diet consistency

[sis14rn]

I'm ready to pull my hair out!

I'm the nurse manager in a 108 bed SNF. In July, we had noticed nurses giving liquid nutritional supplements to Residents that should be on thickened liquids. Boy did this open a can of worms!

We are now starting an Advanced mechanical soft diet. We had regular consistency, mech soft and pureed. Now, we have added the advanced mech soft. this is based on the National Dysphagia Diets. The diet we previously called mech soft was more of an Advanced MS. Our dietician is saying that because of this, the residents with orders for MS should just be changed to the Advanced because they've pretty much been getting that consistency anyway. Our speech therapist says no, because the order says mech soft and now we have mech soft, the resident should get the mech soft, not the consistency they were getting previously. this has started the discussions of quality of life. I can see both sides of the issue-quality of life vs. risk of complications/litigation/state deficiency for not following the ST recommendations. Whew!

Help! Have any of you adapted the Dysphagia Advanced diet? How do you make the decision of which way to go?

[CoffeeRTC, BSN, RN]

Could you post a link or point me to more info on this.

As far as supplements to res with thickened liquids...we were told our milkshakes are nectar thick already...I still thicken them.. also thicken the honey and pudding thick ones.

[ktwlpn, LPN]

I'm ready to pull my hair out!

I'm the nurse manager in a 108 bed SNF. In July, we had noticed nurses giving liquid nutritional supplements to Residents that should be on thickened liquids. Boy did this open a can of worms!

We are now starting an Advanced mechanical soft diet. We had regular consistency, mech soft and pureed. Now, we have added the advanced mech soft. this is based on the National Dysphagia Diets. The diet we previously called mech soft was more of an Advanced MS. Our dietician is saying that because of this, the residents with orders for MS should just be changed to the Advanced because they've pretty much been getting that consistency anyway. Our speech therapist says no, because the order says mech soft and now we have mech soft, the resident should get the mech soft, not the consistency they were getting previously. this has started the discussions of quality of life. I can see both sides of the issue-quality of life vs. risk of complications/litigation/state deficiency for not following the ST recommendations. Whew!

Help! Have any of you adapted the Dysphagia Advanced diet? How do you make the decision of which way to go?

what is the difference between your mech sift and advanced soft? I would follow the speech therapists' recommendations-Order evals on each resident-that is the proper way to proceed....I bet the surveyors would love to see diet orders "just changed because" a dietitian says so.....