SUBJECT: ALTERED CONSISTENCY OF FOODS AND LIQUIDS

POLICY:

Any resident/patient who requires alterations in the consistency of food and/or liquids will receive an individualized dysphagia diet, as per physician’s order.

DATE EFFECTIVE:___________________

DATE REVISED:___________________

DATE REVIEWED: Annually

APPROVED BY: ______________________

ISSUING DEPARTMENT: Nutritional Services

APPROVED FOR USE IN: ________________________

PROCEDURE:

1. Residents/patients who exhibit signs and symptoms of dysphagia such as coughing, choking, pocketing of food, delayed swallow, inability to manipulate food in the mouth, wet, gurgling voice, etc., will be referred to the speech language pathologist (SLP) for a dysphagia evaluation.
2. The SLP may request a “test tray” from the Nutritional Services department with a variety of altered-consistency foods for evaluation purposes.
3. Upon completion of a dysphagia evaluation and/or video fluoroscopy, the SLP will make recommendations to the physician for the appropriate food consistency (e.g., pureed, mechanical soft, ground) and liquid consistency (e.g., nectar, honey, pudding). The SLP will communicate recommendations to Nursing and the Clinical Dietitian as per facility protocol.
4. The physician will write the diet order with specified food and liquid consistencies. The change in diet order will be communicated to the Nutritional Services department and Care Plan Team according to facility protocol.
5. The Nutritional Services department will be responsible for preparing and serving food as ordered.
6. Unless pre-thickened products are used, Nursing will be responsible for thickening liquids to the desired consistency using a commercial thickening agent, as specified by the physician’s order and SLP recommendation.
7. Liquids will be thickened according to manufacturer’s directions.