1.  PUREE DIETS and THICKENED LIQUIDS Improving Quality April 4, 2014 Utah Dietary Mangers

2. Why Are You Here Today  Improve quality of life!!!  Improve hydration.  Lower costs of thickened liquids.  Improve the diets offered at your facility.  Off work for a few hours and home early!

3. What we want to Accomplish:  Learn more about puree food consistency.  Learn about thickened liquids tips & traps.  Learn about costs of thickeners.

4. Who do we interact with? Dietary Manger RESIDENT!NursingCNA’sSpeechRDAdminCaretakersFamily

5. What is the best puree food texture?  All references state smooth and creamy.  All food does not puree to smooth and creamy.  Expectations from surveyors appear to vary with other survey observations.  Some residents WANT some texture to know it is real food.  Is a subjective area!

6. How to Know the Best  Have a tasting system in place.  Know recipes reflect current practice.  Educate staff – the best recipe still may need work due to moisture content.  Residents eat and drink well.  Puree menu matches all regular menu components.

7. Puree Principles  Serve food at the correct temperatures.  Food should be consistency of mashed potatoes and pudding.  No Weeping!  Liquid foods can be liquid (soup)  Use thickener as needed – powders change taste and content.  No sticky, gummy, chunks, large grains.

8. Puree Prep Steps  Wash Hands.  Assemble clean and sanitized utensils.  Recipe/Directions.  Product: Cool if hot, Chilled if cold.  Number of puree portions  Portion food.  Process.

9. Steps in Processing  Bowl filled to correct height.  Process for correct time.  Added ingredients: liquid.  Thickening agent.  Process  Taste  Scraping  Reheating/re chilling  Portion  Decorate or Garnish

10. Specific Foods To Puree  Soup  Meats  Starch  Vegetables  Fruits  Desserts

11. See It First  Textures add variety.  Plate placement can add color contrast.  Selling the food with staff explaining content.  Try different dishes, shapes, colors of serving plates, bowls and glasses.  Drizzle sauces and condiments for interest.

12. Color and Placement  Color adds contrast.  May need some food coloring.  Try sauces and shapes.  Make puree garnishes: extra gelatin for cutouts, avocado, jelly, dessert sauces, condiments.  Try different dishes, bowls, glasses

13. Know your equipment  Blenders, grinders, processors, blixers.  Caring for your equipment.  Purchase the right size of tool.

14. Best Liquid Texture  Acceptable to resident  Tastes like liquids prepared  Looks like real liquid  Staff can prepare ahead of time  Does not continue to thicken  Blends well with many fluids, even hard to thicken nutrient dense items

15. Thickened Liquids  Flavor is not altered.  Does not affect diabetes control.  Mixing parameters  Can be prepared in bulk for kitchens  Limits inventory and saves space

16. Thickened Beverages'  Variety  Pre-Thickened  Powder  Gel’s

17. Hydration  Cost of dehydration, under hydration  Increased nursing costs  Loss of revenue for the facility  Wound care  Causes of low fluid intake?  Not appealing.  Lack of Variety.

18. Tricks & Traps  Tricks  Variety  Appearance  Prep ahead  Bulk  Traps  Under Mixing  Guessing over mixing  Sets Up  Serving Temperature

19. Cost Information  Explanation of cost  Back Door costs  Powder Lowest costs.  Resident Appeal  Waste Costs  Pre-Thickened Highest cost.  Inventory cost and space  Gel-Thickener

20.  Thank you for coming