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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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

 


Want to make bread, cakes and baked goods safer for those with a swallowing problem? Watch this video!


2015 is the Year of the Caregiver

Recently, I worked with a 93 year-old male client who told me that he used to abide by “happy wife, happy life” but now that he has lost his wife after seventy years of marriage, he abides by “happy caregiver, happy life”.

So true: if the care-giver isn’t happy and healthy, then the cared-for can suffer.

Whether you are a family member taking care of a parent (or child) or a professional caregiver, it is vital that you stay healthy, strong and resourceful.

One key to staying healthy is to make time for physical activity. Notice I didn’t say “exercise”. Activities like working in the garden, walking through the neighborhood or the mall, or chasing your dog around the backyard, or dancing to your favorite music all qualify as physical activity. Physical activity not only burns calories and gets your blood flowing, helps you do your “mental laundry” and work-off stress. If you are caring for someone else, you are experiencing stress, whether you recognize it or not.

Another key to good health is eating foods that help you maintain your activity level and core health. The good news is that those foods that help you be you maximize your health are delicious, don’t take a whole lot of preparation and we readily available.

So what foods should you make sure to get onto your plate at each meal every day? Think color. Naturally colorful foods are full of antioxidants, vitamins and minerals. What foods are naturally colorful? Fruits and vegetables! Fortunately, most grocery store produce sections are stocked with packaged, cleaned lettuce mixes, and pre-cut fruits and vegetables. During the off-season, look beyond the produce department to the freezer section for frozen berries, pineapple and mango. Often, frozen fruits and vegetables have higher vitamin content than those found in the produce department because they are harvested and processed at the peak of ripeness, preserving the nutrients.

Managing stress is another key component to staying healthy. Exercising that part of you that clears your mind and frees you from the everyday toil will help dissipate stress. What is it that you love to do? Make time for it. Spend unstructured time with friends. See a movie. Clean-out a drawer. Play cards with your pals. Walk nine holes. Make time for rest and re-creation.

Don’t let your sleep suffer. Turn-off the television, the iPad, computer or whatever screen you are hooked on, at least an hour before bedtime. The human brain needs an hour to recover from the screen before it can shut-off for a sound sleep. Physical activity early in the day can help you sleep soundly. A leisurely walk after dinner can be relaxing. Avoid alcohol right before bedtime. A drink may help you get to sleep but it can make it difficult to get back to sleep if you are awakened in the night.

Humans need to touch and be touched so find a way to use your hands for pleasure. Pet an animal. Knit, crochet or do some form of needlework. Visit a fabric store and caress the beautiful, colorful, textural fabrics. Or pamper yourself and have your hair shampooed and blown dry. Get a pedicure. Be in the moment and find a way to enjoy the feel of the textures around you.

It is just important to stay connected with your friends and community. It is all too easy to get caught-up in the role of caregiver and forget about maintaining your friendships. When you maintain your friendships, you are taking time to maintain yourself.

Every time I speak with a client or caregiver, I ask them what they did for themselves that day. Often, the first time I ask the response is “nothing” but after we talk about how important it is that they take care of themselves, the next time I ask they usually have something to share.

Take time for yourself so you can better take care of others.

M, D, L 2006 cropped


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.


Braised Red Cabbage and Family Ties

With the change of weather and cooler temperatures, I’ve been craving braised red cabbage, something I don’t normally eat. But I don’t want just cabbage. I want potato pancakes made from shredded potatoes, or “rosti” which are Swiss hash browns and meat. Gotta’ have some sort of pork seasoned simply with salt and pepper; the darker the meat, the better.

I don’t normally eat this way. All summer, I live on salads and vegetable-based meals combined with some grilled meats and maybe some grilled fish. But for the last couple of weeks, I’ve wanted cabbage, potatoes and pork; German comfort food.

I think my craving may just have something to do with the genealogy my sister, Renda, has been doing.  Recently, she traced the maternal side of our family back to our great-great-great-great grandmother Catharine Brodbeck, who emigrated from Baden, which is in southwestern Germany, through the city of Breman, to the US in 1854. Catharine traveled with her nine (!) children on a small ship, landing in New York on the day after Christmas in 1854. She then traveled to Ohio to join her husband, the father of her children. Catharine had a total of 14 children but the nine she traveled with ranged in ages from seventeen to as young as four years-old.

