10 quick and easy dysphagia diet recipes (DailyCaring.com)

This is a good post on DailyCaring.com with ten quick and easy dysphagia diet recipes. The author is Jess McLean, who is a full-time caregiver for her mother. She blogs about caregiving at Givea.Care.

10 QUICK AND EASY DYSPHAGIA DIET RECIPES (FOR SWALLOWING PROBLEMS): 5 INGREDIENTS OR LESS
by Jess McLean with Givea.Care
Posted on DailyCaring.com, about May 17, 2018

Many seniors have difficulty swallowing food or liquids. This condition is called dysphagia and can cause serious issues like aspiration pneumonia, dehydration, or malnutrition. Jess McLean shares her 10 delicious and easy-to-make dysphagia diet recipes that will encourage your older adult to eat. Her mom, who has dysphagia, loves them! Plus, these good-for-you meals and desserts will keep your older adult safe, satisfied, and healthy.

Are you looking for fast, nutritious dysphagia meals for your older adult? When it comes to dealing swallowing problems, the task can seem challenging – from making just the right consistency of food to actually helping your older adult eat.

In my case, my mother has advanced stages of primary progressive MS as well as brain damage from years of seizures. Feeding her is a trial. She can rarely be fed with a spoon anymore, but reacts better to drinking everything out of bottles.

If I do spoon feed her, I have to trick her to open her mouth so I can get anything in; for example, I ask her to say “Hola!” and then she keeps her mouth open for a bite.

What makes a huge difference is when she eats something that is simply so delicious her brain says “Hello! Give me more!”

Over our time managing dysphagia, we’ve nailed down several recipes that are quick, don’t require artificial thickeners, are packed with nutrients, and best of all, are delicious! Here are 10 of our favorites.

10 easy recipes for a dysphagia diet: 5 ingredients or less

1. Coconut Mango Puree
This one is a true island treat and so easy! Blend ripe mango together with coconut milk or coconut cream out of a can – that’s it!

The sugar of the mango is more than enough sweetness to flavor this dessert and the subtle coconut in the background is just dreamy.

2. Acorn Squash Banana Milkshake
You heard that right – squash and bananas, say what?! Turns out acorn squash has just the right amount of sweet and nutty that it pairs perfectly with banana and vanilla ice cream.

I roast the acorn squash until tender and then let it cool before blending (peeling off the skin, of course)

3. Avo-cocoa Pudding
Now this one sounds out of this world, but trust me, it’s incredible!

A rather healthy take on chocolate pudding, all you need to do for this sweet treat is blend together a banana, ripe avocado, milk, and a teaspoon or two of cocoa powder (add honey for sweetness).

4. Savory Beet Puree
This delish dish will shock you with how vibrant and purple it is, but it simply can’t be ‘beet’!

Roast your beet until tender, chop it up into cubes, and blend with plain greek yogurt, a pinch of dried dill weed (or fresh dill), a dash of garlic powder, and veggie broth to thin out.

5. Strawberry Spinach Applesauce
That’s right, sneak in some dark leafy greens to make this applesauce even healthier!

Cook down sliced strawberries with a pinch of sugar, toss in loads of spinach to wilt, and then blend with enough applesauce to make it nice and smooth.

6. Tomato Basil Soup
Roast whole tomatoes (remove skins) and then simmer for 10 minutes with canned diced tomatoes (skinless), garlic, as much basil as you can stand, and a little cream.

Blend until creamy (add a dash of sugar if they prefer foods to be a little sweeter).

7. Green Goddess Puree
This take on a familiar dessert/dressing is wonderfully herby. Blend together an avocado, plain greek yogurt, drizzle of olive oil, dash of lemon juice, and all the leafy herbs you can get your hands on – basil, parsley, cilantro, mint – whatever you have in the kitchen.

8. Cheesecake Mousse
Ditch the blender and opt for the mixer on this one! In one bowl mix cream cheese and sugar together. In another whip cocoa and espresso powder with coconut milk (or half and half).

Combine with heavy cream (ok, this one has six ingredients!) and whip on high until it has a smooth mousse consistency.

