My husband has PSP (Parkinson derivative) and can now only eat pureed food. Any advice?

"Picture a plate with deep orange carrots, creamy mashed potatoes and gravy, bright green beans and moist chicken blended with broth or gravy, all well seasoned. That doesn't seem so bad after all, does it?"

OMG, yes! It sounds absolutely horrid. Babyfood, colorful or not, does not sound appetizing at all. Not to this foodie! Could I get myself adjusted to eat it? Maybe, depending on what the risks and alternatives are. I'm just pointing out that for SOME people, the thought of never eating a pancake or a burrito or a sub-sandwich, or spaghetti again, is extremely depressing. Certainly not everyone falls into this category, but some people really do take their food very seriously, and texture counts a lot.

My husband was told twice in the 10 year period he had LBD that he should have a feeding tube. Since that was out of the question, the next recommendation was a soft diet with pureed foods. He gave it a sincere try both times. The first time he lasted about 6 weeks before he finally said to me, "I am so sorry but I just can't live this way any longer. I will risk choking or aspirating before I will eat blended spaghetti again." I watched him get more and more depressed and I agreed with his decision. He understood the risks and could make up his own mind about taking them. The second time was a few years later. I watched his swallow test and understood perfectly why the speech pathologist recommended pureed food. Again we discussed it and my husband was willing to try it again. He struggled as before. I discussed it with his Geriatrician and his Neurologist (who had ordered the swallow test). They both said, "Let him eat whatever he wants to!" The Neurologist said he only intended to find out if there were some things hubby could do to make swallowing less risky. (There were a few things, including double swallowing each bite.) So that attempt didn't last 2 weeks.

Please, Daffodil, I am NOT trying to talk you out of following the diet! And if your husband is not a "food is a major source of pleasure in my life" kind of person, he may adapt to it just fine. And I recommend at least giving it a serious try for a reasonable period. I'm just acknowledging that for SOME people it is more than a matter of buying a good blender. It is about presentation and smell and options and balancing risk vs pleasure and having control. The road ahead of you may be as smooth as creamy mashed potatoes or it may have lumps and bumps. Some suggestions (but remember, I'm a caregiver who failed at getting her loved one to stick to the diet, so take these with a grain or two of salt.)
1) cwillie's suggestion about arranging colorful food attractively is a good one! We all eat with our eyes first. Even take some care in selecting the right plate and placemat. The meal should look good.
2) if he needs thickened liquids, try it in every kind of liquid he likes -- here's a hint: beer foams like crazy when you add the thickener. (Hubby claimed it tasted OK, though.)
3) take advantage of things he likes that fit the diet with very little modification. Mashed potatoes may be more acceptable than pureed green beans. Obviously this is a matter of preference and tastes, but if your sweety likes pureed squash, serve it every day of the week! If he loves cream of rice, make it part of dinner!
4) again, a matter of preference, but my husband found a "cream of chicken soup" more acceptable than a lump of pureed chicken on his plate. In fact even when he wasn't following the diet I would sometimes see him struggling with a soup he loved and I would offer to make it a "cream" soup and use an immersion blender on it. Cream soup is a "normal adult food" -- pureed chicken is toddler food (in some people's minds.)
5) Keep in mind that raw vegetables do not puree. Raw carrots? No. Cooked carrots (preferably over-cooked carrots)? Yes.

Be clear about what risks you are trying to avoid. Know that a person with swallowing problems can aspirate his own saliva and that is full of organisms that don't belong in the lungs.There is no way to eliminate all risks. This diet is an attempt to minimize the risks.

I knew that my husband's disease (LBD) was fatal and that he was most likely going to die of it. I knew that eating a good, healthy diet was not going to change the course of the disease. I knew that changing the texture of his food was not going to cure him. I was really committed to maintaining the quality of his life as long as I could. Having that focus, and very supportive medical personnel, helped me through some hard decisions.

My heart goes out to you, Daffodil. I hope your dear husband adapts easily to this new way of eating. I hope you learn some new tricks that even you will like!

Are you able to puree the foods yourself, or do you need an aide to help you? Don't be afraid to ask for help, talk to his MD about what home care orders can be written to help you. If your healthcare insurance has a helpline, make use of it, maximize your benefits. If he is a wartime veteran, ask the VA for help.

If you get a good blender, you can puree just about anything, depending on what your husband likes. You can make things like mashed potatoes, cooked squash, beans mashed up, fruits cooked and mashed up, like applesauce or pears. Another easier idea is to buy baby food and things like puddings, and yogurt. You could also make soups and get an immersion blender and blend them in the pan you cook the soup in.

Is the reason he's only allowed pureed foods is he's liable to choke on regular foods? I don't know much about PSP.

I agree with blanne, just about anything can be pureed, and it doesn't have to be bland mush!! Picture a plate with deep orange carrots, creamy mashed potatoes and gravy, bright green beans and moist chicken blended with broth or gravy, all well seasoned. That doesn't seem so bad after all, does it? And lots of regular foods have a smooth, soft texture, so featuring those and including them on your own plate can make meals seem more normal for both of you.
You might also try checking with your local meals on wheels program as they may offer some pureed options.

Some dysphagia foods are presented in the shapes of the food just for visual appeal - e.g. pureed carrot shaped into a carrot shape. I personally recommend against pureed catfish, which I saw them *try* to serve to some of my patients here. There are prepackaged and home-style ways to try. Try culinaryservicesgroup/tastefully-textured-a-puree-food-program-2/

My grandmother cooked homemade baby food for my nephew. It was actually good. Any bean soups, can be seasoned to taste (low sodium if needed, bit spicy if desireable), beans are a great source of protein, but if you like meat, you can add ham, chorizo, sausage, chicken and purree in a good blender. You can even use a juicer like Nutribullet.

If you are interested I can round up some recipes. It sounds complicated, but you cook in a big pot and freeze leftovers in single serve ziplocs, after the first three days of cooking, you will have the next week off from cooking! A grain based diet can be tasty, cheap and healthy, so you may want to have the same (I would skip the purree part)

Speaking of juicing - endless recipes with veggies and fruit. If he needs a thicker puree like consistency, you can add liquid thickener (buy at pharmacy). Again, juicing has great health benefits for both of you.

Thanks to everyone for their good suggestions. I have a food processor and I'll buy an immersion blender. I've been trying different things and will practice new ones. It's a process (no pun intended). Appreciate all your help.