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.

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Cookbook Review – Part 2

Book 4.1

 

I purchased, read and tested recipes from the four best-selling “Dysphagia Cookbooks” on Amazon.  Each is well written and insightful but there are specifics that are unique to each book. Each is a “labor of love” for the author. If you purchase one of these books, I encourage you to read the forewords and acknowledgements as you will find something of value in each.

As a passionate cookbook reader, collector and author, I currently have more than 100 cookbooks in my collection. I subscribe to every food magazine that is currently published and I can’t seem to part with my 20 year collection of the now defunct “Gourmet” magazine. If you called me a “food-wonk”, you would not be far off. I have developed my own techniques and recipes and have combined them into a guide: “Cooking for Someone with Swallowing Problems”.  This guide teaches the techniques you need to modify everyday foods and beverages. It has recipes and suggestions for eating out and stocking your pantry with pre-made, common everyday foods found in the grocery store. This guide is designed as a reference tool so you can modify the everyday foods you love so you can come close to living the life you had before you developed dysphagia. It is available for purchase for $29.95, which includes shipping and handling. If you want to purchase one, contact me directly: laura@dysphagiasupplies.com.  As part of the purchase of the guide, you will receive monthly updates, articles and new recipes.

The four best-selling “Dysphagia Cookbooks” on Amazon are:

  •  “Soft Foods for Easier Eating Cookbook” by Sandra Woodruff, R.D. and Leah Gilbert-Henderson, Ph.D.  This is “A Complete Guide” to dysphagia management.  The first 101 pages cover everything you need to know about stocking your pantry with food and kitchen equipment, thickening liquids, staying healthy, special considerations and more! If you can, take the time to read the first 101 pages, they are truly enlightening. The approximately 200 recipes follow the National Dysphagia Diet guidelines. The recipes are simple and easy to follow. Each recipe includes nutritional information and offers suggestions for substitutions and modifications. There are also tips for menu planning. The last thirty pages lists support organizations as well as products, manufacturers and distributors of products that make life easier for living with swallowing problems.

 o   This book was written in 2010, therefore it does not list many of the, new or improved products, new suppliers and support groups that have been developed in the last four years and there are many.

  •  “Down Easy: A cookbook for those with swallowing difficulties” by Judy Best. This book is especially helpful for someone recovering from cancer. The author, Judy Best, a graduate of a Le Cordon Bleu cooking school, was inspired to write this book as her husband was recovering from throat cancer.  If you want to learn to eat again after you’ve been on a feeding tube, this book offers great tips. The recipes are simple, easy to follow, use whole foods and natural ingredients.  Each recipe also has a complete nutritional breakdown and addresses whether it is gluten-free. This cookbook would appeal to someone who is transitioning to “regular” foods.

o    The author has assigned her own “Down Easy Swallowing Levels”, so the recipes don’t follow the standards set by the National Dysphagia Diet. If you have been given a care-plan for the National Dysphagia Diet, it may be a bit confusing if/how you use the recipes.

  • The “Easy-to-Swallow, Easy-to-Chew Cookbook” by Donna L. Weihofen, R.D., M.S, JoAnne Robbins, Ph.D., CCC-SLP, and Paula A. Sullivan, M.S., CCC-SLP. Part one of the cookbook covers information about how we swallow, and gives tips for managing some of the conditions that occur with swallowing problems. Part two contains approximately 150 recipes that will appeal to someone who enjoys the basic American diet. Each recipe includes a complete nutritional breakdown. This book is written for someone who is on a “Mechanical Soft” diet or who just needs foods that are easy to chew. It doesn’t completely address purees and how to modify each recipe for a “Puree” diet.

o    Written about the same time the National Dysphagia Diet was developed, it does not use the same terminology.  This book was published in 2002, so it can be a bit hard to find.

  •  “The Dysphagia Cookbook” by Elayne Achilles, Ed.D.  In this cookbook, most of the recipes are written for someone who can eat soft foods.  The author offers good advice on how to stock your refrigerator and pantry with foods that are easy to prepare and eat. The book also offers tips for traveling and eating out. The approximately 150 recipes will appeal to a wide variety of people.

 o   The recipes do not use the standards set by the National Dysphagia Diet, so you may need to read carefully and adjust the final dish.  This book does not include nutritional breakdowns of the recipes.

 


Cookbook Review – Part 1

As a teacher and trainer of the National Dysphagia Diet, I am always looking for ways to help my clients eat better.

My goal is to see people enjoy the foods and beverages that they can eat and drink. I like to stay up-to-date on research and publications, so I decided to take a look at some of the cookbooks that were written specifically for people who are living with swallowing disorders.

First, a disclaimer: I am a passionate cookbook reader and collector! I currently have more than 100 cookbooks in my collection. I subscribe to every food magazine that is currently published and I can’t seem to part with my 20 year collection of the now defunct “Gourmet” magazine. If you called me a “food-wonk”, you would not be far off!

I chose to review the  four best-selling “Dysphagia Cookbooks” on Amazon:

  • “Soft Foods for Easier Eating Cookbook” by Sandra Woodruff, R.D. and Leah Gilbert-Henderson, Ph.D.
  •  “Down Easy: A cookbook for those with swallowing difficulties” by Judy Best
  • “Easy-to-Swallow, Easy-to-Chew Cookbook” by Donna L. Weihofen,, R.D., M.S, JoAnne Robbins, Ph.D., CCC-SLP, and Paula A. Sullivan, M.S., CCC-SLP
  •  “The Dysphagia Cookbook” by Elayne Achilles, Ed.D.

Each is well written and insightful but there are specifics that are unique to each book.

As I read through and tested the recipes in each of these cookbooks I came to realize that each is a “labor of love” for the author. If you purchase one of these books, I encourage you to read the forewords and acknowledgements as you will find something of value in each.

In my next blog, I’ll go into detail on the pros and cons of each book.

If you can’t wait until my next blog post, please contact me at Laura@dysphagiasupplies.com and I’ll email you the full review.

 

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