When I think of the kind of woman great-great-great-great grandma Catherine must have been, I’m in awe. She traveled half way around the globe, without her husband, with nine children in tow. When she climbed aboard that ship, she’d left behind her home and her extended family. Like so many immigrants, she and her children left their homeland to escape war and economic hardship. Baden is on the banks of the Rhine River, an area that has seen struggle and conflict for centuries.

Once aboard that small ship, what was daily life like for Catharine and her children? How she they feed everyone?  What did they eat? I can’t imagine traveling for weeks and weeks with nine hungry, growing children.

And when they arrived in the US, how did the family travel the 540+ miles overland between New York and Ohio?  How long did that trip take? How did she feed everyone then? She and her children made this journey a century before the interstate highway system, with its convenient rest stops and exits for food and restroom breaks. Cars wouldn’t become commonplace for another six decades. What drive, determination and optimism they must have had to have completed just that part of the journey!

So, last night when I made a dinner of braised red cabbage with rosti and grilled country-style pork chops for my family, I thought of her. These foods I’ve been craving are traditionally German. Did Catharine feed her family these foods, as well? Is she why I crave them?  As I looked across the dinner table at my nine year-old son, I thought about Catharine. I could feel her presence so I told my son her story, which is his story, too.

Sharing and eating goes far beyond nourishing the body, it also touches the soul and honors the past. Braised red cabbage = family ties for me.

 Spicy red cabbage stewed with apples

 

Braised Red Cabbage

2 tablespoons butter

1 medium head of red cabbage, quartered, cored and cut into ¼ inch strips

1 tart green apple, skin-on, quartered, cored and cut into ¼ inch slices

¼ cup apple cider vinegar

¼ cup water

3 tablespoons granulated sugar

2 teaspoons salt

¼ teaspoon ground black pepper

¼ teaspoon ground cinnamon

In a heavy large skillet or Dutch oven, melt butter over medium heat.  Add the cabbage and apple and toss until all is coated with butter and begins to melt. Add the vinegar, water, sugar, salt, pepper and cinnamon and mix thoroughly. Reduce the heat to a bare simmer, cover and cook for about one and a half hours, stirring occasionally and adding more water, as needed, to prevent sticking.

This dish is even better the second day!

For a mechanical soft diet: no modifications.

If you are on a puree eating plan:

In a mini food processor, pulse ½ cup braised red cabbage with 2 tablespoons water. Once finely chopped, add ½ teaspoon instant food thickener and process until completely combine. It should have the texture of firm mashed potatoes.

Yield: 6 servings

97 calories. 3 gm fat, 17 gm carbohydrate, 4 gm dietary fiber, 3 gm protein. 800 mg sodium. 44% Vitamin C. 181% Vitamin A.


Gardening is in My Blood.

To my father, food was love. Dad was a “Great Depression” baby and spent his childhood during a time when food and resources were scarce. When he was a child, there was no school lunch program. The SNAP program didn’t exist. Families grew much of their own food in their yards and, as World War II approached, lived on ration coupons. Owning urban chickens may seem like a trendy thing to do in 2014, but during my father’s childhood, it was a necessity.

Dad’s mother, Louise, was a single, working mother during a time when being a single mother or working mother was not nearly as common as it is today. “Grandma Weezee”, as we called her, was a passionate gardener and a fabulous cook. Her pies are legendary in the family lore and vivid in my memory. One bite of strawberry-rhubarb pie with vanilla ice cream and I am six years old again, sitting on the top platform of a step-stool, eating with my family at her Sunday dinner table.

Dad inherited his mom’s gene for gardening. Dad worked in an office, but the garden was in his blood. For almost four decades, he had a 12’ x 12’ plot in the neighborhood community garden at the bottom of the hill. While the other dads in my neighborhood were playing tennis and golf or having a cocktail with their buddies after work, my dad was in the garden. The community garden had its own social network, but the real reason my dad was there was to feel the dirt in his hands, work the soil and watch nature take over after everything was planted.

From late spring until the hard frost of fall, dad would be getting his hands dirty after work and most of our meals contained what he grew. The idea of not eating your vegetables was insane! “Dad grew that.” was a sentence I heard over and over. From the fresh peas of early spring, to the lettuces of early summer, the tomatoes of August and winter squash of autumn and everything in between, we feasted.

Looking back, it is amazing to me the sheer amount and variety of vegetables my dad grew on 144 square feet of Earth. We shared our bounty with our neighbors and friends, often overwhelming them with produce. To this day, my mom can make zucchini in about 426 different ways, including five variations on zucchini bread alone!

