Mother’s Day Dessert – Safe for the Whole Family

When I saw the cover of the May 2016 Better Homes and Gardens® magazine, I was inspired!

Mother’s day is right around the corner and what better idea than to make a delicious modified dessert for the mom who’s having trouble swallowing but that the whole family can share and enjoy.

The recipe in the magazine is for “Showstopping Meringue Desserts”. Crispy, marshmallow-y meringues are unsafe to consume for someone on a puree diet because they consist of several different textures and dissolve on the tongue, making it impossible to control the swallow. Add whole fruit and the original recipe is definitely off the list of “okay” foods if you are having trouble swallowing.

So I created a recipe that is every bit as beautiful and delicious.

The whole family can eat this and not feel like they are being cheated…just ask my girlfriends who ate these for dessert at our “girls’ lunch” yesterday!

This recipe is easy to make ahead and scale up or down, as needed.

  • 1 – 8 oz. brick Cream Cheese, softened
  • ½ cup Powdered Sugar
  • 1 teaspoon Vanilla Extract
  • 1 – 8 oz. container Whipped Topping, thawed
  • 1 jar Lemon Curd
  • Seedless Blackberry Jam
  • Blueberry Syrup
  • Mint for garnish, optional

In a large bowl, mix cream cheese with a mixer until smooth. Add powdered sugar and vanilla and beat until smooth. Fold in whipped topping.

Drop rounded half cup portions on a parchment lined sheet pan that will fit in your freezer. Form a well in each mound, making a shell, and freeze for at least 4 hours or overnight.

When you are ready to serve, peel the frozen shells off the parchment and place on individual plates or on a platter. Place the shells in the refrigerator for 20 minutes or allow them to sit at room temperature for about 10 minute so they can soften.

Add 1 1/2 tablespoons of lemon curd to each shell and top with small dollops of seedless blackberry jam and drizzle with blueberry syrup. Serve and enjoy!

Serves 8

The shells can be made ahead up to a month ahead, just freeze them until they are firm before you cover them with plastic wrap

.

If you are concerned about carbohydrates and fat, you can easily substitute Neufchatel cheese and “lite” whipped topping.

Nutritional Info each: 325 calories; 17.25 gm fat; 40 gm carbohydrates; 135 mg sodium; 0.33 gm protein

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Tips for Thickening Nutritional Supplements

If you are on thickened liquids, how can you safely drink pre-made nutritional shakes like Boost and Ensure? This video will help answer your questions.


“How to Puree Just About Everything” – A How-To Video

Though I haven’t posted recently, I have been busy.

I am in the process of filming cooking lessons on the techniques neccessary to puree almost every food. There will be five lessons in all.

The cooking lessons will be on a DVD that will be included in the purchase of my care manual “Making Every Bite Count”. Because this information is essential to living on a puree diet, I hope to make all the full length videos available to view online for a small fee.

Through these cooking lessons, I will show you how to modify the foods you love so you can still eat them if you are on a puree diet.

First up: Meat

Pureeing meat can be a real challenge! Cooked meats can be hard to puree because meat protein form tight bundles that need can be difficult to chew, let alone puree. When pureeing meat, keep in mind that:

  1. you need to start-out with cooked meat
  2. meats that are easier to chew will also be easier to puree
  3. you’ll need broth or other cooking liquid
  4. you’ll need an instant food thickener to bind the puree into a cohesive mass for safe swallowing
  5. purees don’t have to be soupy
  6. purees can taste great!

This video is just a snap-shot of the full video, so take a look and get some ideas!


Perfectly Safe Popsicles

If you’ve been prescribed thickened liquids and you miss eating ice cream and other frozen treats, this video will help you

 


Thoughts on “Being Mortal”

being mortal

Atul Gawande’s marvelous book “Being Mortal: Medicine and What Matters in the End”, is a must-read for anyone who plans to age in the USA. Dr. Atul Gawande is a surgeon, a professor at Harvard Medical School and the Harvard School of Public Health, a writer for the New York Times, and the author of three bestselling non-fiction books on science and public health. He makes difficult subjects interesting and understandable. You don’t have to be a scientist to understand and enjoy his books.

In “Being Mortal”, Dr. Gawande writes eloquently about the history of how we care for our aging population and the importance of retaining the dignity and freedom to be the “authors of our own lives.” In the end, when all else is said and done, that is what matters.

This book has inspired me. This month, I spoke at the Arizona Geriatric Society’s Fall conference. My topic was “Managing Dysphagia Beyond Acute Care”. Once read this book, I reworked my presentation. I made sure to address the joy of eating, the social aspects of sharing a meal and the cultural significance of food. The medical professionals who attended this conference know the science so I shared with them my thoughts on the art and soul of eating.

“Being Mortal” is a call to action for doctors and other medical professionals to expand our responsibilities beyond trying to “fix” what is wrong and embrace the final years of living. This time period should be about living as fully as possible and having the best possible day (week/month/year); it should not be focused on dying.  As we reach advanced age or fight a terminal illness, much of what happens to our bodies can’t be “fixed”. Yes, we can eat right and exercise but there is nothing we can do to stop time.

