Speech Therapy
Frequently Asked Questions
Q:Where can I buy thickener?
Q:What is mixed consistency food?
A:
Different brands of thickener can be
purchased from most hospital and community
pharmacies.
A:It refers to food with both solid and liquid
components, e.g. ice cream (solid but melts
into liquid), watermelon or orange (fruit
pulp plus juice), or noodle soup (noodles in
soup). Ways to avoid mixed consistency food
includes: taking watermelon or orange juice
instead of the fruit itself; draining the soup
base from noodle soup.
A: No. If modified fluid is prescribed, thickener
needs to be added to all fluids (e.g. coffee,
milk, soup) unless the fluid is naturally
thickened (see examples on previous page).
Q:What alternatives do I have if the patient
refuses to drink thickened fluids?
A:You may explore different brands of starchbased thickener which may be more palatable,
or explore naturally thickened fluid options.
Q:Why does the consistency of thickened
fluid change after some time?
A:Enzymes in saliva can interact with starchbased thickened fluid and thin it down over
time. Hence it is strongly recommended
that fluid is thickened and served whenever
required, rather than pre-thickening a large
volume of fluid. It is advisable to regularly
check if the thickened fluid is of the right
consistency particularly over a prolonged
period of feeding, i.e. over a long meal.
Q:Can I use commercial baby food if blended
diet has been prescribed?
A:While commercial baby food that is fully
pureed may be used as blended diet, do
note that some may contain vegetable or fruit
pieces, which would need to be removed or
blended before consumption. However as the
nutritional needs of an adult differ from that
of an infant, please consult your doctor or
dietitian for further advice.
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Q:How can I feed the patient medication if
the patient is on modified consistency?
A: You can check with the doctor or pharmacist
if the medicine is available in liquid form, or
if it can be crushed. Crushed medicines may
be served with modified fluid or diet to aid
swallowing.
Please consult your Speech Therapist if you
require further information or clarification.
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Tel: (65) 6256 6011 Fax: (65) 6252 7282
Central Appointment Line: 6357 7000
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Q:Is thickener only added to water?
Modified
Consistencies for
Swallowing Problem
What is Dysphagia?
Dysphagia refers to any difficulty in swallowing.
People with dysphagia may experience difficulty
in chewing food or safely transporting food and
fluids to the stomach. This can lead to aspiration referring to food or fluid entering the airway to the
lungs, thus increasing the risk of chest infection.
Dysphagia can be caused by different medical
conditions such as stroke, Parkinson’s disease and
dementia.
Easy Chew diet
Food that is in small pieces and softer in texture,
can be easily broken up by a fork. Chewing is
required. In preparation, food is chopped and
cooked longer to soften it.
Thin fluid
Examples
Firm tofu
Steamed fish
Chopped kway teow
Examples
Water, Milo, Tea, Coffee
Why is there a need to modify food/
fluids?
Modifying food and/or fluids can help to
make swallowing safer and easier. This may be
recommended by the Speech Therapist after a
swallowing assessment.
Types of Diet Consistencies
Diet of Choice
Regular food that is either large in size or hard
in texture. Chewing is required. No special
preparation of food is needed. Examples
Wholemeal bread
Nasi lemak
Fried rice
Types of Fluid Consistencies
Fluid runs quickly through fork prongs (held at
45o) with no coating and no residue.
Nectar thick
Soft Moist diet
Fluid coats approximately one-third length of
fork prongs (held at 45o), but drips off quickly.
Food that is soft, moist and minced. It can be
easily mashed with a fork. Minimal chewing is
required. In preparation, food is minced into
very small pieces of about 1/8 inch.
Examples
Thick barley drink
Mango juice
Examples
Oats, Porridge
Minced meat
Silken tofu
Honey thick
Blended diet
Food that is smooth and lump-free. No chewing
is required. A food processor is needed to blend
the food.
Examples
Mashed potato
Fruit puree
Sesame paste
High risk food
Certain types of food may be particularly difficult
for people with dysphagia to manage. It is
recommended that these groups of high risk food
be prepared with care, or otherwise avoided.
Stringy, fibrous food
Eg: pineapple, string beans, kang kong, celery
Vegetable and fruit skins, including
beans
Eg: peas, grapes, plums
Crunchy or Crumbly food
Eg: kaya toast, muruku, flaky pastry, dry biscuits,
potato chips, pie crusts
Chewy food
Eg: soon kweh, glutinous rice dumplings, gummy
Fluid coats the entire length of fork prongs (held
at 45o), drips off slowly.
sweets, Malay kueh, Nonya kueh
Examples
Honey
Papaya milkshake
Hard food
Pudding thick
Fluid is cohesive and does not drip off fork
prongs (held at 45o).
Examples
Mayonnaise
Thick, plain yoghurt
Eg: toasted you-tiao (fried fritters), nuts, seeds,
coconut flesh, bak kwa
Slippery food
Eg: agar-agar, grass jelly
Mixed consistency food
Eg: multi-grain bread, noodle soup, cornflakes in
milk, tau suan, half-boiled egg