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Hi everyone, I’m looking for ideas or recipes for things you had luck with feeding your loved one who is on a puréed diet. My mom is 83 with worsening dementia and the puréed food she gets at her nursing home is terrible. She refuses all of it and says is taste like poop. I don’t blame her. She is bed bound and and has been declining fast these last few weeks. I’ve been making and puréing soups for her, and she’s been enjoying those. I bring her cherry applesauce, cherry jello, mashed bananas, and high protein boost drinks. I tried cream of wheat with cinnamon and brown sugar and she turned her nose up at it. I was thinking of trying some smoothies, but I need some good tasting ones as she’s very picky. Any ideas to get some calories in her I would greatly appreciate.
Thank you!

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Bring her a buttload of ice cream imo.
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ANY food you make for yourself can be pureed.
If you take each component and freeze it in portion size amounts, I would do more than 1/2 cup each.
But...are you bringing each meal to her and feeding her each day or several times a day? If so this does not seem like a sustainable option.
Have you discussed options with the care manager?
There are liquid meal replacements that can be used and there are liquid calorie boosters (these are essentially small portions of oil) that can be added to food or liquid meal.
Again this all should be discussed with her care manager I would also ask the dietitian be included in the meeting
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Not to criticize anyone's suggestions, but milk shakes could be harmful, depending on her level of dysphagia. Our speech therapists cautioned that given their fluidity, and as they melt, they could slip down more easily and enter the pathway to aspiration.

This obviously depends on the individual's specific condition. Dad couldn't have any fluids that weren't thickened, which included (water and ) ice cream, since it melted so quickly. So we gave up ice cream and milk shakes, but I fed him a few tablespoons of ice cream at a time so he could swallow it BEFORE it melted.

Baby food was recommended though.
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Llamalover47 Oct 2022
GA: Thank you for your post.
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Ange17: Try some milkshakes or some pudding. Many years ago when my parents, brother and I traveled by automobile in a sixteen hour trip to my dad's mother's house, my mother had the brilliant idea to give my brother and me fruit baby food as it was easy on the stomach. Perhaps your mother could tolerate that.
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1. I'm assuming a speech therapist or pathologist was involved in determining that she needed pureed food? There's another level of softened food known as "mechanical soft", and there are various levels of swallowing compromise with corresponding appropriate foods.

2. Our speech therapists gave us lists of diets with corresponding foods. It was surprising how much some foods could be dangerous, such as foods swallowed through a straw.

3. You've gotten some good advice, but can also find excellent ideas online. through the established diets. Some of the big well known hospitals publish information on dysphagia, and it's valuable information.


These are good explanations and guidelines for understanding the concepts:

Dysphagia Diet | Saint Luke's Health System (saintlukeskc.org)

Dysphagia Pureed Diet - University of Mississippi Medical Center (umc.edu)

Eating Guide for Puréed and Mechanical Soft Diets | Memorial Sloan Kettering Cancer Center (mskcc.org)

