SALT have decided dad doesn't need mashed diet after all...

looviloo

Registered User
May 3, 2015
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0
Cheshire
So dad was placed on a mashed diet about 18 months ago (maybe a bit longer) after several choking episodes. This was arranged after two different members of the SALT team had assessed him. He could still just about talk at the time.

Since then, he has moved care home and lives in a different local authority. His dementia has progressed and he can barely speak, and his mouth is open most the time because the muscles have slackened. But he is alert, if a little anxious.

His new home noticed he was coughing a lot while drinking, so the doctor prescribed thickeners for his drinks. He seemed to notice no difference! And it improved the coughing. The home also arranged for the SALT team in his new local area to visit.

Well... the person from SALT assessed dad this week and has said he doesn't need the mashed diet, he's ok with a normal diet. Apparently she was there for hours, observed two meal times, gave him biscuits, watched him drink and has ordered that he be taken off the mashed food and thickener.

I'm feeling a bit shocked by it to be honest, so wondered what others think??? Can PWD improve in this way? Has it happened to anyone else here, and how did it go? The carers aren't too happy about it but have to follow orders... they will still use discretion not give dad boiled sweets etc (eek, the thought of it!).

I did wonder if it has anything do with his trazodone being reduced a couple of months ago, and perhaps less sedation is helping. But as I mentioned above, his anxiety/agitation seems to have increased again. Sigh. Not sure if this would affect his eating though.
 

Canadian Joanne

Registered User
Apr 8, 2005
17,710
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Toronto, Canada
Like you, I find this rather concerning. Is it such a problem for him to be on a mashed diet? If you are PoA, can you not insist on a mashed diet? I know that here in Ontario, the PoA can overrule just about anything a doctor may suggest. I know, as I overruled certain meds for my mother and also pushed and pushed till other meds were prescribed.

The reduction of his trazodone may well be part of it but the trade-off seem to be increased anxiety and agitation. Perhaps you could discuss the pros and cons of this also.
 

AliceA

Registered User
May 27, 2016
2,911
0
My husband has a soft diet at home. When out he makes his own choices, so he can choose the wrong thing. Even when I make suggestions by setting an example! However the techniques he was taught do help,
So up to a point I have to let him take the risk, when I can I get extra cream or gravy.
SALT explained that the danger is when a food had two textures, so food has to be taken in small amount, chewed until one consistency, the swallowed followed by a sip of water.
Both jelly and ice cream can dived into two as they melt so are banned.