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This is really just a whine I need to get off my chest. Mom is on a pureed diet... I'm over the despair about the texture but am still feeling angst about the actual food that is served. No matter what is on the menu in the end what is served will invariably be a daub of pureed meat, mashed potatoes , a vegetable, and the ubiquitous "bread pudding" that is part of every meal. Oriental beef stir fry with rice and pineapple becomes pureed beef, mashed potato and mystery veg, no pineapple in sight. Bbq pork ribs with sweet potato fries and mixed veg? Pureed pork, regular mashed potatoes and a mystery veg (this one was bright mustard yellow but tasted of something cruciferous, any ideas?). No, there was no bbq sauce available on the side, I asked. In my recent discussion with the dietary director she was proud of the fact that they didn't smother everything in sauces and gravy, and while I agree that constant over use is a bad thing I couldn't get her to see that judicious, appropriate use is the thing that takes a meal to the next level. Yes, to extra barbecue sauce! Gravy when appropriate. Cheese or butter sauce for the veg! Pickles, mustard, ketchup relishes, chutneys, hot sauce, herbs and spices....

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GA, infant cereal, the stuff you mix up for babies, not the stuff on the cereal aisle. Rice or barley infant cereal can add bulk to thin sauces, soups or desserts without changing the flavour.

Have you ever pureed a salad? I would have though it impossible until I saw it done, the greens can be thickened and the dressing and any extras drizzled across. The cold lunch plates at the NH are actually some of the most appealing in colour, flavour and texture.
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Garden, wish you ran the facilities we've had in Texas.
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Cwillie, you've given me some ideas. I've noticed too that similar colored food is bland. I try to put the green vegetables between the bland ones to provide some color, but now I'm going to puree some separately, and either drizzle them on the bland ones or make designs, such as we used to do when we were kids when we had pancakes on Sunday morning.

I'm thinking a broccoli fern, or a cranberry rose, on something pale might be a nice treat. I liked the idea of cranberry relish as well; it's packed with nutrients. Somewhere I have the recipe for the delicious Trader Joe's cranberry relish that I think we discussed somewhere else here.

I do have some Thik-It for anything too liquidy. Good suggestions. What children's cereal do you use specifically? I don't pay any attention to kids' food, but most cereals I've seen are loaded with sugar and some have BHA and BHT.

GuestShop and HugeMom, in our area the hospital we use regularly and the rehab facility fortunately less frequently have a different approach than the standard bland food. The hospital has an a la carte menu, with heart healthy items designated. Each patient orders from that menu, calls in the order, and it's delivered individually within about 1/2 hour.

No more large carts with standardized meals are rolled around the floors. I've seen that kind of food; it's bland, dull, boring, and unappetizing. Blah.

The rehab facility is similar, but there's a standard offering daily but an a la cart menu for those who don't want that menu. Orders are personally taken and delivered by aides. And the meals are good. Dad gained 6 pounds while there, and that's good b/c he's almost down to 100 pounds now.

In both places, limitations are charted by nurses on the floors and read by the cafeteria staff before preparing orders. When I asked for one food which I don't remember now, the cafeteria "waitress" said one of the doctors had banned that food for me. I don't remember what it was.

Dad and I both loved the food! It was so good that the last time I was in the hospital I kind of dawdled on my departure so I could get an extra free meal to eat before I left. At the rehab facility, I frequently ordered the Chef's Salads and packed them in carry-out boxes to take home. They were as good as the famous Hudson's Chef Salads, and more reasonable than restaurants.

Coffee was good too; so I always had a nice cup with hazelnut crème while I was visiting.

I think this move to an on site chef and tailored meals is wonderful; it makes a real difference in a critical part of healing.

One of the other benefits of this rehab facility was a plan for 2 free meals for a family member or guest.
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Me too MsMadge.
Sometimes I fantasize about donning my SuperWoman cape and flinging mom in the car for a trip through the dive through..... KFC popcorn chicken? McD's smoothies or a hot fudge sundae? Timmies chili and a double double with a sour cream glazed donut? (Yeah, we loved our fast food outings)
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Cwillie
JG is spot on - you are making a huge difference in your mom's world

I think of mom's last roomie who didn't have family and shudder to think of her situation now

Last night a nurse at hoca whom I don't get to interact much with chatted about her disappointment on many fronts but food in particular for the residents

I wish I could take mom out for a big breakfast which was always her favorite meal
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Cwillie, I know what you mean about wanting to make a difference. After all, I went to the DON with my request to reduce drooling. I think my mother wouldn't even have noticed if her drooling stopped. But I'm sure she would notice if I dropped off the earth. She may not have been able to articulate what was bothering her, but she would be bothered.

