Department of Veterans Affairs

Back to Basics: The Minced Diet In-Service FSW/Cooks

Emily Elliott, Renee Ingalls

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Table of Contents

In-Service Training: The Minced Diet .................................................................................................................................... 2

Cheat Sheet: Appropriate Texted Foods for Minced Diet ..................................................................................................... 4

Back to Basics: The Minced Diet ........................................................................................................................................... 5

Back to Basics: The Minced Diet Quiz ................................................................................................................................... 6

Back to Basics: The Minced Diet Quiz Answer Sheet ............................................................................................................ 7

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In-Service Training: The Minced Diet

Time Sequence of Events 2:00-2:05pm Brief Introduction

Intern Introduction

Staff Introduction

2:05-2:10pm Purpose: The Minced Diet is not an actual diet; it is a texture modifications used for those who are

experiencing swallowing and/or chewing difficulties. It is also used for patients who tend to eat too rapidly. This is determined by a Speech Language Pathologist. This could be as a result of:

o Stroke (CVA) o Cancer of the throat/neck/mouth. o Dementia/Alzheimer’s o Age o Generalized weakness o Traumatic brain injury o Poor dentition o Other neurological and/or physiological problems

Dysphagia is a common medical issue for hospital patients, especially in the VA system. It is the medical term for difficulty swallowing. Symptoms include:

o Choking or breathing saliva into lungs while swallowing o Coughing while swallowing o Regurgitating liquid through nose o Breathing in food while swallowing (aspiration) o Weak voice o Chronic heartburn o Sensation of food stuck in throat/chest o Weight loss

This condition, can lead to life-threatening choking episodes, as well as inhalation of foods. In order for food and liquid to be safely eaten, its texture has to be altered to make it easier to swallow.

Question: Have you ever had to modify your diet because of a toothache, surgery, etc? How did you like it? Does anyone have any questions about this diet modification?

2:10-2:25 What applies to Food Service?

Transition – Now that we have talked a little about why someone would need to be on a minced diet, let’s talk a little about what you need to know when preparing the patient’s tray.

There are 3 key principles to a Minced Diet. They include: o Foods need to be easy to swallow with a minimum of chewing required. They are also

modified to prevent obstruction of the airway (“choking”). o Foods must be moist, soft-textured, and can be easily formed into a ball for ease of

swallowing (without risk of aspiration). Meats are ground or diced to no larger than ¼” pieces.

o All foods from the pureed diet are acceptable at this level.

Note: It is important to remember that texture modification is separate than the liquid/beverage modification. There are many food items on the minced diet that would not be appropriate for a patient requiring thickened liquids (i.e. dry cereal with milk, coffee, thin soups, etc.)

Transition: We just reviewed the main concepts of the Minced Diet that are already incorporated into your meal tickets. Now let’s over what you will need to know on your own.

Pass out and Discuss Cheat Sheet

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o Let’s look at it together The chart compiles all foods that are either allowed or not allowed on the meal tray

for a patient on a Minced Diet. Activity: We are going to read off a few different complex menu items. Can you

figure out if they are allowed on this diet? Does anyone have any questions? 2:25-2:30pm Conclusion:

Today we learned: o Why somebody would be on a minced diet; what dsyphagia is. o What foods are allowed and what foods may be harmful for somebody with dysphagia.

.

Does anyone have any questions? Thank you for your time!

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Cheat Sheet: Appropriate Minced Foods

Choose These! Avoid These

Meat/Meat Alternatives

Moistened ground or cooked meat, poultry, or fish (serve with sauces or gravy); tofu; moist or mashed beans (like baked or refried); poached, scrambled, or soft-cooked eggs

Breads

Soft, well-moistened pancakes; pureed bread mixes or slurried breads

Cereals

Cooked cereals with little texture, including oatmeal; Slightly moistened, dry cereals with little texture, including corn flakes, Rice Krispies, and Wheaties. *If patient is on thickened liquids, all liquid needs to be absorbed into the cereal.