9. Chia Seed Pudding
This one takes a little longer to set, but the omega-3-rich chia seeds are worth it!

Mix a good amount of chia seeds in coconut milk with a splash of vanilla and maple syrup and then let set in the fridge for about an hour to thicken. Blend and serve cold!

10. Monkey Nut Milkshake
Another banana milkshake but this time use coffee ice cream and add peanut butter. Blend with milk to get to preferred consistency and serve cold. This shake offers yummy flavors and a little caffeine to put some pep in your loved one’s step!

Thickness: you’re the best judge
You may be wondering why there are no measurements and no exact quantities. Because with dysphagia, it all comes down to your older adult’s individual needs.

What works for my mother might not work for your older adult. Plus, all blenders are different, and if you are managing dysphagia, you’ll have an eye for what is the right smoothness and thickness for your older adult.

When in doubt, always avoid adding too much liquid right away since it is always easier to thin something out than re-thicken it. I have found that water, broths, and milks (cow’s, almond, coconut, etc.) are the best for thinning out food as you blend it.

Safety note about ice cream
If you are a well-informed dysphagia caregiver, than you know ice cream on its own is a no-no because it can melt in the mouth and potentially cause your loved one to aspirate.

What I have found when ice cream is blended on high speed with other foods like in the “milkshakes” listed above, it thickens and transforms into a whipped consistency that is more like soft serve and is safe for someone with dysphagia to swallow.

Let your creativity flow!
If you don’t follow these recipes exactly, who cares! The hope is that it gives you some ideas and lets other caregivers see that feeding our loved ones with dysphagia whole, healthy foods doesn’t have to be hard. Happy cooking!

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Guest contributor: Jess McLean is a full-time caregiver for her Mom who has Primary Progressive MS and Epilepsy. Moonlighting as a freelance writer with a passion for cooking, Jess lives in Austin, TX with her wonderful husband and Mom. You can find her blogging about caregiving tips, ideas, and solutions at Givea.Care.

How can I alleviate fear in someone with dementia?

This article came to us by way of Nina Poletika, LMFT, a therapist in the San Francisco Bay Area who specializes in helping caregivers to those with dementia.  She adapted this article from Emma Hamilton’s “AgedCarer” website, which is no longer in existence.

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How Can I Alleviate Fear in Someone with Dementia?
Adapted from an article by Emma Hamilton, AgedCarer, October 2010

People with dementia often live in a permanent state of anxiety and fear.  This can be very upsetting, not only for the person who has the disease but also for the people around them.  Imagine living in an unrecognizable world, where familiar items and faces gradually bring no comfort or meaning.

Many people with dementia can constantly search for a loved one that died many years ago or wander aimlessly in search of their home.  If you have visited a residential facility for those living with dementia, you would recognized the scared residents, the ones that continue to call out “help,” wander down the corridors or repeatedly ask what time their husband, wife, son or daughter are coming.

It can be difficult to know how to relate to a person with dementia.  Even if you were to explain to the person the reality of a situation, they will not be able to process this information correctly, will likely become upset, or will often forget.  A few minutes later they may ask you the same question again.

People living with dementia can have many fears including:

  • Being left alone
  • Strangers or intruders in their “home”
  • Anything new or different
  • Forgetting plans and appointments
  • Losing their independence
  • New environments and unfamiliar faces
  • Losing a loved one

Depending on the progression of the dementia, providing a person with a “reality check” about a situation is not useful.  Since a demented person’s ability to reason is impaired, telling the person that their mother died years ago will only heighten the person’s confusion and fear.  To them, it may be the first time they’ve heard the devastating news.  Clearly, honestly isn’t always the best policy.

Distracting a person without revealing the facts may be a more effective approach.  For instance, if a person believes their dead mother is coming to visit and insists on waiting for her, try going along with the scenario while suggesting that perhaps her mother may be late.  It can also be helpful to reassure the person by saying that you will make sure that the staff knows to come and get her as soon as her loved one arrives.

Remember a person’s fears are very real and not imagined.  Giving someone some acknowledgment that you know that they are upset, offering physical comfrot, and reassurance may allay their anxiety.