Cwillie, just being you and being there for her is doing something for your mother. Even if you can't fix everything (or anything) in her environment, being part of it is important to her, even if she isn't consciously aware of it.
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Nursing homes and hospitals seem to be notorious for lousy food. My husband was only in one hospital where the food was actually good and thought was given to the preparation. During his four months in rehab, I tried to have lunch or dinner with him 2 or 3 times a week. We often joked about the "mystery meat" they served. I started bringing him fast food once in a while and sometimes food from home. He was hardly starved, but the food was unappetizing for sure. My mom's NH was just a little better. An aide told me once that it depended which cook was in the kitchen. I actually asked for her recipe for crab cakes once! My mom was on a semi-puréed diet too. She often called it her "abc" diet--already been chewed. She didn't complain much about the food and I think it bothers us more than them. I find myself wondering if those photos of gourmet meals they post on the facility websites actually exist. I would make it up to Mom and Hubs by bringing in sweet treats and things like that. They both really enjoyed them.
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CW, it's easy to forget that nursing home food is institutional food. Like hospital or most public school food. Especially in non-profit or Medicaid or charitably run facilities (like Catholic or Good Samaritan/Lutheran). They are trying to make dollars go the farthest, feed the largest swathe and range of tastes and physical impairments and needs for the lowest dollar per body. It's not set up to be attractive. They don't serve flavored applesauce at my MIL's facility because the dyes or fruit in them may be an allergen for some individuals. With turnover, you can't be sure a food allergy will be caught in time for your loved one. Or if it's severe, that food made in the same kitchen won't set your loved one off. Walnuts in brownies brought by a family member caused MIL real issues, and it was just in her room (well, that was her story). The sad truth is that most of our family members that end up in nursing homes will not eat as attractive, tasty or special foods to suit their palate as they did with us. The people I saw at MIL's facility eating the most tasty food were eating stuff that family brought in to supplement or replace what was on table. My bag lunch at school was the source of my special snacks, not the institutional lunch line with the net haired ladies...
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When my mother was in AL, we ate lunch with her a few times and thought the food was horrible. Meat was thin slices and tough(Mom couldn't cut or chew it so didn't eat it), veggies overcooked, etc. And the AL was expensive, exclusive! Mom was mostly anorexic and barely ate anyway. We told them over and over, but no matter how many times, they didn't cater to her eating quirks and served her what they served everyone else. They didn't watch to see if she was eating, and didn't always make sure she was there for at least 2 meals (as she NEVER came down for breakfast) She didn't know enough to go to the window and ask for something during the day or have a meal served in her room.  That was a good option they offered but with mild dementia she couldn't process that - and had they observed her and listened to us they would have taken the initiative as we were paying for that care and observation.   I ended up stocking her fridge with Ensure and yogurt and puddings, a few bananas, canned fruit,  so she at least ate something.
When she weakened and fell and went to the NH, the dietician interviewed us to find out her preferences. I was pleased to see that her meat, well flavored and moist was cut up or shredded so she could eat it. She was offered a huge variety of different things every meal. One aide made sure she had her "tea and cookies" in the afternoon.  Bless her!.  I ate some of her meal several times and it was really really good! (The sad thing is, with anorexia, the more food offered at a time, the more it scared her) Mom lived only 5 months there but, I could see how difficult it was for the nutritionist to cater to so many different tastes and conditions.  Our family felt that everyone in the NH gave her the best of care and did everything they could to get her to eat.
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Hm, your post resonates with me JG. I think I am grasping at straws looking for some way to still feel part of mom's life and to try to influence things I perceive as an improvement to mom's QOL, the reality is that I could probably fall off the face of the earth and it would cause barely a ripple.
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I'm going to wander a bit, cwillie, but I'll come back.