The diets we were given were very thorough, broken down into 4 and sometimes 5 levels, with examples of what could be eaten and what could not. I don't recall who published them, but I haven't seen such elaborate and thorough lists online for years.
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I have the same issue with my mom. She is also a vegetarian. She cannot tolerate the regular Ensure. I tried the Ensure Clear Mixed Fruit drink. It is 180 calories and is somewhat nutritious. She absolutely loves it. It also helps with her dehydration issues. I am able to get two Ensure drinks in her daily so that is almost 400 calories. The problem is pureed vegetables are healthy but do not give her very many calories. Sounds like you are doing a great job with some options that are healthy and delicious. I am going to try the cream of wheat with my mom. Thanks for the suggestions.
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cwillie Oct 2022
Silken tofu pureed together with fruit makes a delicious pudding, you can either use your own mix and match stewed fruits or just use baby food.
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I had my tonsils out as an older adult and couldn't take anything hot and pureed as it made the healing worse. Smoothies made out of Cream/ half and half and with frozen fruit sweetened with some liquid sweetener might do the trick. You can also add High fat content yogurt to make it thicker and get some protein. I can not take ensure. YUCK. But they do make clear liquid protein drinks that are fruit flavored. you might try that.
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We used to make milkshakes and fortify them with peanut butter powder, he really liked those and it’s high protein.. Adding Hershey syrup is also high calorie. His doctor said once they get to that stage that any calorie is a good calorie, so don’t worry about a balanced diet. Feed her high calorie foods all the time.
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In most hospitals the pureed food was horrendous. When my dad was at in-patient hospice, they literally took "regular" food and pureed it. I don't know what device they used, but it was wild. Pizza, yup, Thanksgiving turkey with gravy, yup, meatloaf, yes indeed, mac and cheese, you bet. Like I said, I'm not sure what device they used, but it was amazing. They only thing they "cheated" on were desserts, which was premade/prepackaged items.
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Bone broth spiced up with the flavors she likes will provide protein. It sounds like you've done a great job getting her sweet treats: they all sound good. I love smoothies because you can put so many needed ingredients in it.

When I was hospitalized I found out that some of my medications changed my taste buds.
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I make smoothies with fresh blueberries, some other berries as well, like raspberries, strawberries will do, all fresh no frozen, add melon any type, pineapple, the banana for thickness and avocado for good fats, you can add some honey.
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When my dad was near the end egg custard was his favorite. Easy to make slides right down, has protein, and tastes good.
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You of course want to check with her facility doctor/nurse to assure that whatever is brought to her is in compliance with her medical needs. You are doing a wonderful job it seems and, I only mention this as you are exploring other options. Speak also with the dietary dept. at the facility, the dietician may be very helpful.

All of that said, it is important to remember that as dementia( or other illnesses) progress, the patient's taste buds change and, also they actually do not need nor want as much intake as one normally does. This is important to factor in the equation because your mother may simply not want nor be able to manage more calories. Talking with the dietician and your mother's doctor may help you further assess and understand this. Often loving, well meaning family members have the hardest time accepting that their loved one simply does not want nor need food regardless of how it is prepared or processed.

It can be anxiety producing for family members to watch this and experience it. Loving your mother and being present with her is "nourishing". Take care of yourself making sure that you are well hydrated, exercising and getting good support from other family and or your faith leaders if you practice a faith ; and or speak regularly with the facility chaplain and social workers ; both can be very supportive.
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When my dad was on a pureed diet we did smoothies (add greek yogurt for protein) like you mentioned but also puddings, jello, sherbet, greek yogurt lots of options in the baby food section too. Also mashed potatoes were a favorite. Soups are easy to pureed like you are doing and you can add a thickener if needed. Texture is important.
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There is quite a smoothie culture out there with the young folks. You might try looking at a few of their magazines and books for ideas. Sounds like you are doing well but just need more time at it. Try some of the big clinics sites (Mayo, Cleveland, etc.) to see if there are recipe suggestions under nutrition. Many patients can't swallow. And facility food is often nasty; they ship it in from an underground kitchen somewhere and pass it off as real prepared food. Even the senior living places are doing this scam now. While you are at it, write a letter to your state agency and Medicare. They do investigate, and many patients have no one to prepare food or advocate for them. Of course, complain to the facility's director.
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It sounds like she prefers sweet tasting things. You could also try ice cream and puddings, flavored yogurts, scrambled eggs.
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Does your mother have any health conditions, such as high A1c or diabetes? Because sugar and simple carbs are not good. Check with her doctor about the proper diet and taste preferences.
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I had surgery on my jaw when I was a teenager and had my mouth wired shut for 2 months. I can attest to how many foods taste like poop when they are pureed!