 

Daily caregiving balancing act – how much to help?

Brain & Life magazine (brainandlife.org) is published by the American Academy of Neurology.  In the most recent issue, they have a good article on caregiving.  Here’s an excerpt:

“As many caregivers know, offering just the right amount of help can be challenging and stressful for both sides, and requires time and communication. And even after striking the right balance, the needs of the person being cared for may change, requiring caregivers to recalibrate.”

Here’s a “caregiving rule” suggested by a nurse practitioner in the article:

“Dr. Resnick has what she calls a three-time rule: A caregiver allows a patient three tries at a task before stepping in. If the task is putting on a shirt, Dr. Resnick will do one step, perhaps helping the patient put on one sleeve, and then step back. If getting the button secured is the next challenge, she breaks down the action and allows the patient to try again. If the patient is truly not up to a task, Dr. Resnick suggests working together to accomplish it, for example, by placing a patient’s hands over your own as you perform an action.”

Here’s a link to the full article:

www.brainandlife.org/the-magazine/article/app/14/2/20/in-the-balance-knowing-how-much-to-help-is-a

In the Balance
Knowing how much to help is a daily challenge for many caregivers. Our expert advice can help you find that sweet spot.

by Natalie Pompilio
April/May 2018
Brain & Life

Using medical cannabis to treat PD – story of Frank De Blase

On May 9, a news station in Rochester, NY interviewed Frank De Blasé, a music writer, photographer and person with Parkinson’s. Frank says that Parkinson’s has hijacked his life causing him to think before he does anything — walking, talking, swallowing, even thinking!

Two physicians were also part of the news show — Frank’s movement disorder specialist, Dr. Michelle Burack, and the palliative care specialist who certified Frank to buy medical marijuana in the state of New York, Dr. Robert Horowitz. The interviews focus on the use of cannabis for Parkinson’s symptoms. In the end, Frank did not find cannabis helpful for his most bothersome PD symptoms but feels it has improved his sleep.

That’s probably enough for most of you. Read more if you are interested….

Robin

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wxxinews.org/post/connections-using-medical-cannabis-treat-parkinsons-disease

Notes by Denise Dagan, Brain Support Network volunteer

Using Medical Cannabis to Treat Parkinson’s Disease
By Evan Dawson and Megan Mack
WXXI AM News Connections
May 9, 2018

This 51:27 minute audio recording is an interview by Evan Dawson, the host of Connections, a WXXI public radio production, in Rochester, New York. In this program from May 9, 2018, Evan’s guests are Frank De Blase, a music writer, photographer and person with Parkinson’s, Frank’s movement disorder specialist, Dr. Michelle Burack, and Dr. Robert Horowitz, the palliative care specialist who certified Frank for a medical marijuana card in New York.

In the beginning of the audio, Evan introduces his guests and tells listeners that Frank wrote an educational and entertaining article for the City Newspaper in Rochester, NY about the year he spent researching and experimenting with medical cannabis specifically to treat his Parkinson’s symptoms. So, I started by reading and summarizing that article. Then, I went back to listen to the interview. Here are some things that stood out for me:

Frank describes in the article his experience having Parkinson’s disease as: “…I don’t have tremors or cognitive difficulty…I’ve learned how to manage sharing the same body — my body — with PD. Its like having a 4-year-old roommate living inside me, with cloven hooves and ADD and who always wants to start a tickle fight.” He tells Evan that Parkinson’s has hijacked his life causing him to think before he does anything (walking, talking, swallowing, even thinking!).

Dr. Burack – medical cannabis is not FDA approved, but is regulated by the Drug Enforcement Agency (DEA) as a schedule I drug (with heroin & LSD). When New York State approved medical cannabis physicians felt it was a political move as there is no systematic scientific research to show its effectiveness for any medical use. There is some anecdotal evidence it can help Parkinson’s pain and uncontrollable muscle spasms, but not at all most Parkinson’s symptoms.

