Exploring Texture-Modified Diets for Dysphagia


Dysphagia is reported by the World Gastroenterology Organisation to affect over 50% of all elderly patients in care homes worldwide. As a result, it is likely that care home caterers will need to consider texture modifications to ensure the food on offer is suitable for its residents.

In this blog, we explore what dysphagia is, what texture-modified diets are, and considered why it is extremely important for care caterers to be skilled in this area.

What is dysphagia?

Dysphagia relates to difficulty swallowing and can occur for many reasons. Common causes of dysphagia include neurological conditions such as dementia, stroke, Parkinson’s disease and motor neurone disease. Individuals with head or neck cancer also commonly suffer from dysphagia. 

Due to these diseases being more prevalent with age, it’s no surprise that many elderly care home residents are at risk of suffering from dysphagia. 

What is a texture-modified diet?

Whatever the cause of the dysphagia; affected individuals are likely to struggle with certain textures of food and drink. A texture-modified diet is when food needs to be moistened, mashed or pureed to make it safer for an individual to eat; fluids may also need to be thickened. A great example recipe for this would be roasted pumpkin soup!

What are the risks?

Those who struggle with dysphagia are at risk of choking when they eat food or drink not suited to their swallowing abilities. They are also at risk of aspiration pneumonia; which is where food or fluid enters the lungs, potentially leading to chest infections and hospital admissions. Therefore, it is highly important that any resident identified as struggling to swallow should have an urgent swallow assessment carried out by a trained professional such as a speech and language therapist.

How to provide a nourishing and tasty texture modified diet:

  1. Knowledge and skills
  2. Nutrition
  3. Flavour

1. Knowledge & skills

First things first, get yourself trained. Given the risks associated with giving the wrong texture to an at-risk individual, care home caterers should be knowledgeable on how to create dishes with the appropriate texture. Speak with your manager about accessing training. You can also check out the ‘International Dysphagia Diet Standardisation Initiative (IDDSI) which is a framework to grade different textures between levels 1-7 as depicted in the diagram below:

2. Nutrition

Remember to think about how nourishing the meal is. Many individuals with dysphagia are at risk of malnutrition due to poor nutritional intake. Therefore, they may benefit from meals which are fortified with nutrient dense foods such as added smooth nut butters, cheese and skimmed milk powder to increase the energy content of their meals (remember that adding these may affect the
overall texture of the food). You may also consider offering texture-modified snacks between meals; this is the time of day when individuals with dysphagia will miss out if nothing is available for them.

3. Flavour

If you are preparing your own texture-modified meals on-site, remember to think about flavour. Use herbs and spices to add interest to the meal without compromising the texture. You can also add salt but be aware that too much salt can contribute to high blood pressure so go easy!

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