IDDSI Implementation Advice

March, 2019
IDDSI Changes

IDDSI (International Dysphagia Diet Standardisation Initiative) is being implemented from May 1st 2019.

IDDSI provides a standardised framework for the terminology and definitions for modified diets and thickened fluids.

There are many differences between the current Australian Standards and IDDSI.

IDDSI Implementation Advice #1 – Bread is only suitable for residents on a regular diet.

One of the most significant changes is that bread is now only suitable for residents on a regular (Level 7) diet, unless approved by a speech pathologist.

Why have the recommendations for bread changed?

IDDSI is based on current best practice and the latest international research, which shows that bread is often identified as a cause of choking. Choking is the second most common preventable cause of death in Australian aged care facilities.

Although bread looks and feels soft, it can’t be easily chewed or broken down into the very small particles required for something to be swallowed safely.

This is due to its fibrous nature, and the fact that it doesn’t dissolve and becomes sticky when wet.

In fact, it takes the same amount and strength of chewing to swallow bread safely as it does to swallow peanuts safely.

How can this be best managed?

We recommend that menu reviews be conducted, as alternatives may need to be arranged for some residents e.g. sandwiches for the evening meal.

At Food Solutions, we recognise that bread has been a standard part of numerous residents’ diets for many years.

We always endeavour to be as least restrictive as possible with our recommendations, and we are more than happy to conduct assessments to see if residents are able to safely manage bread.

Over the coming weeks, we suggest that sites look at the residents who are currently on a soft (Texture A) diet and compile a list of those you would like assessed by speech pathology prior to IDDSI implementation.

Please contact your speech pathologist if you would like any further information.

IDDSI Implementation Advice #2 – Mixed consistencies are only suitable for residents on a regular diet

IDDSI (International Dysphagia Diet Standardisation Initiative) is being implemented from May 1st 2019.

IDDSI provides a standardised framework for the terminology and definitions for modified diets and thickened fluids.

There are many differences between the current Australian Standards and IDDSI. One of the significant changes is that mixed consistency foods are now only suitable for residents on a regular (Level 7) diet, unless approved by a speech pathologist.

What are mixed consistency foods?

Mixed consistency foods are those which contain both a solid and a liquid component, such as cereal in milk, minestrone soup, oranges, watermelon, and foods with an excess of gravy or sauce.

Why have the recommendations changed?

IDDSI is based on current best practice and the latest international research, which shows that mixed consistencies are a very challenging texture for people with dysphagia to manage safely, due to the need to separately manage each component of the food.

How can this be best managed?

We recommend that menu reviews be conducted to determine if they contain many mixed consistency foods, and how these can be made suitable for residents with dysphagia e.g. soups will need to be strained or pureed, milk will need to be drained from cereal prior to serving.

The Food Solutions team always endeavours to be as least restrictive as possible with our recommendations, and we are more than happy to conduct assessments to see if residents are able to safely manage foods of mixed consistencies – please let us know if you would like any residents assessed prior to IDDSI implementation.

Please contact your speech pathologist if you would like any further information.

Dietitians Australia
Aged & Community Care Providers Association

Don’t let your residents or budget experience the side effects of malnutrition or dysphagia.
Call us on 1300 850 246 or email and request a call back.

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