Dr. Horowitz – can certify a person qualifies for medicinal trial of cannabis at which time that person may purchase medical cannabis at a state approved dispensary. As it is not FDA approved it cannot be prescribed, therefore it will not be covered by insurance. Frank spent about $400 on various formulations to see if it would relieve him of any symptoms.

Dr. Burack – First, do no harm. As there is no systematic scientific evidence demonstrating the effect of cannabis on those with Parkinson’s, she only knows that with Parkinson’s there is loss of neurological redundancy and, therefore less ability to compensate for the effects cannabis may have. She cannot say if any individual with Parkinson’s will have severe effects from cannabis, like hallucinations or psychosis leading to falls or hospitalization.

One medication Dr. Burack prescribes for Parkinson’s disease has three molecular compounds within the one pill. Cannabis has over 100 molecular compounds.

Dr. Horowitz – To make it more complicated, each plant has different combinations of those 100 compounds. He has a 1/2 hour power point he shared with Frank to explain what is known and unknown about medical cannabis.

His experience is in palliative care for all types of illnesses. He is not a raving fan of medical cannabis, but is grateful to have it in his toolbox for some conditions. Sadly, improved sleep does not qualify someone for medical cannabis. He cannot certify someone for an ‘off-label’ use, meaning a use that is not specified on the NY state’s approved list of uses, or he can go to jail.

Cannabis is a lower risk for long term pain management than opioids, which is an approved use in NY. Dr. Horowitz has certified several people with hard to manage pain who are taking significantly lower doses of opioids along with medical cannabis. More study of medical cannabis is definitely warranted in this area.

Frank shared that without his Parkinson’s medications he wouldn’t be able to move, but with them he moves in a jerky fashion and has speech stutters. He has already had DBS surgery to some benefit. He hoped cannabis would compensate for the Parkinson’s medication side effects causing stuttering of his speech. Dr. Burack shared this hope.

He started with a tincture under his tongue to no effect, then tried vaping with a high THC content which made him high and caused problems with his Parkinson’s. Finally, he tried vaping with higher CBD and lower THC which helped him sleep, although that is not the effect he was looking for. He also got gummy bears from California with 100% CBD to no effect. He did not try any formulation for a sustained period of time. He only tried each for a week at a time so no effectiveness can be definitely determined.

Dr. Horowitz – certifies a person for trial up to one year and no longer. He sees that person periodically throughout that year. In NY there are only tinctures, vaping and tablets in THC to CBD ratios (20:1, 9:1 and 1:1), so only 9 products. The tincture is, apparently, nasty.

A caller tried medical cannabis high dose CBD capsules for nerve pain, rheumatoid arthritis, shoulder pain and leg muscle cramping with tremendous relief. She had been getting repeated cortisone shots at a pain clinic who could not certify her for medical cannabis. She got similar rejection from her rheumatologist. Her chiropractor sent her to Dr. Broadwell with her medical history, who certified her. NY State’s medical marijuana website for those who are certified to get an appointment to purchase cannabis products cannot use Safari as a web browser. Firefox works well. Once she figured that out it was not an arduous process. Frank also found that once they found someone registered with the state to certify patients for medical cannabis use, the process is pretty easy.

29 states and DC have legalized medical marijuana and 9 states and DC have legalized recreational marijuana. Frank believes the gross sales are so high that marijuana will become legal federally, eventually.

Dr. Horowitz – says there are several obstacles to studying medical marijuana but none of those will be overcome as long as it is still a schedule I drug with heroin and LSD.

Dr. Burack – says individuals really should test various medical cannabis formulations for longer than a couple doses and by controlling as many factors as possible to really determine what, if any, effect is found. Not as many research dollars and medical attention is given to cannabis because there is so much hassle involved legally with so little potential return as compared to other, more easily studies substances and potential treatments with great potential return.

Highlights from International Congress on Multiple System Atrophy

The International Multiple System Atrophy conference was held in early
March 2018 in New York City. In late April, an article describing the
highlights of the conference was published by NYU’s Dysautonomia
Center. Check it out….

dysautonomiacenter.com/2018/04/24/progress-in-a-rare-disease-highlights-from-the-6th-international-congress-on-multiple-system-atrophy/

Robin