The things I enjoyed most through a straw were mashed potatoes watered down with gravy, milkshakes, carnation instant breakfast drinks (chocolate & strawberry), applesauce, and baby food fruits. But the mashed potatoes and gravy were my absolute favorite. I felt full and satisfied, it was almost like having a real meal.
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There was (almost) nothing that my mom's nursing home didn't puree, I remember tasting her chicken caesar salad (pureed chicken over pureed and thickened lettuce with dressing) and thinking it was really weird and not really worth the effort, but nonetheless it did taste like a chicken caesar salad. Have you spoken to the dietitian or food service supervisor about your concerns?

For those resistant to the idea of pureed foods I think it goes better if you try to concentrate on foods that are normally almost that texture -
mashed potatoes with gravy (some meat can be pureed with the gravy)
as you've mentioned almost any soup is good pureed (thickened if necessary)
lentil dahl
hummus
silken tofu
polenta with marinara sauce, or refried beans
squash and rutabaga are both often served mashed, as are sweet potatoes
grits
guacamole
custards, both sweet and savoury
egg salad
for breakfast cream of wheat or oatmeal with lots of sugar and butter/cream
yogurt, especially greek yogurt
fruit sauces - there's more than applesauce
....
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My mother lived on Ensure for seven months. Get her some of the high-calorie ones. Just watch that they aren't her sole source of nutrition, or if they are, get the diabetic version. The regular version has a ton of sugar in it, and my mom developed gout as a result.
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If you puree a lot of different vegetables together, it probably does ‘taste like poop’. If you want to give her veges, do them separately and give her a couple of teaspoons sequentially. You will need lots of little plastic containers!
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ZippyZee Oct 2022
Wouldn't that essentially be just a salad with very tiny ingredients?

Hipster types will pay $30 for a meal like that.
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During my mother’s time with puréed foods the thing she liked most was a Wendy’s frosty
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The pureed stuff probably has no, salt, pepper or sugar. Maybe add a little. Sweet Potatoes come to mind if it was me. They are naturally sweet but a little sugar, butter and cinnamon is good. Applesauce I would think needs to be like babyfood. Reg sauce is more "rough" in texture. Little cinnamon and sugar there too. I drank ensure last week when I was sick. An hour or so in the freezer and it gets thick like a milkshake.
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I made puréed food for two family members and they liked it.

1) Make clear light soup or broth first with chicken, beef or pork; add salt and ginger only; I use high-pressure cooker for 40 min. Pour the soup into bottles and refrigerate it overnight. Take out all the grease. Save the meat. Prepare this twice a week.

2) Use the broth to cook quick oats for three mins. Bake walnuts. Add a few sliced meat and any vegetable you like (tomato, celery, carrots, spinach, peas, green pepper etc. ) . Add onion power and garlic powder if you like it. Add little olive oil. Sometimes, add avocados.

3) Use a good blender to purée it.
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I'm not surprised that she thinks the pureed food tastes like poop. If they just take what's for dinner and puree it, that sounds utterly disgusting!

We make a lot of smoothies in our vitamix. Basically we just take a variety of fruits - berries, banana, sometimes some other fruit like an apple or whatever we have on hand. Add a good amount of plain whole milk yogurt - has good protein and no added crapola. For liquid with extra nutrients - add coconut water or a green juice blend.
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My husband after almost dying from aspiration pneumonia in 2018 came home on a pureed diet and since I don't really cook all that much, I just pureed everything he normally like to eat, from meatloaf, turkey and gravy, beef stew to different vegetables. I also made his favorite mashed potatoes which were very easy for him to eat. And of course any creamed soups or otherwise as well. And for breakfast you can make either oatmeal, cream of wheat or grits if she's open to that.
It's really not that difficult to come up with things because again, pretty much everything can be pureed.
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raisin011 Oct 2022
Yes, before my mom had a feeding tube put in she was on pureed food. I put anything and everything in the blender. Chicken, beef, pork, vegetables & fruits. Mashed potatoes are the best.
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To be honest, I would bring her a milkshake; it tastes great, has calories, and will likely make her very happy to get to have such a treat. It's very tough for her to be in such a position in the first place, so my heart goes out to both of you. You are a great daughter (?) to be helping mom like this.

Best of luck!
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