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Redesigning Texture Modified Foods to Bring Back the Joy of Eating

Research Priority: Optimising Health and Wellbeing
Researchers: Dr Liz Cyarto, Dr Judy Lowthian, Dr Marissa Dickins, Dr Angela Joe
Partners: Ms Caroline Lucas, Bolton Clarke; Dr Cherie Hugo, My Nutrition Clinic; Ms Bernadette Dutton, Loqui Speech Pathology; Ms Cathie Watt, Flavour Creations
Study setting: Residential Aged Care
Funding support: Dr and Mrs J Luddy Charitable Trust; Bolton Clarke

Many aged care residents have dysphagia. For residents on a texture modified diet, the meal experience can be one of disinterest, unhappiness and frustration because the food is presented as scoops of food that do not resemble the food they contain. This puts residents at greater risk of malnutrition due to loss of appetite, depressed mood, and weight loss.

Bolton Clarke’s Food Services team has been changing the way texture modified meals are prepared and presented. Custom-made silicon moulds are being used to shape foods to look like their original form. For example, minced/pureed chicken is moulded to form the shape of a drumstick.

Three care homes in metropolitan Brisbane participated in a research project on the transition from ‘scoops’ to moulds. While all residents in these care homes received the new moulded meals, 26 residents and some of their family members, Personal Care Workers (PCW) and catering teams assisted with a nine-month evaluation of the implementation of the new meals. The aim of the project was to determine the impact of the moulded TM meals on the health and wellbeing of residents. We also surveyed and interviewed family members and staff before and after the introduction of moulded foods.

Data analysis is underway, however we can share anecdotal evidence based on our mealtime observations and conversations with family members and staff from the care and catering teams. At one community, a resident who had been eating her meals with a spoon, asked for a knife and fork when the fish she usually ate for lunch on a Friday was presented as a fillet. Family members commented that the moulded meals looked more appetising.

Prior to implementing the moulded meals, catering and care staff felt reluctant to serve residents scoops of meat and vegetables. After the switch to moulded meals, staff felt a greater sense of pride in their work. PCWs told us that they could now distinguish between beans and broccoli! Staff members who said they would never consider eating the “scoops” of minced or pureed foods had changed their mind when they saw the same foods presented in moulded form.

We are taking the learnings from this first phase and are preparing to roll out the next stage of TM moulded foods to three more homes. Two changes will be made. Firstly, kitchen staff told us that it requires extra time and knowledge to achieve the desired result with the moulded food. To address this, the moulds will be produced at the Central Production Unit kitchen and distributed to the homes with regular deliveries. Secondly, we will enhance the mealtime experience for residents. Prior to implementing the moulded meals, we will provide training for the PCWs and nurses on how to present these meals to the residents they are supporting. The training will incorporate a video that was specifically developed for the project by Bolton Clarke’s Clinical Learning team.

BCRI will continue to assist the General Manager of Hotel Services to evaluate this next stage as we strive to bring back the joy of eating for our residents on texture modified diets.