Diet Compendium Update Diet Texture and Consistency Changes
![Diet Compendium Update: Diet Texture and Consistency Changes Jean Helps, RD Regional Clinical Nutrition Diet Compendium Update: Diet Texture and Consistency Changes Jean Helps, RD Regional Clinical Nutrition](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-1.jpg)
![WRHA Feeding and Swallowing Expert Review Group • RD and SLP representation • Site WRHA Feeding and Swallowing Expert Review Group • RD and SLP representation • Site](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-2.jpg)
![Feeding and Swallowing Executive Summary Goal: Review the literature and evaluate practice to determine Feeding and Swallowing Executive Summary Goal: Review the literature and evaluate practice to determine](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-3.jpg)
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![Middle of the (current) Continuum • Soft-minced • Minced • Total minced Middle of the (current) Continuum • Soft-minced • Minced • Total minced](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-8.jpg)
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![IDDSI Framework • The framework consists of food and fluid consistencies • Levels are IDDSI Framework • The framework consists of food and fluid consistencies • Levels are](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-12.jpg)
![Copyright November 2017 - Used with permission from IDDSI FUTURE USE X X X Copyright November 2017 - Used with permission from IDDSI FUTURE USE X X X](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-13.jpg)
![Changes from Manufacturers of modified foods and fluids are moving towards meeting IDDSI guidelines Changes from Manufacturers of modified foods and fluids are moving towards meeting IDDSI guidelines](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-14.jpg)
![Commercial Products • Nestle Thicken. Up and Nestle Thicken. Up Clear – In the Commercial Products • Nestle Thicken. Up and Nestle Thicken. Up Clear – In the](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-15.jpg)
![Thicken. Up & Thicken. Up Clear Thicken. Up & Thicken. Up Clear](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-16.jpg)
![Prevalence of Texture Modifications • Dysphagia prevalence in LTC has been estimated to be Prevalence of Texture Modifications • Dysphagia prevalence in LTC has been estimated to be](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-17.jpg)
![What is involved to ADOPT? Implementing IDDSI will take time and will involve changes What is involved to ADOPT? Implementing IDDSI will take time and will involve changes](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-18.jpg)
![Support for Implementation Visuals: • What and Why of IDDSI • Transition Table comparing Support for Implementation Visuals: • What and Why of IDDSI • Transition Table comparing](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-19.jpg)
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![Industry Resources Industry Resources](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-23.jpg)
![Dual Labelling Lyons Magnus/Sysco Juice Dual Labelling Lyons Magnus/Sysco Juice](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-24.jpg)
![Hormel Milk Old label New label Hormel Milk Old label New label](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-25.jpg)
![IDDSI Resources • Diet Descriptions • Audit forms and process IDDSI Resources • Diet Descriptions • Audit forms and process](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-26.jpg)
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![Education Sessions – January 22 and 23 • • • Representation from 38 of Education Sessions – January 22 and 23 • • • Representation from 38 of](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-29.jpg)
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![Education Sessions – General Comments Great session, Very informative session Information was very clear Education Sessions – General Comments Great session, Very informative session Information was very clear](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-32.jpg)
![Recommendation for Future Focus… Implementation of food textures in 2020 • Review Food Textures Recommendation for Future Focus… Implementation of food textures in 2020 • Review Food Textures](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-33.jpg)
![Our plan moving forward… • Identify a transition date • Finalize package for transition Our plan moving forward… • Identify a transition date • Finalize package for transition](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-34.jpg)
