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August 2006

Special Diets

As professionals, we all have the desire to provide attractive, nourishing and appetizing meals; to promote optimal health while maintaining as normal a diet as possible; and we all want our residents to eat and enjoy foods in a normal healthy way. 

Many health care facilities offer mechanically altered and therapeutic diets. Certain diseases and conditions may warrant these diet modifications. However, there are many good reasons to keep diets as liberal as possible for older adults: to achieve better compliance, reduce unintentional weight loss, improve nutrition and reduce incidence of nutrition related conditions; and most importantly, to improve quality of life.

The regular diet is appropriate for residents who have no complicating illness and no chewing or swallowing difficulties. The regular diet should also be the basis on which all diet modifications are built. By following basic diet guidelines and modifications, individuals can continue to enjoy optimal nutrition status well into their golden years. 

For altered consistencies, allow the individual the highest level of consistency tolerated.  The basic rule of thumb is “never grind if chopped is tolerated and never puree if a ground is tolerated.” The National Dysphagia Diet guidelines are considered to be the best practice standard for dysphagia diets and thickened liquids. For a liberalized low salt diet, remove salt from the tray and table, and make simple substitutions to replace very salty foods with lower salt versions (such as lower salt soups or fresh meats instead of cured). Diabetics in nursing facilities can often tolerate a regular diet, especially if well planned and consistent in the amount of carbohydrates from meal to meal and day to day. Consistent carbohydrate diets are the best practice standard for other diabetics needing additional control for stable blood glucose levels.

Overly restrictive diets are not effective if residents do not accept them. By keeping diets liberal and simple you can assure that you are offering your residents the foods that comfort and nourish to enhance quality of life. For more information on this subject, Click here to review the American Dietetic Association’s 2005 position statement: Liberalization of the Diet Prescription Improves Quality of Life for Older Adults in Long-Term Care.

For diet guidelines, Becky Dorner & Associates’ Diet Manuals provide a wealth of current information on regular and therapeutic diets that are easy to understand and implement.

Becky Dorner
RD, LD, Dorner and Associates

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