For many of us, as we age, our ability to swallow can become impaired. Illnesses like oral cancer and dementia can rob us of more than our vitality; they can steal from us our ability to eat and enjoy food. According to the National Institutes of Health, one in six Americans over the age of 60 is having trouble swallowing. In 2013, over ten million Americans had a swallowing assessment.

In “Being Mortal” Dr. Gawande builds the case that “as our time runs down, we all seek comfort in simple pleasures – companionship, everyday routines, the taste of good food, the warmth of sunlight on our faces”. Not being able to eat and drink like everyone else can interrupt our everyday routines, be isolating and can lead to depression. Food and eating is basic to our survival, but is even more important to our quality of life and our joy of living. How we eat and with whom we eat feeds the spirit.

Caring for someone with swallowing problems is about more than the mechanics of feeding. Doing it right is science combined with art. With the right tools, creativity and information, it may be possible for those with swallowing problems to share and enjoy a meal. Diagnoses and food modifications help to sustain the ability to nourish the body but we should acknowledge that we need to feed the soul, as well.


Swallowing Problems? What to do about Thanksgiving dinner.

Family eating at the dinner table

Gathering at the holiday table is one way we share our love, show our humanity and honor our cultural traditions. For manyof us, holiday feasts like Thanksgiving and Christmas don’t feel like a holiday without certain well known and loved dishes. Traditional foods and recipes are handed down from one generation to the next, keeping alive our memories and honoring those no longer at the table.

For most of us, feasting with friends and family is basic to our humanity. But when you are having trouble swallowing, the act of eating can be scary, difficult or even dangerous.  Needing to be conscious of every bite you take, how you position your head and thinking through the swallow is no picnic! It can create anxiety, prevent you from being in the moment, taking part in the conversation at the table and enjoying the occasion like everyone else. Those who are recovering from a stroke, are having treatment for cancer or who are living with dementia may already feel isolated.  Not being able to share traditional family meals in a “natural” manner may be frustrating and challenging and can make matters worse.

It is understandable when those with swallowing problems may be tempted to “cheat” during the holidays and eat foods that are not part of their eating plan. Sharing traditional foods with family and friends is how we celebrate! Platters get passed and everyone takes a little bit of this and maybe a whole lot of that. Traditional foods have a special place at the holiday table but if those foods are the wrong texture, they can be a problem for someone who is at risk for aspiration. Aspiration is when a small particle of food or liquid enters the trachea (a.k.a. the airway or windpipe).  Aspiration can cause choking and aspiration pneumonia, both of which can be life-threatening.

Whether your family celebrates a holiday dinner with roast beef, turkey or ham, it is possible for someone with dysphagia to eat almost everything on the dinner table with a few modifications.

If you are on a Mechanical Soft Diet, remember to take small bites of soft, well-cooked foods. Add gravy and sauces to your foods to make them moister and easier to chew and swallow. Dark meat turkey is often more moist and tender so choose thigh meat and cut it into small pieces. Be mindful when eating foods with mixed textures. Avoid foods that aren’t easy to chew like nuts and raw vegetables. Stick with roasted vegetables and stay away from the crudité plate. Have the pumpkin pie instead of the pecan pie.

If you’ve been prescribed a puree diet, you’ll need a make a few additional modifications to many foods to make them the right texture for you.  To puree a single serving or two, you will find that a powerful mini food processor will become an invaluable tool.  Full-size food processors and blenders won’t work because they are too big to efficiently puree one or two portions to the correct texture. You will also need an instant food thickener like ThickenUp Clear® or ThickIt®.

Here is a puree plan for most traditional foods:

Turkey

Roasted Turkey/Beef/Ham/Brisket

  • In a mini food processor, place cooked a 2 – 3 oz. portion of cooked meat and process until finely chopped. Add 2 tablespoons of broth and process again until very finely chopped. Add 1 scoop instant food thickener and puree until smooth. The texture should be as thick as mashed potatoes. For visual appeal, place the meat in the corner of a quart-size zip-top bag and seal. Snip off the corner with the meat, and pipe the puree onto a plate in the approximate shape and size of a serving of meat.

Mashed Potatoes & Gravy

  • No modifications needed, just make sure the potatoes and gravy are lump-free and the potatoes are firm (not soupy).

Stuffing

  • Avoid stuffing. Try slurried dinner rolls (below) which taste a lot like stuffing.

Sweet Potatoes

  • Mash with lots of butter.

Green Bean Casserole

  • No mushroom soup allowed. Instead, puree a portion of well-cooked green beans and fried onions in a mini food processor with a small amount of cooking liquid. Add 1 scoop of Instant Food Thickener (I like ThickenUp Clear) and blend until smooth. You are looking for a texture like smooth mashed potatoes.

Dinner rolls

  • Use only soft dinner rolls. NO SEEDS OR WHOLE GRAINS! Make a slurry with ¼ cup of chicken broth and ½ scoop of Instant Food Thickener (ThickenUp Clear) and mix until it thickens. Pull apart the roll and cover with the slurry. Set aside for about ten minutes, until the roll has absorbed the slurry. Reheat as needed.

