As our residents age, they experience changes in their physical and mental abilities which may require alterations in the consistency of their diet. Dysphagia affects anywhere from 35 to 60 percent of elderly people living in long term care facilities. It is important as health care providers to ensure that even though the consistency changes that the variety and taste of foods do not change. Unless there are other diet restrictions in place, pureed foods should be prepared with the same ingredients as the general facility menu. It is essential that all food groups are included on a pureed diet to provide a balanced diet with lots of variety.

Our aim in foodservice should be to provide nutritionally satisfying meals regardless of diet consistency or restrictions. It is of utmost importance that we ensure these foods are prepared in a safe matter to limit the chance of food borne illness. Using proper methods for serving and delivering texture modified foods is our part in maintaining and or improving the health of our residents. Below are some rules to follow when preparing pureed foods.

• Begin with a clean food processor.  Puree food of choice to a smooth consistency ensuring all lumps are gone.  If necessary to meet nutritional needs or create a desirable consistency, add hot milk, margarine, etc.  End product should resemble a mashed potato/pudding-like consistency that can stand on a plate without running.
• If not being utilized immediately, product should be cooled down to 41° F following HACCP guidelines. If using product immediately, reheat to hot foods to 165°F, hold hot foods >135°F and cold foods <41°F, and serve within an hour.
• In general, pureed foods can hold in a refrigerator below 41°F in a shallow pan for 24 hours.  It is recommended for best results that food is served within an hour of preparation.  Discard any leftover pureed items after meal service is complete.

If your facility pipes its pureed food or uses molds verses scooping it, here are a few rules of thumb to follow:

• When filling the pastry tube, ensure cold products are below 41°F and hot products are above 135°F.  Pipe three ounces (or per menu) of product.  Hot foods must remain >135°F and cold foods <41°F.
• If your facility freezes your piped portions to be served at a later time, freeze until the product is frozen solid.  When it is time to re-heat frozen product be sure to follow CCP guidelines for re-heating.  Discard any leftover pureed items after meal service is complete.