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| RDs in the Field |
Dietitians Can Help Prevent Choking
 Resident incidents related to choking on food seem to be on the rise. While these have not happened in facilities served by HMC dietitians, be aware that improper food preparation can contribute to avoidable incidents and even death. Many years ago the dietitians dubbed a resident favorite food as "killer dogs" and removed hot dogs from the menus. In today's facilities we often find 75% or more of the residents on a texture modified diet (mechanical soft, dysphagia or puree.)
Here are some of the foods that have been reported to us related to choking incidents:
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Hot dogs and sausages (numerous deaths known)
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Hamburger patty on a bun (two deaths that I know about)
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Carrot coins (one death)
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Peanut Butter Sandwich (one near death remained in a coma on tube feeding)
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Taquito, baked (one death)
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Donut (from the nursing station treats)
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Meatball (resident incident just this week)
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Toasted garlic bread
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Garnish (resident choked, this became a survey deficiency)
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Cherry tomato
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Popcorn
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Peanuts
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Pasta (egg noodles, spaghetti and lasagna)
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Grapes, fresh
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French Toast
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Fried Egg |
| RD Resources |
HMC Diet Manual
The HMC Diet Manual has excellent resources to guide professionals and the dietary staff. Consistency (texture) modified diets are defined starting on page 61. Familiarize yourself with the "Continuum of Food Textures" and "Glossary of Cooking Terms Related to Consistency Modified Diets" (pgs. 63-65.) These are excellent references for dietary or nursing inservices. Of course, we are also aware that any food can be potentially hazardous and some people even choke on their saliva.
However, the best defense to prevent choking in the LTC facility is the awareness of the clinical team (licensed nurse, nursing assistant, therapists and RD) to suggest the most appropriate diet consistency (texture) for the resident, direct supervision for all meals (including those on a regular texture or eating in their rooms) and a well trained dietary supervisor and staff that ensure every resident received the right diet and all foods are prepared according to the recipes and menus to the proper consistency.
 Do not overlook foods brought in by visitors, prepared in cooking classes, served in facility activities, barbeques and vending machines. If you have physician orders stating "Resident may have a regular diet on holidays," this only refers to the therapeutic diet, not the consistency.
A resident cannot waive their right to safe food. Presently, Lee is assisting a California attorney as an expert witness in a wrongful death case where a SNF resident choked --- this is serious business with a multimillion dollar price tag. |
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Dear Dietitian;
HMC consultant dietitians provide a critical set of eyes
when you thoughtfully and regularly review the consistency of modified diets. You can save a life by ensuring procedures are followed. Our residents deserve the tastiest, safest and nutritious foods --- the dietitian can show them how.
Thank you for all your work as an HMC dietitian.
Sincerely;
Lee Tincher, MS, RD
President
HM Composite, Inc.
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Registered Dietitian Newsletter