June is Dysphagia Awareness month and so all month we have been focusing on different ways we can help you if you are supporting people with Dysphagia.
Today we are talking about choking, how to reduce the risks of choking, some general advice to support people to eat safely -
And an innovative new anti choking device.
I would like you to imagine that, following a stroke you are unable to chew or swallow food and drink normally or to safely pass liquid or solid foods from your mouth to your stomach.
As a result of this, and in order to minimise the risk of you aspirating or choking, you are prescribed a texture modified diet, where your meals have to be pureed down to a smooth, moist and uniform consistency. You become increasingly dependent on carers at mealtimes to assist you, no longer are you able to enjoy dignified, independent eating, which can be both degrading and upsetting.
You are served your pureed meals either all mixed up in one bowl, where all ingredients have been pureed down together and which look colourless and smell and taste disgusting, (I know as I have tasted this, and it made me cry) or a number of coloured blobs on a plate where the individual foods have been pureed separately, at least, but are unrecognisable and unidentified, therefore you don’t know what you are eating.
It may take you longer to physically consume your meals, meaning that your food can go cold and unappetising; no one likes to eat food which has gone cold right?
How would you feel if you, or one of your loved ones, were presented with either of the above meals? Would you want to eat them?
And if your answer is no, then why would it be considered acceptable to present these meals to people with Dysphagia?
After all, we all eat with our eyes first.
You could easily lose your appetite and not want to eat meals presented in this way, resulting in weight loss, depression and anxiety, or fear at mealtimes which can exacerbate malnutrition. Secondary complications could include constipation, poor wound healing, increased susceptibility to infection and impaired muscle function.
So managing, the ladies and gents you support with Dysphagia and ensuring that they maximise on the correct levels of nutrition and hydration represents a huge challenge to care managers, and their teams, given that these residents are at high risk of being deficient due to consistently having to eat an altered consistency of meals, which can offer less nutritional value, and finding it difficult to tolerate large volumes of fluids.
And Dysphagia is known to affect between 53%-74% of nursing home residents. It may occur in people who have a Dementia, stroke, motor neurone disease and other neurological conditions
What are the warning signs and symptoms to look out for?
If you notice any of the above signs it is important to make a referral to SALT (Speech and Language Therapist) for an assessment.
Our top tips to help you support people with Dysphagia achieve optimal nutrition and hydration
1 - Oral Hygiene
2 - Assisting a person at mealtimes
3 - Fortification of meals
A texture-modified diet should ideally meet the recommended daily allowance of energy, protein and micronutrients for a meal. However, due to poor nutrient density, high dilution factor and limited palatability, modified consistency meals are known to result in significant weight loss. In view of difficulties in achieving an adequate nutritional intake from a modified consistency diet alone, food fortification may be necessary.
4 - Meal Presentation
For people on a pureed diet particularly, meal presentation is as fundamental as the dish itself. We all eat with our eyes and it is common for people with a Dementia to refuse to eat what they can’t recognise.
It’s so important to ensure that food always look appetising and is attractively presented using colour and contrast on the plate for everyone, regardless of their condition so that no one is isolated or treated differently.
The clever use of food molds is an increasingly popular tool to help recreates the original shapes of pureed foods as family members and care caterers understand their key benefits:
But don't just take our word for it, read below what a difference it made for one 12 year old little girl and her enjoyment at mealtimes when her Mum started to shape her foods with our range of food molds.
"My daughter is 12 years old. She has diagnosis' of Down's syndrome, oral dysphagia, autism, sensory processing disorder and food intolerances. I have only been able to give her pureed or mashed food which she was not particularly interested in. She is assisted while eating. The first time she saw her 'food molded' dinner she shouted, "carrots!". The second time she wanted to know what every bit of food was on her plate. This time I had used parsnips in the carrot mold. "What's that, what's that?", she said as she used a fork to scoop up individual pieces of dinner into her mouth with glee. I have neither the time, energy nor interest for 'faffing' about these days so the molds are extremely practical. Easy to clean, easy to fill with food, easy to freeze and the frozen food just pops out. I have made batches of vegetables, meat and fruit, popped them out of the molds and stored them in another container in the freezer to use later. One can use the broccoli mold for cauliflower and sprouts. The pumpkin mold for turnip and sweet potato and as I mentioned earlier parsnip in the carrot mold. But what is most important is that my daughter is beginning to enjoy her meal times and showing greater independence .... because of the molded food. From my experience, the silicon food molds have been a success." - Mrs Dewery, Private Customer
5 - The use of food thickeners
Food thickeners are used to thicken liquids and foods to various consistencies, helping to slow the transit of foods and fluids to allow more time to coordinate the swallowing process safely, thus preventing food and fluid entering the lungs and causing serious complications including chest infections and death due to choking or aspirational pneumonia.