Cranberry Sauce

  • Canned smooth, jellied sauce is okay.

Pumpkin Pie

  • Filling only. No crust.

Apple Pie

  • Puree the filling in a mini food processor. No crust.

If you crave apple pie a la mode, check-out the archived recipe on this blog.

With a few modifications, you or someone you love can safely enjoy a holiday feast!


Autumn Pie Smoothies

apple drawing

Autumn is in the air and apples and pumpkins are in season.

It seems that everywhere you look, there are pumpkin-spiced lattes, pumpkin bagels, pumpkin cupcakes, pumpkin pancakes not to mention apple pie, baked apples, apple cider, apple this and apple that! Both fruits (and yes, pumpkin is technically a fruit!) are full of vitamins, fiber, phyto-nutrients and other goodness. Because pumpkin is full of Vitamin A and fiber, it is a super-food. Combine pumpkin with a powerful anti-inflammatories like cinnamon, ground ginger or other warm spices and you have an especially delicious super-food!

The old saying: “An apple a day keeps the doctor away” is grounded in truth…though the saying does not include the all-American apple pie…which is too bad! The good news is that an apple pie smoothie can be just what the doctor ordered when you have trouble swallowing and can no longer eat a traditional apple pie. This apple pie a la mode smoothie recipe includes great anti-inflammatory spices (cinnamon and ground ginger) that boost overall health and is so delicious that you won’t miss the crust.

These autumn-in-a-glass smoothies are delicious and nutritious…even if you are not having trouble swallowing!

 

Pumpkin Pie Smoothie

 ½ banana, chopped (and frozen is possible)

1 container honey Greek yogurt

4 ice cubes

½ cup canned pumpkin

1 cup orange juice

½ teaspoon pumpkin pie spice (or cinnamon)

1 teaspoon finely ground flaxseed meal

1 tablespoon honey, maple syrup or brown sugar (optional)

Place all ingredients in a blender and blend until perfectly smooth. If too thick or chunky to drink, add more juice and re-blend until smooth. Taste and adjust spices and sweeten, as needed.

Makes one generous serving

Nutritional Info:

375 calories, 12 gm protein, 4 gm fat, 73 gm carbohydrate. 388% RDA Vitamin A, 88% RDA Vitamin C, 30% RDA Calcium, 13% RDA Iron.

 

Apple Pie a la mode Smoothie

 ½ banana, chopped (and frozen if possible)

1 container vanilla Greek yogurt

4 ice cubes

½ cup canned apple pie filling

1 cup apple juice or apple cider

¼ teaspoon ground cinnamon

¼ teaspoon ground ginger

1 teaspoon finely ground flaxseed meal

1 tablespoon honey, agave nectar or brown sugar (optional)

Place all ingredients in a blender and blend until perfectly smooth. If too thick or chunky to drink, add more juice and re-blend until smooth. Taste and adjust spices and add sweetener, as needed.

Makes one generous serving

Nutritional Info:

475 calories, 12 gm protein, 4 gm fat, 103 gm carbohydrate, 6 gm fiber, 103% RDA Vitamin C, 28% RDA Calcium


Aids for Daily Living help those struggling to feed themselves

When I speak to dementia support groups, I mention how helpful it can be to use specially adapted eating utensils. Something as simple as a fork with a larger handle can help restore a bit of dignity to someone who is struggling with feeding themselves.

Recently, I was visiting my friend Yolanda Romero-Alemany in her medical supply store and I saw the helpful eating/feeding items she stocks. Yolanda is a great resource for medical equipment and supplies so I asked her to write this guest blog:

Ever wonder why restaurants’ menus and interiors often are red?  Studies have shown that the color red stimulates the appetite. 

How does this relate to people eating independently, especially those with Alzheimer’s or Dementia?  Red is the color easiest to perceive for Alzheimer’s and Dementia patients which makes it great for tableware.  Many Alzheimer’s patients do not eat enough due to lack of hand-eye coordination with silverware or not being able to distinguish the food from the serving bowl/dish.  At Scottsdale Medical Equipment & Supplies, we carry the Power of Red line of utensils, bowls, and cups by Essential Medical.  The red dish and bowl have nonslip bottoms which hold it in place while eating and the great red color provides contrast between the food and dish.  The forks and spoons have large handles to make it easier to grip and can actually bend so the motion to scoop something up from a bowl to the mouth is easier.  The Power of Red line also includes a cup with a nose cutout so people don’t have to tilt their heads back to drink.   These items range in price from $18-$45.

Scottsdale Medical Equipment & Supplies stocks other Aids to Daily Living products carried at our store in Scottsdale, on the NW corner of Loop 101 and Shea Blvd. We stock many eating/feeding tools which make meal time more enjoyable for everyone. 

If you are in the area, stop by our store is at 8752 E. Shea Blvd, Scottsdale, AZ 85260 and “Let our Family Take Care of Your Family”.

 

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