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- Slides: 35
![Diet Compendium Update Diet Texture and Consistency Changes Jean Helps RD Regional Clinical Nutrition Diet Compendium Update: Diet Texture and Consistency Changes Jean Helps, RD Regional Clinical Nutrition](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-1.jpg)
Diet Compendium Update: Diet Texture and Consistency Changes Jean Helps, RD Regional Clinical Nutrition Manager Long Term Care
![WRHA Feeding and Swallowing Expert Review Group RD and SLP representation Site WRHA Feeding and Swallowing Expert Review Group • RD and SLP representation • Site](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-2.jpg)
WRHA Feeding and Swallowing Expert Review Group • RD and SLP representation • Site representation: – – – – Concordia Place Deer Lodge Centre Golden Links Lodge Grace General Hospital River Park Gardens Victoria Hospital WRHA Home Care
![Feeding and Swallowing Executive Summary Goal Review the literature and evaluate practice to determine Feeding and Swallowing Executive Summary Goal: Review the literature and evaluate practice to determine](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-3.jpg)
Feeding and Swallowing Executive Summary Goal: Review the literature and evaluate practice to determine the continuum of texture and consistency modified diets. Conclusion: IDDSI recommendations are current best practice
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-4.jpg)
Copyright November 2017 - Used with permission from IDDSI
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-5.jpg)
Copyright November 2017 - Used with permission from IDDSI
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-6.jpg)
Copyright November 2017 - Used with permission from IDDSI
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-7.jpg)
Copyright November 2017 - Used with permission from IDDSI
![Middle of the current Continuum Softminced Minced Total minced Middle of the (current) Continuum • Soft-minced • Minced • Total minced](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-8.jpg)
Middle of the (current) Continuum • Soft-minced • Minced • Total minced
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-9.jpg)
Copyright November 2017 - Used with permission from IDDSI
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-10.jpg)
Copyright November 2017 - Used with permission from IDDSI
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-11.jpg)
Copyright November 2017 - Used with permission from IDDSI
![IDDSI Framework The framework consists of food and fluid consistencies Levels are IDDSI Framework • The framework consists of food and fluid consistencies • Levels are](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-12.jpg)
IDDSI Framework • The framework consists of food and fluid consistencies • Levels are identified by text labels, numbers, and colour codes to improve safety and identification • Note “Regular (7)” has a subcategory: “Easy to Chew”
![Copyright November 2017 Used with permission from IDDSI FUTURE USE X X X Copyright November 2017 - Used with permission from IDDSI FUTURE USE X X X](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-13.jpg)
Copyright November 2017 - Used with permission from IDDSI FUTURE USE X X X Pha Cha se 1 nge Com s Ma ing y 20 19
![Changes from Manufacturers of modified foods and fluids are moving towards meeting IDDSI guidelines Changes from Manufacturers of modified foods and fluids are moving towards meeting IDDSI guidelines](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-14.jpg)
Changes from Manufacturers of modified foods and fluids are moving towards meeting IDDSI guidelines starting in January 2019 • You will start seeing dual labelled thickened liquids in 2019 – Once you finish using your site product and – suppliers have depleted their old labelled product • Within WRHA – changes to take place after April 2019
![Commercial Products Nestle Thicken Up and Nestle Thicken Up Clear In the Commercial Products • Nestle Thicken. Up and Nestle Thicken. Up Clear – In the](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-15.jpg)
Commercial Products • Nestle Thicken. Up and Nestle Thicken. Up Clear – In the process of transitioning to IDDSI labels • Lynch Thickening Powder – No designation on the label currently re: diet terminology • Sysco Thickened Juice and Water – Not yet transitioned to IDDSI labeling • Hormel Thickened Milk – Transition complete for Nectar Thick – Not yet transitioned for Honey Thick • Oasis Hydra – ?