They are added to pureed foods prior to placing in the food molds to help retain the food shape and to create the appealing finish.
Regular staff training should take place to ensure that the correct volume and amount of thickener is used for both foods and fluids, to ensuring safe and acceptable consumption for the resident.
6 - Varying the menus.
The more varied and interesting the menu choices are for residents on pureed diets the greater chance of increased acceptability of foods and nutritional intake.
7 - Training - a whole team effort
Where I have witnessed the best success stories for improving mealtime experience for residents with Dysphagia is where the whole team including management, care staff and catering teams have all embraced the concept of ‘why we want to achieve this’ to ensure continued and sustainable improvements.
We have teamed up with experienced and passionate care industry chef/trainers to bring you a range of training packages to help educate and inspire care teams to deliver better outcomes for the people they support with Dysphagia.
Please contact us if you would like to learn more details on the training packages available of if you would like to request your FREE copy of our unique and innovative Dignified Dining Solutions Guide designed to help people with a Dementia to eat better.
At [email protected] or by telephone 01773 713713 today.
For more information on Dysphagia and how to help those in your care with it you can visit our blog for more articles about this important topic.
#dysphagia #nutrition #nutritiontips #nutritioneducation #dignity #safety #carehome #caremanagement #carehomes #care #carelikefamily #passionatepeople
Ever since I was a little girl, I remember that my Mum loved everything about the pantomime.
And frankly, why not? According to the Oxford dictionary ‘a panto is funny and has something for the girls – a love story, and something for the boys – a duel fight with swords.’ Add in a measure of slapstick comedy, some music and dancing and you have the perfect recipe for some good old fashioned entertainment which can be enjoyed by all generations.
Mum always fancied herself in the traditional role of the principle boy, where a lady would don a short jacket, long over the thigh length boots and engage in plenty of thigh slapping – and she definitely had the legs for it!
So there was always an annual seasonal trip to the panto clearly marked in our family social calendar, and was eagerly anticipated by us all. From an early age, like my Mum, I absolutely adored the brightly coloured sparkly costumes, the singing and dance routines, joining in with all of the audience participation, (oh yes I did!), not forgetting, of course, the good old pantomime dame, “cos there ain’t nothing like a dame"!
I can even remember one year being one of the ‘boys and girls’ invited to go up on stage and singing Rupert the Bear along with the cast!
Fast forward to my teenage years and Dad was in the local rotary club and once a year, my Mum and I would help him and his fellow Rotarians to take a coach party of elderly pensioners to the pantomime.
When Ashleigh and Joseph came along, (my children) Mum couldn’t wait to introduce her grandchildren to her beloved panto and would treat us all to tickets to see the latest show at the Nottingham Playhouse. We chose there over the bigger and grander Theatre Royal in Nottingham which attracted the celebrity cast, preferring the lower key locally written performance by Kenneth Alan Taylor, who generally also starred in the production as Widow Twankey or another such pantomime dame.
These trips created a special bond between the three generations of our family and the kids would insist on taking Granny to Macdonald’s afterwards for a happy meal of chicken nuggets and fries, a whole new experience for her!
Sadly the day came when, due to Mum’s failing mobility, coupled with her fear of heights and steps, she resigned herself to the fact that she would no longer be able to join us on our annual outing. However not wanting to deprive us of our annual treat, Mum insisted on continuing to pay for me to take the children without her. So we hit on a happy compromise and would call at Macdonald’s after the performance and take a happy meal for us all back to her house with a programme of the play. Mum would love to hear from the children all about the performance.
One of the saddest things about growing old, I believe, is facing the realization that you are no longer able to manage to do the things you used to love to do, and the prospect that you have done something for the last time. I can only imagine how that would have affected Mum, to know that she would probably never get to see another live pantomime during her lifetime.
Mum is now 97 and three quarters, (and will be 98 on March 8th) and is currently being supported at home with Vascular Dementia.
Now my kids are grown up too and so it was a particular treat to be invited to visit the panto this Christmas with Ashleigh, along with my step daughter Anna and her two children Harlow and Austin, to see Robin Hood and The Babes in the Wood. To see their little faces light up and how much they enjoyed it really brought home to me how much pleasure my Mum must have got from watching us all. Another 3 generations enjoying the panto together, the family tradition lives on, happily.