Fruit

Soft and drained canned or cooked fruits without seeds or skin; and ripe bananas

Vegetables

All soft, well-cooked vegetables that are less than ¼ inch pieces and are easily mashed with a fork

Potatoes/Starches

Well-cooked and moistened boiled, baked, shredded, or mashed potatoes; hash browns that are not crisp; chopped noodles; well-cooked pasta noodles in sauce

Desserts/Sweets

Puddings and custards; soft fruit pies (bottom crust only); Crisps and cobblers with soft topping and no seeds; ice cream; sherbet; gelatin; mousse; soft moist cakes with icing or slurried cakes; jam or jelly without seeds; syrup; chocolate bars; soft cookies; well-moistened cakes

Beverages

All beverages with little texture or pulp

Meat/Meat Alternatives

Whole, sliced, or shaved meats such as bacon, sausage, or hot dogs; peanut butter; hard-cooked or crisp fried eggs; sandwiches and pizza

Breads

Slices of bread; toast; any bread with nuts Cereals

All cereals with whole grain, dried fruit, coconut, nuts, or seeds

Fruit

Fresh or frozen fruits; cooked fruit with skin or seeds; cherries; pineapple

Vegetables

Cooked corn and peas; tomatoes with seeds; brussels sprouts; broccoli; cabbage, asparagus; or other rubbery cooked vegetable

Potatoes/Starches

Potato skins and chips; fried potatoes or French fries; rice; plain noodles

Desserts/Sweets

Dry, coarse cakes and cookies; desserts with nuts, seeds, coconut, pineapple, or dried fruit; rice or bread pudding

Beverages

All beverages with thick texture and pulp

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Back to Basics: The Minced Diet

What is the purpose of the Minced Diet?

The Minced Diet is not an actual diet; it is a texture modification used for those who are experiencing dysphagia. It is also used for patients who tend to eat too rapidly. This is determined by a Speech Language Pathologist. This could be as a result of:

o Stroke (CVA) o Cancer of the throat/neck/mouth. o Dementia/Alzheimer’s o Age o Generalized weakness o Traumatic brain injury o Poor dentition o Other neurological and/or physiological problems

What is Dysphagia?

Dysphagia is a common medical issue for hospital patients, especially in the VA system. It is the medical term for difficulty swallowing. Symptoms include:

o Choking or breathing saliva into lungs while swallowing o Coughing while swallowing o Regurgitating liquid through nose o Breathing in food while swallowing (aspiration) o Weak voice o Chronic heartburn o Sensation of food stuck in throat/chest o Weight loss

This condition, can lead to life-threatening choking episodes, as well as inhalation of foods. In order for food and

liquid to be safely eaten, its texture has to be altered to make it easier to swallow. It is important to remember that texture modification is separate than the liquid/beverage modification. There are

many food items on the minced diet that would not be appropriate for a patient requiring thickened liquids (i.e. dry cereal with milk, coffee, thin soups, etc.)

What are the texture modifications for the Minced Diet?

Foods that are soft textured and moist, making them easy to swallow

Soft, well-cooked foods, and well-moistened ground meats

Moist and well-cooked potatoes, and noodles

Nothing larger than ¼ inch in size!

All foods of a pureed consistency are allowed on this diet.

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Name: _______________________________________ Date: _________________

Back to Basics: The Minced Diet

Quiz

1. Which of the following food items would not be appropriate for a Minced Diet?

a. 1/4” cut chicken breast with gravy b. Mashed potatoes c. Banana nut bread d. Pureed carrots

2. What is the medical term for difficulty swallowing?

a. Dyslexia b. Jabudy c. Iatrogenic d. Dysphagia

3. When would it be inappropriate to provide coffee to a patient on a Minced diet?

a. When they are on a calorie-restricted diet b. When they are on thickened liquids c. When they have too much energy already d. None of the above

4. What may happen if a patient who requires a minced textured diet receives a regular

textured diet? a. The patient could choke on larger food pieces b. The patient may not be able to chew the food c. They may lose weight due to the inability to eat the regular textured food d. All of the above

5. What is the largest acceptable size for a piece of minced beef? a. 1/4” b. 1/2” c. 1/3” d. 1/8”

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Name: _______________________________________ Date: _________________

Back to Basics: The Minced Diet

Quiz Answer Key

1. Which of the following food items would not be appropriate for a Minced Diet? a. 1/4” cut chicken breast with gravy b. Mashed potatoes c. Banana nut bread d. Pureed carrots

2. What is the medical term for difficulty swallowing?

a. Dyslexia b. Jabudy c. Iatrogenic d. Dysphagia

3. When would it be inappropriate to provide coffee to a patient on a Minced diet?

a. When they are on a calorie-restricted diet b. When they are on thickened liquids c. When they have too much energy already d. None of the above

4. What may happen if a patient who requires a minced textured diet receives a regular

textured diet? a. The patient could choke on larger food pieces b. The patient may not be able to chew the food c. They may lose weight due to the inability to eat the regular textured food d. All of the above

5. What is the largest acceptable size for a piece of minced beef?

a. 1/4” b. 1/2” c. 1/3” d. 1/8”