip Test: For testing foods and drinks that fall in the IDDSI Level 3-5 range. The level of thickness is determined by whether the food/drink flows through the tines of the fork, or sit on top of the fork tines.
- Fork Pressure Test: Best used for foods in the IDDSI Level 4-7 range, and completed by seeing how the food changes when pressure is applied to the food with the fork tines.
You can also test the consistency of foods and drinks with a “gravity flow test” that uses a 10mL syringe. IDDSI has a complete testing guide to help you get more familiar with using these tests at home.
Ready-to-go Product Solutions
We understand that sometimes life is busy and you might not have time to thicken your own foods and drinks. We have several ready-to-go dysphagia food and beverage options that can give you time-saving convenience while also adding some variety to your diet.
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- Thickened Meals: Our 6 varieties of Thick & Easy® Pureed Meals give you shelf-stable options for every meal of the day. Preparation is remarkably simple—just microwave in 60 seconds and it’s ready to serve!
- Thickened Beverages: We have a full line of thickened beverages to ensure there is something to meet each individual’s needs. Our Thick & Easy® Clear Drinks give you plenty of options to quench your thirst and help keep you hydrated, while our Thick & Easy® Dairy Drinks provide a dysphagia-friendly alternative to milk. For coffee lovers, we even have a thickened coffee mix that can be prepared in just seconds.
- Frozen Pureed Foods: Having frozen food options on hand can add convenience and give you an easy way to add variety to your diet. We offer a wide variety of options for breakfast, lunch, dinner, snacks, and more, that can help ease the stress of meal-planning.
Sometimes, it’s nice to have convenient solutions on hand for a quick and easy meal to take the stress out of meal preparation, or in case of emergencies.
Transitional Foods
Not all foods and drinks have a concrete IDDSI level—there is a subset known as “transitional foods”. These foods may initially begin at one IDDSI level, but transform into a different consistency when chewed, often due to changes in moisture or temperature. Transitional foods may be incorporated to help facilitate retraining of chewing skills. Examples of transitional foods include ice cream, gelatin, and certain cracker varieties.
Transitional foods can still be part of your diet with careful monitoring and when appropriate. Read our complete guide to transitional foods, and consult with your physician, SLP and/or registered dietitian nutritionist before consuming transitional foods to ensure they’re safe for your needs.
Kitchen Creativity with Dysphagia Diet Recipes
Transitioning to a dysphagia diet doesn’t mean your meals have to be bland. Getting creative in the kitchen can provide a feeling of normalcy, while also providing important variety to your diet. Our library of 90+ recipes feature meals and drinks for all occasions and IDDSI levels. Filter by your IDDSI level to find recipes you can try that are both safe and tasty!
Swallowing Techniques & Exercises
For those transitioning to homecare, you may have already talked with your physician or speech-language pathologists (SLP) about exercises you can do at home. The Swallowing Disorder Foundation has a comprehensive list of common exercises to help improve swallowing function. These exercises should only be used under guidance from your physician or SLP. You can use this information to help remember how to properly perform these exercises if your physician and/or SLP prescribes them as part of your treatment plan.
Resources & Support
Remember that you don’t have to go through it alone. There are wonderful dysphagia support groups to connect you with others going through similar challenges, and resources to help you learn more about dysphagia.
Educational Resources
Expanding your knowledge about dysphagia can help you become more comfortable with your condition. The resources below provide opportunities for you to expand your knowledge around the unique challenges that dysphagia may present.
Emotional & Social Support
Navigating your dysphagia diagnosis can add stress and anxiety to your day-to-day life. It’s important to ensure that you prioritize your mental well-being. There are several great support services and resources to aid you on your journey with dysphagia.
For Home & Family Caregivers
Management of dysphagia may require the assistance of a caregiver who may also be a spouse or family member. Becoming a caregiver, especially for a unique and unfamiliar condition like dysphagia, can be a significant undertaking. For individuals who have recently assumed the caregiver role, it is important to familiarize yourself with anticipated responsibilities.
Tips for Caregivers
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- Attend appointments and take notes: A new diagnosis can be confusing for both patient and caregiver—new, unfamiliar terminology, significant changes to everyday life, and fear of the unknown may be daunting. Attending medical appointments with your loved one is beneficial for both parties. As a caregiver, it gives you an opportunity to learn more about your loved one’s needs and what is expected of you, while also allowing you to converse directly with the physician and SLP to ask any questions you may have.
- Don’t forget about nutrition and hydration: While your focus may be on ensuring that your loved one’s foods and drinks are safe to consume, those with dysphagia also face nutrition challenges. It is important to monitor food and drink intake, and encourage a nutritious diet with adequate fluid intake.
- Help them with exercises: If an SLP recommends muscle memory exercises, learn how they should be properly performed and ensure your loved one is doing them regularly.
- Provide support: Dealing with dysphagia can be hard. Sometimes, gentle guidance and assistance is all that’s needed to lighten the burden of living with dysphagia.
Preparing & Serving Dysphagia Foods
If you’re preparing and serving foods for a loved one on a dysphagia diet, you can follow the tips above for making foods and drinks at home. Ensuring that foods are safe for consumption prior to serving is critical.
Altered consistency foods and drinks can change from kitchen preparation to service, For example, food that is hot can become stickier as it cools down. Keep hot foods covered until the food is ready to be eaten to ensure proper consistency.
Use sauces and gravies to help keep food from thickening as it cools down. Mixing sauces and gravies into meals will add moisture and help create consistency throughout the dish.
If there is any question whether a food or drink has changed consistency between preparation and serving, remember to test the consistency using IDDSI testing standards.
Managing Caregiver Burden
The load of managing a loved one’s well-being and day-to-day activities while also trying to stay on top of your own can lead to an excess of stress—often referred to as caregiver burden. Studies have shown that the rate of caregiver burden can be especially high in those caring for someone challenged by dysphagia—spousal caregivers of older adults with dysphagia and children caring for their parents are especially at risk. This prolonged stress can have severe consequences on a home caregiver’s mental health.
There are ways to spot the warning signs of caregiver burden, and many resources to help lessen the effects. If you think you may be feeling the effects of caregiver burden, screen yourself with the CARES checklist. The first step of figuring out an action plan to remedy caregiver burden is to identify the symptoms you’re challenged with.
There are also many resources available to help you overcome the feelings of added stress and anxiety. Read our guide on managing caregiver burden to get some helpful tips and discover some networks you can lean on.