Don’t let dysphagia keep you from cooking
cooking for dysphagia

The moment of diagnosis is emotional when the diagnosis is dysphagia or swallowing disorder. It is a big challenge for caregivers. When a person has a swallowing disorder, suddenly, from that moment forward, it’s all puree. For the newly diagnosed, this is an emergency. The whole family, patient and caregiver, are in a new moment. They must respond.

I was my mother’s principal caregiver for five years. When she was diagnosed with dysphagia, as the result of dementia, I was on my own. I approached this task as a journalist. I researched the available cookbooks and found them wanting in practical advice, the how to do it. I researched the foods available commercially and found them to be poor examples of nutritional healing.

I interviewed professionals in all the relevant fields, from physicians to dietitians and speech language pathologists to nurses and nurses’ aides. I got an editorial review from a top dysphagia care expert.

Essential Puree: The A to Z Guidebook — This is the volume that I wish I had when my mother got the diagnosis.

Essential Puree aids in the transition, takes away the moment of confusion and even fear. This is for helping the caregiver shoulder the responsibility of feeding, whether the caregiver is a family member or a professional caregiver, whether the patient is at home in a home healthcare situation or in a healthcare facility. Nutrition for the Elderly is important, and it is vastly overlooked.

Essential Puree marries the art of fine food with the science of puree. Just because the form of the diet changes, does not mean you have to give up flavor. I teach the biggest secret to the art of puree. The sauce is the medium of flavor.

This volume takes the reader from the moment of diagnosis step by step through the setting up and running of a puree kitchen. It is fast, easy, organized and smart. The pantry, the freezer, the fridge, food storage and labeling. The book celebrates clean eating and nutritional healing. It is all about flavor, flavor, flavor.

This book includes 67 family recipes for classic American comfort foods done in a healthy manner. The recipes and their variations have been handed down for generations.

I also include a section called The Science of Puree, with information about the National Dysphagia Diet, Instant Thickeners for food and for beverages. This was contributed by the dysphagia care expert, Laura Michael, a member of the board of the national Foundation of Swallowing Disorders. I tested the best kitchen appliances for simplifying the labor or food preparation, storage and cleanup.

Patient and caregiver may try free recipes, posted in my Blog at the Essential Puree website.

I offer a Free Download, Shake, Rattle and Roll, for creating three nutritionally dense shakes, ready in a flash.

These are classic American shakes, the Miami shake, the Memphis Shake and the Motown Shake. Better-tasting than anything you could buy off the shelf, with no white sugar, preservatives or chemicals. Check out the e-book.

Essential Puree is available in print and eBook editions on the website, and at Amazon and other online sources.


Diane Wolff has been published in “The New York Times, ” “The New York Times Book Review, ” and the “Chicago Tribune”, among others, for her work on China and Tibet.

I do this work in my mother’s memory, that what I created for her may be of benefit to others.

I have recently done a dessert tasting at the New York charity God’s Love We Deliver, and I do lecture demonstrations at the stroke centers of Bayfront Medical and Fawcett, here in Port Charlotte, Florida, where I live.

Written by Guest Author
The Caregiver Space accepts contributions from experts for The Caregiver's Toolbox and provides a platform for all caregivers in Caregiver Stories. Please read our author guidelines for more information and use our contact form to submit guest articles.

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  1. I could have used this months ago. Too late :'( Mom is gone.

  2. Eh, I have mixed feelings about this article. My father does have dysphagia, so yes, I do ‘get’ what the article is doing to help others. Thing is, not all have to be on what my father calls the ‘mush’ diet. There are different levels of the condition. My father hates it when they mush his food. He hates the taste of the ‘Thick It.’ We tried it, still have the container left, and it has been over a year since we learned he has dysphagia. I shocked ENT when I insisted on trying everything with Thick It to understand why my dad didn’t like it. Any thing they wanted him to eat a certain way, I ate. First problem with the action to ‘thicken foods’ is the doctors are not paying attention to the natural thickeners we have in real life. Clear gelatin, flour, corn starch, bread crumbs, and arrow root. They do not lock away or destroy the flavor of the meal you are preparing. Reducing how much water you add works pretty well too. Or just not having the sauce as part of the dish, but as a side, thickened up, so they can choose. I cook from scratch, and by eating what he eats, I have figured out the best ways to thicken, or if I need it as mush, to not put everything into a food processor and make the ‘mush’ blob my father finds so horribly discouraging. His potatoes and carrots do need to be mush. I simply do them separately. The hand held blender works wonders in cutting down cleaning, and easier to make single portions when you are cooking for more than one person. Flavor is a BIG issue, especially when items like ‘Thick It’ locks away all flavor. It may sound weird, but knowing which herbs to use to help make the food more savory is a huge help. With older people, they tend to become really big on sugar or salt or both, and yes, my father loves both. So learning alternatives to seasoning helps them feel they are getting those taste hits while they adjust to their modified diet. We have only had 3 events of chest infections since we changed his diet. This is a huge cut back from the near once a month trip to the ER prior to the discovery. He’s 72, with dementia due to cluster strokes, and while he may not eat as much as he used to, food flavor is still very important to him. I hope my input helps along with the article.

    • My husband has dysphasia and he hates the thick it. Refuses to drink anything with the thick it in it. I didn’t know about or even consider natural thickeners. I think this will help us out a lot! Btw. I didn’t read the article so don’t know if the article has any useful info.

    • Gelatin works best with fruit juices. It comes from what my mom used to have us drink when we were sick, she would warm up the jello so we could drink it in place of broth. You can make ‘jello’ from any choice of fruit juices. Soda, though, that is pretty much out, sadly. Not much works well with it. Oh, nearly forgot to mention, dad just reminded me, he has saltine crackers on the side for his broths. Again, this works for him with thickening, it may not be appeasing to everyone. Thank you for posting. Again, really hope this helps others find alternative ways to work with it. 🙂

    • My wife and I both have issues with swallowing, she had a stroke and I have Parkinson’s. We hate Thick It and refuse to use it. I had a speech therapist out to the house and she tried to get us on it. I had already tried in the hospital. It tastes terrible.

    • Yah, gotta love how they insist – there’s no taste to it. My time with the therapist – Um, it is chemical, for starters in smell, don’t get me going on how it tastes alone in water. Did you know it actually locks up the flavor of the food? No? Wow, I can tell you haven’t really tested it. This is when she went, ‘Wait, you ate it too?’ Um, yes. How can I understand what is wrong if I don’t eat the food too? I told her I didn’t see Thick It working in our home since there are so many different natural thickeners out there which compliment the foods and drinks. Again, I blew her mind away. This is when my father suggested she read Julia Child’s. LOL

  3. Thank you for sharing this is going to make my day for all


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