Texture‐modified diets in aged care facilities: Nutrition, swallow safety and mealtime experience

Objectives: Over 35 000 people live in residential aged care facilities (RACFs) in New Zealand. Texture-modified diets (TMDs) are commonplace. They are associated with malnutrition. The aim of this study was to characterise TMD prevalence and practice in RACFs.Methods: Data from 35 460 residents were extracted from the interRAI™ database. Mealtime observations (including 459 residents), meal audits (IDDSI, 2018) and menu audits (Dietitians New Zealand Menu Audit Tool for RACFs 2013) were completed at 10 RACFs.Results: One-third of residents were on TMDs. Half the residents ate full meals. Feeding assistance was more common in residents on TMDs compared to those on regular diets (P < 0.001). The majority of pureed meals met IDDSI standards; none of soft and bite-sized meals complied. TMD carbohydrate and protein servings did not comply with standards.Conclusions: Texture-modified diets reflect 1/3 of meals produced in RACFs. This study provides insight into TMD use in RACFs and highlights service gaps and training opportunities.Keywords: deglutition disorders; dysphagia; food services; nutritional status; old age homes.