During the interval, Ashleigh pointed out to me a leaflet which was in her programme, advertising a dementia friendly performance of the pantomime.
This idea really sparked my interest and it got me thinking about the possibilities. What if this adapted performance enabled me to take Mum to enjoy just one more pantomime show?
The following morning I rang the theatre to find out more about what was special about a dementia friendly performance. The young girl on the phone was extremely helpful and explained:
Overall they describe it as a much more relaxed attitude towards noise and movement during the performance.
I was quite nervous about the prospect of this big trip out, so I decided to ask Mum if she would like to go, and when I did, her face told me everything I needed to know. She broke out in the biggest, beaming smile I’d seen from her in a long time. So, from then on it just has to be done, there was no turning back and the tickets were booked that same day. Although Mum can’t remember what time of day it is or which meal she’s recently eaten, she remembered and KNEW that we were going to the pantomime on Thursday January 17th 2019 for a matinee performance. She kept referring back to it, and telling everyone, ‘I'm going to the pantomime you know’ so I knew how much it meant it to her to be going.
The day dawned, and Mum was dressed up and ready to go in her Sunday, complete with new hair do, lipstick and her pearls. On arrival, we were welcomed by a smiling male member of the Playhouse team who took complete care of us from that moment, organising programmes, (including a specially adapted programme), and the obligatory bag of Maltesers and who then personally escorted us to our seats. The auditorium was roughly three quarters full with many ladies and gents, some of whom had come with their spouses and others in parties from care homes and local societies. It was such a pleasure to see a great turn out and to know that so many were going to be able to enjoy this experience.
There was a good ratio of staff around to be of assistance throughout the performance, all dressed in yellow T shirts for instant visibility, and Mum soon got into the spirit of the performance - joining in, singing along to ‘Underneath the Spreading Chestnut Tree’ together with the actions, and booing the baddie, ‘Oh no! Not the Sheriff of Nottingham!' when prompted. I could see how it took her right back and was a great experience for her.
At the end of the show, the performers all came out into the audience, chatting and posing for photos. They were fantastic and couldn’t have been kinder and more patient. Robin Hood himself came over to talk to Mum. She was fascinated by his costume asking if she could feel the sequins on his jacket. I asked if Mum would like her photo taken with Robin and before I knew it, he had gathered several other cast members around him and we were able to snap an amazing pictorial memento of the occasion, with Mum surrounded by a mass of colorful and sparkling and beaming smiles. A fantastic experience overall. Mum did take Robin into her confidence and told him that she had actually starred in the previous year’s performance, (wishful thinking I believe!) and that she was there on that day in her official capacity escorting 70 elderly people to watch the performance! Being there had obviously evoked some powerful memories for her!
I have given Nottingham Playhouse a 5 star rating for doing a fantastic job to enable so many ladies and gents to enjoy the panto that day. Since then, I have learnt that they offer relaxed and dementia friendly performances of all the plays they stage. We have already talked about the fact that we may well return. As Mum’s carer, I get to go for free, what’s not to love about that?! I will happily continue to be Mum’s theatre buddy.
Bookings are already being taken for Sleeping Beauty for Christmas 2019, and God willing, we will definitely be going back!
For more information on dementia friendly performances and familiarisation visits plus any questions - you can email [email protected] or you can call the box office on 01159 419419 at the Nottingham Playhouse.
We know you've all been keenly waiting to hear the news from Red Rose about their brilliant refurbishment project and here's the latest update. As you can see, there is a lot of work going into this project and we know it will help to make a huge difference in end of life care for many people and their loved ones.
For many years our Hcsuk servicing team has been working with care providers just like you, to help keep their equipment;
• Compliant with legislation (Loler BS5827 BS EN ISO10535)
• In good working order, to keep replacement costs down
Together we can offer you :
• Same day call out
• Full service history – you’ll have all the information you need when you need it
• Hassle free diary management - To keep your business compliant and ensure that nothing is missed
• Written recommendations of new parts before supply for cost control
• Peace of mind we operate under a health care industry code of practice, so you can be assured you’re dealing with a reputable company
• DBS checked engineers- we are trustworthy
• A seamless service when old equipment needs replacing
• On loan/short term hire of essential equipment to help keep your residents safe and well.
Our team of caring and skilled technicians work closely with customers to take the hassle out of keeping their equipment compliant and in the best possible condition.
Phil and Rachel work closely together to give you the very best service and customer care they can and together they really are a true superhero team! Phil is something of a speed freak witha love of motor bikes and Rachel has recently completed two YES TWO half marathons! Watch out for more on that later.