But I never liked being in the garden. There were bugs. It was dirty and smelled of compost and soil. I HATED weeding, so I avoided working in the garden for much of my childhood. When I graduate college and moved to the desert southwest, I bought my vegetables and fruits in the grocery store like civilized people do. My love for produce (and pie!) is deeply ingrained, but store-bought vegetables and fruit just don’t taste the same. Produce from the farmer’s market is an upgrade and those from a CSA (community supported agriculture) are better still, but they are still not the same. There is something ethereal about eating lettuce (or anything else) that was in the ground, breathing, just minutes before it hit my plate.

The autumn after Dad died, I was hit with the urge to put in a vegetable garden. Truthfully, what I felt was more than an urge, it was a compulsion. It was a herculean task to remove a 50 year-old prickly pear cactus that occupied the perfect corner of our yard for growing vegetables, so I enlisted my husband and his brothers to make it happen. Desert soil is nothing like mid-western soil so we had to amend and amend the sandy clay to give the seeds a fighting chance. It didn’t matter: I was driven like never before.

My first vegetable garden was a success in more ways than one. I was able to feed my husband, son and neighbors the fruits (and vegetables) of my labors but, more importantly, I felt closer to my dad and his mother than I ever had in the past. I discovered that I, too, have the gene for gardening. It was long dormant but I share it.

This year marks my fifth year vegetable gardening which means that it’s been five years since we lost Dad. My 2014 garden is shaping-up nicely. This year, I planted Tuscan kale, heirloom rainbow beets, red carrots, mixed lettuces, scallions, tomatoes, and a variety of herbs. Dad never grew Tuscan kale, but I know he’d love it in the minestrone I’ll make when my husband has declared that he is tired of eating kale salad and kale chips.

Working in the garden helps me remember my dad in his best, most vital time, not in his final years when dementia overtook him. Now, if I could just make a pie like Grandma Weezee’s…

tillerman tomato jungle


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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Nourishing Independence with Mom’s Meals

Recently, I worked with a client who had just returned home after six weeks in hospital and rehab. “Irene” had been a vital, active 78 year-old woman before her stroke. More than anything, Irene and her husband “Bob” want to get their lives back to normal.

Since Irene has arrived home, Bob has been working overtime managing all of the activities that come with recovery from stroke including: scheduling doctor’s appointments then going to the appointments, ordering and receiving a hospital bed and wheel chair, juggling therapy visits, picking-up prescriptions, making the house wheel chair friendly and opening all the mail that accumulates while you are occupied away from home, just to name a few.

Bob asked me to help him learn how to cook for and feed Irene. Before the stroke, cooking was Irene’s job in the family but Bob will do anything it takes to care for his wife, including learning how to cook at 78 years-old! Being a bit overwhelmed, Bob has no time to cook for himself, let alone cook and then puree meals for Irene. I’m glad that there are foods like Mom’s Meals – Purees to recommend to him.

Mom’s Meals is an online supplier fresh-cooked, ready-made refrigerated pureed meals. Each meal has a main dish, vegetable and dessert. Their menu consists of comfort foods like:

  • Scrambled Eggs with Brown Sugar Pork Loin Bacon, Bread and Applesauce
  • Roast Beef with Gravy, Mashed Potatoes, Brown Sugar Glazed Carrots, Vanilla Pudding and Applesauce
  • Pork with BBQ Sauce, Cheese Mashed Potatoes, Green Beans, Fruit and Chocolate Pudding
  • Roasted White-meat Chicken with Gravy, Mashed Potatoes, Green Beans and Carrots, Fruit and Vanilla Pudding
  • Pasta with Marinara Sauce and Broccoli, Blueberry Applesauce and Pudding

You order online (or by phone) and Mom’s Meals ships directly to your home. The meals have a 14 day shelf life and are easily reheated in the microwave.

I sampled four meals and I found them delicious and hearty. At between 600 and 700 calories per meal, they are ideal for helping to rebuild your strength. With four breakfast menus and eight lunch/dinner choices, you have some ability to eat a variety of foods. If you like home-cooking, Mom’s Meals purees will appeal to you, as they did to Irene and Bob.

Each full puree meal is $7.49 plus shipping. Shipping is $14.95 regardless of the size of your order.

And if you are too busy to cook, like Bob, check-out their regular meals, as well!

To order from Mom’s Meals purees visit their website: http://www.momsmeals.com/independent-at-home/pureed-menu/.

If you need advice, please contact me: laura@dysphagiasupplies.com or 480-266-5622.

moms meals