Addressing Chewing and Swallowing Difficulties

It is common for aging adults and those with illness to have trouble chewing or swallowing their food. Arbor Hospice recommends individuals who have trouble chewing and/or swallowing may benefit from changing the consistency of their food and trying either a mechanical soft or puree diet.

A mechanical soft diet requires some chewing ability. Food should be moist and cooked to a fork-mashable texture. Meat should be ground or minced. Covering the meat with gravy may help. Bread products, crackers and other dry foods may be difficult to swallow and a good substitution can be pasta with sauce.

A puree diet requires minimal chewing. Food should be processed in a food processor until smooth and pudding-like. It should contain no small particles or chunks, which could make swallowing much more difficult. Adding small amounts of water, milk, broth or other fluids to the food being pureed can make the process quicker and help yield a smoother product. Peanut butter should always be mixed with other items when pureed and should never be eaten alone as it is a choking hazard for those with swallowing difficulties. Some items puree better than others. For example, cooked sweet potatoes puree better than regular potatoes, and cooked carrots puree well but corn does not.

Here are some meal suggestions:

Breakfast:

• Regular cooked cream of wheat or grits: no need to puree
• Fruit: some fruits become wet when pureed and require the addition of a stabilizer. Unflavored gelatin works well for this. Add a bit of lemon juice and sugar to pureed bananas to reduce discoloration. 
• Coffee cake, danish or donut: add one tablespoon milk or more to reach desired consistency.
• Hardboiled eggs and toast: puree one egg with two tablespoons milk, one slice of toast and one teaspoon of butter until completely smooth. 

Lunch and Dinner: 

• Casseroles: puree freshly cooked casserole and add gravy or broth to achieve desired consistency
• Meat: add a stabilizer like bread, mashed potato flakes or fat to help produce a smoother product
• Vegetables: cook raw and frozen vegetables first. Puree and add butter or a stabilizer as needed. 
• Fruit: Some fruits become wet when pureed and require the addition of a stabilizer. Unflavored gelatin works well for this. 
• Peanut butter and jelly sandwich: puree two slices of bread, three tablespoons creamy peanut butter, two tablespoons seedless jelly and three tablespoons milk or more to obtain desired consistency.
• Smooth cream soups

Snack Ideas: 

• Pureed cottage cheese
• Pudding
• Apple sauce
• Yogurt

Dessert:

• Dutch Apple Pie: puree one slice of pie with three tablespoons milk until desired consistency. 
• Cupcake: puree cupcake with two tablespoons milk
• Frosted brownie: puree browning square with 1.5 tablespoons milk or more to reach desired consistency