Phil popping one of the hoists into his, very tidy and well cared for, van.
Don't just take our word for it -
I just wanted to take this opportunity to say thank you for an excellent service we received when we had our hoist, hoist slings and weight chair scales serviced. The gentleman who came was very polite and friendly with a professional manner.
The reason we choose HCSuk is that we have always received excellent service from you and always received a friendly response when we contact any member of your team.
Colleen Joyce, Manager at Stanton Manor Residential Home, Burton on Trent.
To find out more, and to book your professional, friendly audit, call Rachel now on 01773 532582 or email her at [email protected]
Watch out for Phil/Superman in the van!
Today sees the end of an era for Health Care Services, as we say good bye and ‘bon voyage’ to the founder of our business, Michael Bonser as Michael is retiring after 29 years of being associated with and working in the Company.
He first started the business in 1989, quite by chance, when he saw an opportunity. At the time he was running a company offering a baby nappy delivery service to local new mums, and one day a nursing home rang and asked him if he could supply them with adult style incontinence products.
Michael instinctively said, “Yes, of course we can”; he saw a customer with a need and he wanted to help them fulfil it. At this stage he hadn’t any experience of working with adult incontinence products, but he made sure that he went out and found out and was able to fulfil the order and then thought who else might need these products? So, he started to contact other local nursing homes and care homes and that is how the business began as he started to supply more care homes in and around the area.
As Michael continued to visit his care home customers, they would to ask him, “Can you also supply me with other products, gloves, pressure relieving mattresses, (known as ‘spencos’ at that time!) and beds?” And each time Michael would say yes, and he would go away, do his research, find suppliers and come back equipped and able to give his customer the solution that they were looking for.
That was nearly 30 years ago, and the business has gone from strength to strength, adding on a retail division, Health Care Mobility, to help people remain living at home independently with aids for daily living. Michael was also instrumental in the launch of our Health Care Servicing division where field service engineers go out to service, repair and maintain essential equipment in care homes to help residents stay safe and care home providers complying with all of the relevant legislation including LOLER and PUWER. And we still maintain the same values which Michael instilled in the business all those years ago.
Due to the wide experience he has gained working in various departments of the business, Michael has been a great asset to the team because of his ability and flexibility to switch between different roles as and when needed, including sales, distribution, warehouse and servicing.
Michael set the standards of high levels of customer care from the outset, which have remained throughout, are now embedded throughout the team to this day. His attention to detail, coupled with his cheeky style and unfailing sense of humour, has enabled him to build some great long and lasting relationships with many customers over the years. Some of which we are fortunate to still provide services to, nearly 30 years on.
We are extremely grateful to him, for giving life to Hcsuk so many years ago and we all wish him well as he and his wife Debbie, embark on new adventures. Please do share your memories of Michael with us.
Today we want to help celebrate and support all those very important people who care from someone with a dementia.
Dementia is an incredibly cruel affliction for both those who have a dementia, and those who care for them, making that care work very difficult and draining. Through our work with care home managers, individuals who care for their nearest and dearest and our personal experience, we know how taxing this can be.
In this email we've selected a few of the resources we think can help you as a carer and we want to say a very heartfelt "Thank You" for all that you do.
Our recent blog on activity groups for carers will point in the right direction for a breather and a chat with people in the same position.
And here's a personal story from our MD, Jo Bonser, talking about her experiences with her own mum who has vascular dementia.
For more practical advice to help those in your care, you can view all our dementia care blogs(including product tips and lots of advice).
Thank you for all that you do for those in your care. We know how hard it is and how much it means.
It’s important to us here at Hcsuk, that everyone in the care industry is given the best tools to do their job, whether that’s the product solutions to help care for those in their care or the training they receive. Part of that training in most places is a good induction to a new workplace and part of that induction should be learning about the suppliers your care home uses.
Caring for a loved one with a dementia can be challenging, tiring and lonely for relatives and carers, and so often we forget that we need to look after ourselves too.
Jo Bonser, MD of Hcsuk, speaks from her own personal experience, having taken 4 months away from work to care for her own Mum, aged 97, living at home with vascular dementia.
‘My Mum would get extremely anxious if I was to leave the room, just to make a cup of tea, and would even follow me and shout at me for nipping out for a much needed loo break! So my days were spent sitting beside her in the same room from the time she got up until going to bed, with her repeatedly asking me the same questions – it was exhausting. Luckily I had my Border Collie, Hollie, living with us and my daily sanctuary came when a carer would relieve me for an hour and so I could get out in the fresh air and walk in nature, one of my favourite things to do.’