MECHANICAL SOFT VS. MODIFIED MECHANICAL SOFT DIETS Prepared by: Emily Cook, OHSU Dietetic Intern April 2015
DEFINITION The mechanical soft diet includes any foods that have been mechanically altered to aid in chewing and swallowing Ways foods are prepared to become mechanically soft include: Chopped Ground Pureed Boiled Steamed (long enough for food to become soft) Tools used to mechanically alter the foods include, but are not limited to: Blender Potato Masher Meat grinder Fork Knife This diet only limits texture and consistencies
PURPOSE OF THESE DIETS Ensure the patient is safely and successfully swallowing foods and liquids Avoid aspiration Avoid pocketing food Foods on these diets require little chewing and are soft in texture
BARIUM SWALLOW STUDY https://www.youtube.com/watch?v=ri8bbhw9msq
IMPORTANT NOTE These diets can be modified for the individual patient based on the Speech Pathologist s recommendations!
WHEN ARE THESE DIETS PRESCRIBED? Speech Pathologist (SLP) will come evaluate the patient Assist patient in trialing different textures and thicknesses of foods and liquids Make recommendations based on the patient s: Physical ability to chew Ability to safely swallow
WHEN DO WE SEE THESE DIETS?
KEY FOODS ALLOWED Mechanical Soft Modified Mechanical Soft Meat & Meat Substitutes Ground and tender-baked meats Ground and tender-baked meats Eggs Scrambled, poached, or hard boiled Scrambled, poached, or hard boiled Cheese Cottage and mild cheeses Cottage and mild cheeses Peanut Butter Smooth Smooth Lentils and Beans Soft-cooked lentils, beans, peas, tofu mashed by fork Soft-cooked lentils, beans, peas, tofu mashed by fork Casseroles All soft and moist Soft and moist without stringy veggies Fruits & Fruit Juices Vegetables & Vegetable Juice Breads & Other Starches All juices. Soft fruits without tough skins or seeds All Juices. Well-cooked veggies able to be mashed by fork. Fresh tomato. Soft breads including waffles, pancakes, French toast and muffins. Dry cereals without dried fruit. Oatmeal. Pasta and potatoes Fruit approved by SLP Well-cooked veggies able to be mashed by fork Cream of Wheat/Rice. Oatmeal. Blenderized pancakes, muffins, toast. Soft pasta, mashed potatoes with gravy. Pudding, custard, ice cream, Jello, Katie Desserts Cakes, puddings, Jello, ice cream, cookies whips Soups All Thickened, strained, cream soups.
FOODS TO AVOID Mechanical Soft Modified Mechanical Soft Meat & Meat Those with stringy, dry, doughy Meats that aren't ground Substitutes components Eggs Fried eggs Fried eggs Cheese Hard cheeses & cheeses containing Hard cheeses & cheeses containing particles that are difficult to chew particles that are difficult to chew Peanut Butter Crunchy nut butters Crunchy nut butters Casseroles -- Dry, doughy, crumbly Fruits & Fruit Juices Fruits with tough skins or seeds, raw, hard fresh fruits, dried fruit, coconut Fruits with tough skins, raw, hard fresh fruits, dried fruit, coconut Vegetables & Vegetable Juice Breads & Other Starches Whole kernel corn/corn on the cob, peas, lima beans, raw vegetables except fresh tomato and lettuce as liners for salads Hard, crusty breads or rolls, English muffins, bagels, hard/coarse/dry cereals, crisply fried potatoes, fried rice, baked potato with skin Vegetable juices, peas, lima beans, whole kernel corn/corn on the cob, spinach, green beans, cooked greens, celery Dry cereals, whole wheat, coarse textured cereals, breads Fats & Oils Nuts Nuts, peanut butter, bacon Desserts Any containing coconut, nuts, or dried fruit Cake, cookies, pastries, pie, candy Condiments Whole pickles and pickled vegetables, coarse pepper, marmalade Pickles, marmalade Soups Soup containing whole kernel corn or peas Broth, unthickened blenderized soups
SPECIAL CIRCUMSTANCES: MODIFIED MECHANICAL SOFT Veggies prepared on this diet in the hospital will always be pureed
WHEN TO ADD EXTRA SAUCE AND GRAVY? Most modified mechanical soft foods will be prepared with added gravy or sauce Sometimes, SLP will assign the Slick diet in addition to the soft diets Patients and providers can always ask for a side of gravy to be sent on meal trays
LIQUIDS Thickened liquid consistencies: Nectar-thick Honey-thick Pudding-thick The thickness of the liquid will be assigned by the SLP based on the patient s ability to safely swallow Thickness of liquid is at room temperature Jell-O Soup Milkshakes/Ice Cream
QUESTIONS? Speech Pathologists are now on Vocera! Feel free to call them with additional questions during normal business hours
REFERENCES Academy of Nutrition and Dietetics. Nutrition Care Manual. Dysphagia level 2: Mechanically Altered. https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=44. Accessed April 2, 2015. Academy of Nutrition and Dietetics. Nutrition Care Manual. Head and Neck Cancer Nutrition Therapy. https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=135. Accessed April 2, 2015. Academy of Nutrition and Dietetics. Nutrition Care Manual. Mechanically Altered Foods Nutrition Therapy. https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=40. Accessed April 2, 2015. Academy of Nutrition and Dietetics. Nutrition Care Manual. Soft Foods Nutrition Therapy. https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=39]. Accessed April 2, 2015. Amanda Brown, SLP. Kaiser Sunnyside Medical Center Aurora Health Care. Mechanical Soft Foods. Version current March 2012. Internet: http://www.aurorahealthcare.org/fywb_pdfs/x26790.pdf. (accessed 2 April 2015). KP Diet Manual: Mechanical Soft Diet KP Diet Manual: Mechanical Soft Diet, Modified KP Diet Manual: Slick Diet KP PolicyTech: Inpatient Evaluation of Speech, Language, Cognitive, and/or Swallowing Skills Jackson Siegelbaum Gastroenterology. Jackson, FW. Soft and Mechanical Soft Diet. Internet: http://gicare.com/diets/soft-and-mechanical-soft-diet/. (accessed 2 April 2015). Memorial Sloan Kettering Cancer Center. Patient Education: Eating Guide for Pureed and Mechanical Soft Diets. Version current 1 March 2013. Internet: http://www.mskcc.org/cancer-care/patient-education/resources/eating-guidepureed-and-mechanical-soft-diets. (accessed 2 April 2015). Wikipedia, The Free Encyclopedia. Soft diet. Version current 31 December 2013. Internet: http://en.wikipedia.org/wiki/soft_diet. (accessed 2 April 2015).