![Thicken Up Thicken Up Clear Thicken. Up & Thicken. Up Clear](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-16.jpg)
Thicken. Up & Thicken. Up Clear
![Prevalence of Texture Modifications Dysphagia prevalence in LTC has been estimated to be Prevalence of Texture Modifications • Dysphagia prevalence in LTC has been estimated to be](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-17.jpg)
Prevalence of Texture Modifications • Dysphagia prevalence in LTC has been estimated to be over 66% (Dietitians of Canada) • Within WRHA approximately 50% of PCH residents are on texture modified diets – 7% of residents are on thickened liquid diets
![What is involved to ADOPT Implementing IDDSI will take time and will involve changes What is involved to ADOPT? Implementing IDDSI will take time and will involve changes](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-18.jpg)
What is involved to ADOPT? Implementing IDDSI will take time and will involve changes to: • Kitchen related: – Food and liquid definitions – Production process and recipes – Production lists (tallies), diet compliances in recipes – Food and liquid terminology – Menus, diet manual, lists, orientation material – Point of service considerations, including testing • Site wide related: – Education to staff in several departments – Updating diet information and forms – Updated policies and procedures
![Support for Implementation Visuals What and Why of IDDSI Transition Table comparing Support for Implementation Visuals: • What and Why of IDDSI • Transition Table comparing](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-19.jpg)
Support for Implementation Visuals: • What and Why of IDDSI • Transition Table comparing current and new diet terminology • Industry resources IDDSI Resources • Diet definitions and descriptions • Food Audit forms and process Education Session held January 22 and 23
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![Copyright November 2017 Used with permission from IDDSI FUTURE USE X X X Copyright November 2017 - Used with permission from IDDSI FUTURE USE X X X](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-22.jpg)
Copyright November 2017 - Used with permission from IDDSI FUTURE USE X X X = No Fluids = Pediatric Only = Regular
![Industry Resources Industry Resources](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-23.jpg)
Industry Resources
![Dual Labelling Lyons MagnusSysco Juice Dual Labelling Lyons Magnus/Sysco Juice](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-24.jpg)
Dual Labelling Lyons Magnus/Sysco Juice
![Hormel Milk Old label New label Hormel Milk Old label New label](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-25.jpg)
Hormel Milk Old label New label
![IDDSI Resources Diet Descriptions Audit forms and process IDDSI Resources • Diet Descriptions • Audit forms and process](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-26.jpg)
IDDSI Resources • Diet Descriptions • Audit forms and process
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-27.jpg)
Copyright November 2017 - Used with permission from IDDSI
![Copyright November 2017 Used with permission from IDDSI Copyright November 2017 - Used with permission from IDDSI](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-28.jpg)
Copyright November 2017 - Used with permission from IDDSI
![Education Sessions January 22 and 23 Representation from 38 of Education Sessions – January 22 and 23 • • • Representation from 38 of](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-29.jpg)
Education Sessions – January 22 and 23 • • • Representation from 38 of 39 sites Food Service representation from all sites except 9 Clinical Dietitian representation from all sites except 3 Some sites had 3 representatives from a variety of roles All LTC SLP attended Two nursing leaders attended • Total of 70 attendees
![Education Sessions Feedback Question Yes No Better Awareness 46 0 Concerns 25 18 Education Sessions – Feedback Question: Yes No Better Awareness 46 0 Concerns 25 18](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-30.jpg)
Education Sessions – Feedback Question: Yes No Better Awareness 46 0 Concerns 25 18
![Education Sessions Comments Concerns Transition is difficult for staff Training staff Education Sessions – Comments Concerns: • Transition is difficult for staff • Training staff](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-31.jpg)
Education Sessions – Comments Concerns: • Transition is difficult for staff • Training staff – time and resources and staff comprehension • Buy in/acceptance of the change What will help? : • • Resources – posters Standardized recipes Seeing the chart made it easier and the flow test is pretty straightforward Locally produced video
![Education Sessions General Comments Great session Very informative session Information was very clear Education Sessions – General Comments Great session, Very informative session Information was very clear](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-32.jpg)
Education Sessions – General Comments Great session, Very informative session Information was very clear Excellent hands on session Ability to access a contact easily should any concerns arise, but very informative • Thank you for the opportunity, great session, I wish my FSS and lead cook attended • Slow roll out (e. g. fluid first) will allow for a greater success in transitioning • Support for providing education – not just the RD • • • Food Texture update will be more of a challenge
![Recommendation for Future Focus Implementation of food textures in 2020 Review Food Textures Recommendation for Future Focus… Implementation of food textures in 2020 • Review Food Textures](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-33.jpg)
Recommendation for Future Focus… Implementation of food textures in 2020 • Review Food Textures and compare this to our current diets Current Terminology New Terminology Standard/Regular (7) Soft/Soft Minced Easy to Chew (subcategory 7) Minced To be determined Total Minced and Moist (5) Pureed (4) Blenderized Liquidised (3)
![Our plan moving forward Identify a transition date Finalize package for transition Our plan moving forward… • Identify a transition date • Finalize package for transition](https://slidetodoc.com/presentation_image_h2/72b294a5fe14d9e53d2e039df0975669/image-34.jpg)
Our plan moving forward… • Identify a transition date • Finalize package for transition • Finalize education materials • Initial goal: transition fluids within the first quarter of 2019/2020 • Future plan: transition foods in 2020 (? fall 2020)
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