In this edition of Nutrition Matters, we discuss common problems residents have with the meals and we want to provide some tips on how to make them look great, tasty and nutritious.
How often do you hear that pureed meals always look the same? That it appears residents on puree diets lack food variety and generally have poorer eating? Negative feedback from residents, carers and relatives regarding puree meals is common-place in residential aged care facilities. This understandably frustrates catering staff who have spent many hours preparing meals.
Such diets are frequently used in acute and residential aged care predominantly for people with dysphagia (swallowing difficulty) and who are at risk of choking, which can result in serious illness or even death. Unfortunately, there is no other means to offer food without the risk of choking.
So what can be done?
In aged care facilities having puree meals look good, smell good and sound good can be a challenge! Getting meals to smell good can be difficult, with many facilities having centralised cooking kitchens well away from resident dining areas; being able to hear foods crunching would mean the food is not suitable to be part of a puree diet. Therefore we are left with needing to work on the visual appeal of meals to increase resident appetites. Think colour, height and shape with the presentation emphasis to mimic normal foods.
Photo Source: Tibor’s Kitchen
To plate more appealing meals, catering teams need to be motivated and creative, thinking ‘outside the box’. Feel confident to sit the ice-cream scoop aside and experiment with other plating methods. Some successful strategies are as follows:
Use food moulds for some or all of the components of the meal. We are seeing more and more homes ditch the ice-cream scoop and take on using moulds. Many of these homes have improvements in resident oral intake and a decrease in resident complaints. Facilities are even going above and beyond to create pureed meals that mimic the look of the original shape of the food.
Using piping methods. In addition to moulds, some food components can be pipped onto the plate to create depth and height for certain meal components. Piping isn’t particularly used to try to mimic the look of the normal food, but to distinguish it from it looking like a round ball from the regular ice cream scoop.
Allowing residents on texture modified diets to have bread, cakes and ‘sandwiches’ again by using the soaking method. Bread, cakes and sandwiches are such a large component of many residents diets and once they are placed on to a texture-modified diet, they are no longer able to have breads again. By soaking the breads in a custard mixture (such as the one used traditionally for bread and butter pudding), and then bake/steam for 10 minutes, you then have bread that is appropriate for those residents requiring a pureed diet.
Order pre-moulded pureed meals. If your facility does not have the capacity to be creative with plating pureed meals or you only have a small number of residents requiring pureed meals, you can purchase pre-moulded pureed meals. There are now many suppliers out there who are able to do this for you and have a large variety that can be ordered.
To begin with this can seem overwhelming and too difficult. Creating great looking smooth pureed meals requires a lot of experimentation. It’s always best to focus on improving one thing at a time rather than trying to do everything at once. If your facility would like to know more or get some advice about how to best improve the look of your pureed meals, please contact Leading Nutrition for further information and advice. We also feature a comprehensive session on this topic in our up and coming Food for the Ages Seminars.
If you have already started creating beautiful smooth pureed meals, please send us some photos and we would love to show the rest of the aged care community what you have created!
Martin J (2012) A Kitchen Manual for preparation of modified texture diets, Brisbane.
Martin J & Backhouse J (1993) Good looking easy swallowing. Available from shop.service.sa.gov.au