My husband drooled at lot during his dementia. It got particularly bad in the final year or so. It bothered him. A lot. He always had a "spit bowl" with him and he single-handedly kept Puffs in business. His hospice nurse offered an idea that greatly reduced the drool. That was good.

My mother began to drool a lot. I went to the head of nursing and asked if we could try the hospice nurse's suggestion on Mother. She asked me if my mother complained about it? No, in fact she doesn't even seem to notice. Ah. Well then the NH policy was to avoid drugs, medications, OTC remedies that did not serve to improve the daily life of the resident. Drooling was just a cosmetic problem unless it bothered the resident.

Hmmm . I liked that approach. Basically don't try to fix it if your loved one doesn't think it is broke. Drooling felt "broke" to my husband. It wasn't a problem for Mom at all. Different approaches for different situations.

I would hate, hate, hate the menu you are describing. If any of my loved ones could improve it for me I would be grateful. But it sounds like this isn't a big issue for your mother. She finds the food tasty. She doesn't care what it looks like. Cwillie, lots of things are broke in your mother's life. If it aint broke in her eyes, maybe you should not try to fix it.
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I don't miss the shape of food on a pureed diet it is the taste that matters to me. Pureed cardiac diet is my idea of gourmet h*ll. I can eat real food in addition to tube feeding and do sometimes puree regular food as that makes it quicker to eat before it gets cold. Imagine cream of wheat made with hot water and nothing on it!!!!!!!!!!!! And they wondered why i did not eat my breakfast.
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Some of the NH cooks are really good at making the food look attractive GA. Considering colour is simple but so often overlooked, a plate of chicken breast, mashed potato and cauliflower is a big turn off (even when it isn't pureed), but changing the cauliflower to broccoli, adding a dab of cranberry sauce and perhaps a swirl of brow gravy makes essentially the same meal instantly more appealing.
Stews, soups and chili were always favourites for us, even when blended smooth. Those little snack tubs of applesauce are great, the flavoured ones can add a pop of colour too. For some reason the NH only offers plain applesauce though.

One tip, when you are pureeing fresh fruits or veggies that don't hold their shape or turn into fruit/veggie juice you can add a little of the commercial thickeners (I like the xanthan gum Thicken Up). I've also used infant cereal to help thicken some foods.
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Just thought of something else I've done to add "shape" to the food. My father's been a cookie dunker, whether it's gingersnaps or other cookies. But they're ver boten under his pureed diet.

So we tried dunking them in applesauce, which softens them enough and absorbs enough of the sugar crystals that it doesn't cause choking.

So, at last! Food with a shape!!
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Madge, something I noticed yesterday when pureeing Meals on Wheels beef stew is how easy it is to puree. I didn't have to add anything. So that opens up a whole new avenue of foods. My father likes soups, especially split pea and bean, so those are foods I can add.

I think soups offer a lot of possibilities, not in shape but in content.

MOW also has a "riblet", a boned spare rib which is easy to puree and complimented by cider. It's still shapeless but MOW adds rib sauce, so the aroma clearly indicates what the mush is beneath it.
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CWillie, one of Dad's speech pathologists suggested using gravy to flavor the food. I don't necessarily like salty foods, but at his age and with his weight loss I'm more flexible. I also use OJ and cider to puree complimentary foods, so there's at least some good taste.

I've been thinking about the holidays too, and think I might get some of those fancy molds. I've been wondering whether cookie molds could be used, but the puree is too soft to hold a shape. I do have some plastic molds that I used decades ago when I made candy, but the designs are quite small.

What I have found that seems to be a real game changer is pumpkin. Dad loves it. Thus far I've just bought the pies on sale, scooped out the pumpkin and puried it a little bit, then added a bit of French vanilla ice cream.

Interestingly enough, Dad loves the pumpkin and is eating more of it. Since it's a good fruit/vegetable (apparently nomenclature is still undecided), he gets A and C vitamins, but most importantly is that he loves it.

I've also found that he'll cough on ice cream alone, but not with pumpkin. So thoughts of pumpkin pie with French vanilla ice cream are an incentive to finish mushy meals.

