Soft
Last Wednesday Rosemarie had a visit from the Speech and Language Therapy specialist (SALT) - who had been called in to look at her eating difficulties.
It was an early morning visit so I was not there, but the Good Nurse called me because the SALT was concerned and wanted to talk to a family member. Maybe it is the nature of the specialty but every SALT I have met seems to be able to communicate clear, detailed and useful information without recourse to unnecessary jargon or professional vagueness. So it was this time.
The biggest problem is that Rosemarie's swallowing reflex is not working properly and she is at serious risk of inhaling food and liquid without the safety of automatically coughing. It seems that most of the things we have been doing (giving more food when she hasn't swallowed in order to remind her she has food in her mouth, or giving her a drink to 'wash it down') is not helping and has actually made things worse.
So she is now on a regime of pureed food and thickened drinks. The kitchen has been told and should now be providing only soft food, but there is a major communications challenge in making sure any of the dozen or so care workers who may be attending her are aware they should not give her regular juice or water. We must sit her up at 90 degrees, not rush her, and we must be on the lookout for signs of breathing difficulties.
So far it seems to be going OK. She finds eating the pureed food easier but it still takes a long time. The food is always served on plastic plates so it gets cold quickly, but I brought in a microwave so we can reheat it (although I doubt that the care staff always take the trouble).
The biggest challenge is the thickened drinks. They are the consistency of syrup and she only takes small sips (small mouthfuls really - it doesn't exactly pour...) and we need to wait to make sure it is all swallowed. No pressure on her, so it can take 10 minutes for her to drink 10 ml. This is going to make meeting her daily liquid intake target a big challenge.
It was an early morning visit so I was not there, but the Good Nurse called me because the SALT was concerned and wanted to talk to a family member. Maybe it is the nature of the specialty but every SALT I have met seems to be able to communicate clear, detailed and useful information without recourse to unnecessary jargon or professional vagueness. So it was this time.
The biggest problem is that Rosemarie's swallowing reflex is not working properly and she is at serious risk of inhaling food and liquid without the safety of automatically coughing. It seems that most of the things we have been doing (giving more food when she hasn't swallowed in order to remind her she has food in her mouth, or giving her a drink to 'wash it down') is not helping and has actually made things worse.
So she is now on a regime of pureed food and thickened drinks. The kitchen has been told and should now be providing only soft food, but there is a major communications challenge in making sure any of the dozen or so care workers who may be attending her are aware they should not give her regular juice or water. We must sit her up at 90 degrees, not rush her, and we must be on the lookout for signs of breathing difficulties.
So far it seems to be going OK. She finds eating the pureed food easier but it still takes a long time. The food is always served on plastic plates so it gets cold quickly, but I brought in a microwave so we can reheat it (although I doubt that the care staff always take the trouble).
The biggest challenge is the thickened drinks. They are the consistency of syrup and she only takes small sips (small mouthfuls really - it doesn't exactly pour...) and we need to wait to make sure it is all swallowed. No pressure on her, so it can take 10 minutes for her to drink 10 ml. This is going to make meeting her daily liquid intake target a big challenge.
posted by Other Kosh at 10:31 pm
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