Traditionally, the holiday season is a time for us to gather with friends and family, and to celebrate the various holiday traditions that have evolved over the years. More often than not, those traditions revolve around everyone’s favorite subject: FOOD!
Whether it’s baking holiday cookies and cakes or sitting around the table for your favorite holiday meal, food is the essential centerpiece of each gathering. Unfortunately for people living with dysphagia, partaking in those holiday food feasts may not be possible if the proper precautions aren’t taken.
An estimated 1 in 25 adults will experience a swallowing problem each year in the United States. With statistics like that, the chances someone you know that has some degree of swallowing difficulty is pretty high. Dysphagia can range from just needing to take small bites/sips to needing all of your needs met via an alternative means, like a peg tube. Traditionally, dysphagia diets don’t look terribly appetizing, and those assisting with preparing don’t help the cause by saying things like “looks like baby food”, or “looks gross.”
Dysphagia can also be very isolating.
Those with swallowing difficulties may just avoid social gatherings all together since most social situations revolve around food. Imagine if you couldn’t partake in your usual holiday festivities – how would YOU feel? Here are some tips for planning your holiday gathering to be more inclusive, and also to assist you with advocating for your loved one (or yourself!) with dysphagia.
Today, everyone’s dietary preferences are evolving – vegan, vegetarian, keto, top 8 free, peanut free, etc. Why not include texture preferences with that as well? Asking your guests ahead of time if they have any preferences or difficulties around food shows you’re invested in their experience at your gathering. Maybe even ask for some favorite, safe recipes to be sent your way so you have something to serve your guest with an altered diet.
Remember the point of a holiday gathering is for everyone to have a good time – go the extra mile for your guests! On the flip side, if you’re caring for someone with dysphagia that will be attending the gathering, ask the host what their planned menu is. More often than not, hosts will have their menu planned days to weeks in advance and will be able to speak to what they’ll be serving. Make sure when you’re inquiring about the menu to make it clear that you’re not attempting to be critical of their menu, just that you want to plan ahead for your loved one (or yourself)!
If you don’t feel comfortable with the proposed menu, plan your arrival to the gathering to take place after the main meal is served, or arrive early so you can depart prior to food being served. I know this isn’t the best option for all involved, but it’s a way for you or your loved one to still be part of the holiday celebration safely.
Bring your own food!
This does sound strange, but if you’re going to a place where you couldn’t get a straight answer about what’s being served, or you’re nervous about what’s on the menu, this is the best way to ensure your loved one, or yourself, is going to have something safe to eat when it’s time to sit down at the table. Make sure your food items are clearly labeled so they don’t get accidentally served, thrown away, etc. prior to mealtime.
You can bring a small can of food/liquid thicken, or even purchase pre-thickened liquids ahead of time to pack in your DLB – Dysphagia Lunchbox. Don’t worry about offending your host – they’re sure to appreciate the forethought on your part. And to our hosts – be grateful your guest is bringing their own food so they can be a part of the day – don’t get offended that they’re not going to be eating your prime rib. (They would if they could!)
Ask for help!
If you or your loved one is in need of an altered diet, there’s a solid chance that there is a speech-language pathologist you have worked with in the past floating out in the world. REACH OUT TO THEM – THEY WANT TO HELP YOU! Send an email or give a call to them and let them know your concerns, and your plans. They’ll be more than happy to help you structure your meal to make it safe and inclusive for everyone involved.
If you don’t have a speech – language pathologist contact, put out some feelers on social media in dysphagia specific groups. Now, please keep in mind that as helpful as social media can be, remember there’s also a lot of misinformation out there so be careful when sourcing information from social media.
In addition to social media, the International Dysphagia Diet Standardization initiative www.iddsi.org has a wealth of knowledge and information about diet textures, and ways to better prepare food for people on altered diets. There’s even a great section entitled “Focus on Puree” that you can access here: https://iddsi.org/focus-on-puree/ Here’s a direct link to their resource page, which has loads of downloads and even some recipe books for pureed and mined/moist diets: https://iddsi.org/resources/
EDUCATE, EDUCATE, EDUCATE.
Take the time to educate the host, and others that will be attending the holiday gathering about dysphagia (with permission, of course). Be sure to highlight more positive ways to describe the altered food, and also ensure that other guests won’t serve the person something unsafe in error. Also, make it clear that dysphagia just doesn’t ‘go away’ because it’s a holiday. Phrases like “just this once” or “oh, a little bit won’t hurt” are not acceptable – a little bit, will in fact, hurt. It never hurts to be overly cautious. You can initiate a group text with education or send a group email. Everyone is very tech connected nowadays, so communication prior to the gather should not be too much of an issue.
When in doubt, STAY HOME.
If you’re uncomfortable with how things are panning out with your holiday plans, just stay home. Unfortunately, not everyone is going to be receptive to new or different things, and some people are just flat out stubborn. Staying home during the holidays isn’t the best option, but it’s important to put safety first. As mentioned previously, everyone is very tech connected in today’s day and age, and maybe joining the family via Zoom or FaceTime is your best option. You need to surround yourself with people who have your best interest at heart.
It’s important that we move towards normalizing dysphagia, and the need for altered diets. Many people who experience swallowing disorders are living in the community and deserve the same considerations people with other types of diet preferences have access to. You wouldn’t think twice about someone telling you they’re vegan or on the keto diet, so why make people with dysphagia feel alienated? Even some chain restaurants have diet specific menus now. Dysphagia can lead to many things, and isolation is one that isn’t often considered. It’s important to make our loved ones feel included, and safe. Always remember, if you were in their shoes, what would you want? Remember you can thicken pretty much anything… even cocktails.
For more information about dysphagia around the holiday season and dysphagia diets, please visit https://www.asha.org/Practice-Portal/Clinical-Topics/Adult-Dysphagia/#collapse_7 Also, be sure to stay in the loop with ARC Seminars to be the first to know about the launch of our new webinar “Life with Dysphagia: Knocking social and ethical barriers”. This course has loads of information, and ways to better assist patients and caregivers with living with dysphagia.
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