He also adds unsweetened applesauce to meals. It's great - I don't even have to puree it!
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Good morning, thanks for all the comments!
Mom doesn't complain about anything, ever, but I do know what she used to enjoy. Mom can't see the food so the appearance is my own issue, and I know the flavour of the food is usually fine, it is the sameness that gets to me. As I look ahead to thanksgiving and christmas I envision another plate of pureed turkey, mashed potato and a mystery vegetable, your choice of pureed fruit or cake for dessert (pie once a week). Tasty enough, nutritious enough, just.... sad.
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My mom's nh used those molds ( made peas look like peas, etc) when she was on a pureed diet.
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Cwillie
Mom has been on a puréed diet since she came out of the hospital last month and she doesn't like it - and yes I've seen that bright yellow gunk
She usually eats her soup and her ice cream and some of the purée

The food at hoca is so inappropriate anyway - even staff won't eat it - and they wonder why residents get diarrhea after polish sausage at dinner

I leave a bunch of bananas on her nightstand so she gets one at breakfast and At least once a week I do get mom real food - turkey dinner but it's a slow process - little bites and she can't use her one arm much - she likes her treats from Starbucks too

At night I give her a little piece of Halloween candy to wash down the crushed Tylenol which is yucky tasting
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I think the critical thing here, cwillie, is what your mother's preferences and attitudes are. Does she complain about the food? Has she lost weight she can't afford to lose? How important is food to her in the scheme of things?
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First, my apologies for dual posts.

Second, NYDIL, I wasn't aware that herbs couldn't be used. That's interesting, and too bad b/c they're a lot safer than sauces and healthier. But I understand the justification.

I'm with you on cheese sauces; Meals on Wheels menus include these. Sometimes I just have to throw that food away b/c it's impossible to eke out all the melted cheese. I've also found that they use breading a lot.
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I for one hate sauces especially cheese sauces on vegetables! Does the nursing home have a registered dietician on staff or use one to plan the menu? I would ask who they use while recognizing that nursing homes are constrained from using salt, herbs, and spices due to blood pressure, allergies, and general preferences. Maybe bring your mom some condiments like chutney when you visit?
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CWillie, this is I think one of the hardest things about pureed food - making it appetizing and varying it. It does sound as if either the dietician or the chef isn't very innovative.

Do they serve Magic Cups? They're like the old Dixie cups; Dad loved them. Even if the meal wasn't visually appealing, those Magic Cups made plowing through the bland meals worthwhile.

I found them through Gordon Foods; I could buy a case for about $48. That's the smallest size sold. Imagine eating $48 worth of ice cream puddings!

One of the sites I found which addressed dysphagia diets sells molds in lovely shapes, for families that want to add a bit of art to the boring pureed meals. I don't think facilities would use those though.

Now that I'm getting the hang of all this, I'm starting to think of some ways to snazz up Dad's meals. I might put a sprig of parsley on something (he probably would eat it anyway), make some pancakes in the shape of animals as Mom and Dad did when we were kids.

This is a real culinary challenge. I wonder if the culinary schools ever consider that the drama they create in foods could benefit people on boring dysphagia diets.

I'm wondering about adding ground herbs; they'll at least add flavor, and they're healthful.
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CWillie, this is I think one of the hardest things about pureed food - making it appetizing and varying it. It does sound as if either the dietician or the chef isn't very innovative.

Do they serve Magic Cups? They're like the old Dixie cups; Dad loved them. Even if the meal wasn't visually appealing, those Magic Cups made plowing through the bland meals worthwhile.

I found them through Gordon Foods; I could buy a case for about $48. That's the smallest size sold. Imagine eating $48 worth of ice cream puddings!

One of the sites I found which addressed dysphagia diets sells molds in lovely shapes, for families that want to add a bit of art to the boring pureed meals. I don't think facilities would use those though.

Now that I'm getting the hang of all this, I'm starting to think of some ways to snazz up Dad's meals. I might put a sprig of parsley on something (he probably would eat it anyway), make some pancakes in the shape of animals as Mom and Dad did when we were kids.

This is a real culinary challenge. I wonder if the culinary schools ever consider that the drama they create in foods could benefit people on boring dysphagia diets.
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What does your mom think of the food?

My mom was also on varying level of chopped and pureed meals in the 4 years she was in the nh. At times she was on regular meals.

I never once heard her complain about the food!

And she complained plenty when she was in Independent Living! Overcooked string beans, waiters who didn't know the menu and on and on.
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