How to Purée Foods for People with Late-Stage Alzheimer's

Patient Expert

As I mentioned in my last sharepost, my mother was tested and eventually had to be placed on a special diet because she was having difficulty swallowing due to Alzheimer's and chronic obstructive pulmonary disease (COPD). However, people with dementia may have issues with swallowing even if they don't have COPD, as is reflected by various comments on this site.

According to the Mayo Clinic, that's because the brain changes caused by Alzheimer's may affect physical functions such as swallowing (and also balance as well, as bowel and bladder control, but that's another topic). People who are having difficulty swallowing may cough a lot or exhibit signs of choking when eating. "Difficulty swallowing may cause people with Alzheimer's to inhale (aspirate) food or liquid into their airways and lungs, which can lead to pneumonia," the clinic's website stated.   People who experience difficulty swallowing can easily start becoming afraid of choking and may start avoiding food and beverages that may be difficult to swallow. This can lead to dehydration, weight loss and malnutrition.

When people with Alzheimer's have difficulty swallowing, they are placed on a diet of puréed foods. "Puréed foods are prepared by mashing, grinding or chopping food until a very fine, smooth texture is achieved," writes Dr. Wendy Dahl, an assistant professor for the University of Florida's Food Science and Human Nutrition Department. Common examples of puréed foods that we eat every day include mashed potatoes and the filling in pumpkin pie.

Dr. Dahl said the ideal puréed food needs to be ready for swallowing and shouldn't require any additional chewing or saliva (which moistens and binds food morsels together prior so that the person can swallow their food). "Puréed foods should be moist, cohesive (holds together), and spoon-thick," she stated. "They should not be sticky, lumpy, dry or runny."

Dr. Dahl suggests that puréed foods be prepared with a food processor, although hand blenders can be used to prepare small portions of easily processed foods like ripe fruits and cooked vegetables.   She does not recommend using a blender for two reasons - the difficulty in achieving a smooth texture and the possibility that you'll add too much liquid, thus causing the food to be too runny. Dr. Dahl recommends a four-step process to prepare puréed foods:

  • Process the food using a food processor until it is cut into a fine texture.
  • If necessary, add small amounts of liquid. You should use hot liquids for cooked foods or cold liquids for cold foods. Process the liquid and the food until it becomes a smooth, pudding-like texture.
  • Season or flavor before scraping down the puréed food off of the sides of the food processor. Reprocess if necessary.
  • Reheat the cooked, puréed foods or chill cold, thickened foods so that you can serve them at proper temperature.

Dr. Dahl also provided great tips to help you get the right texture. These tips are:

  • Make sure that the puréed food is uniform and appearance as well as color. If the food is chunky or you see pieces, you need to use the food processor again.
  • Use a spoon to test the purée. The composition needs to be similar to yogurt or pudding when you put it on the spoon. If it drips or runs, it's probably too thin; however, if you get a glob on the spoon, it may be too thick.
  • Also, the puréed food is too sticky if it sticks to the spoon. If you have this problem, you can add fat (such as butter, sour cream or gravy) to lessen the stickiness.
  • If the puréed food is too runny, use baby rice cereal to thicken. You also can purée canned chickpeas or other canned plain beans into soups or vegetables to add thickness.
  • If the puréed food is too dry, add liquids such as milk or gravy.
  • Add some seasonings, such as sugar, salt, fat, or condiments to add flavor.

Primary Source for this Sharepost:

Dahl, Wendy J. (2011). Pureed foods for swallowing problems. University of Florida Institute of Food and Agricultural Sciences Extension.