Dysphagia (or difficulty with chewing and swallowing) is common amongst people who have had a stroke or other type of acquired brain injury. It is often caused by damage to the nerves and muscles of the head, face and neck and also by damage to the brain. If it is not managed properly, dysphagia can have a significant detrimental impact on the health of the person, leading to malnutrition or dehydration, because of inadequate intake of food and fluids. It can also increase the risk of choking or lung infections caused by food getting into the lungs.

One of the strategies that may be employed to help overcome certain difficulties of dysphagia is thickening liquids so they are easier to control in the mouth, and blending foods to form a paste so that they don’t require chewing.

Understanding dysphagia
Our activity support staff help our service users to prepare and eat meals every day, so it essential that they understand dysphagia. We also believe that people with an acquired brain injury have a right to enjoy their food as much as anyone else, and we try to normalise it as much as possible.

As part of our continuous training programme, our speech and language therapist recently delivered dysphagia training to support workers. They learned about the different stages of swallowing, what can go wrong at each stage and different diet and fluids that can be used to help manage the difficulties people have.

Our approach
Texture, colour, form and variety are important factors affecting the enjoyment of food, so considerable thought and care must be taken to ensure meals are appetising to people with dysphagia. Here are some the points that were covered in the recent training session.

• We take personal preferences into account as well as each individual’s physical abilities and risk factors
• Fizzy water mixed with fruit juice can provide an alternative to thickening for some service users
• Soft foods like salmon mousse and sweet potato pudding add interest and variety
• Meat and vegetables are blended separately so that each retains its individual flavour
• Strong flavours and foods like faggots and gravy blend well to create a tasty meal, which is served with separately blended vegetables
• Fruit smoothies or smooth vegetable soups provide tasty and nutritious thick drinks
• Cooked foods need to be checked before serving as they can change during the cooking process
• Sandwiches can be modified to a single texture using a soaking solution.

Jennifer Cranstoun, a Senior Care Worker who took part in the training session summed up our approach by saying: “You treat individuals as if they are your family. You want to serve them tasty, nutritious meals that they will enjoy.”