Question

Using the following menus for a healthy adult indicate the adjustments you would make to provide a therapeutically appropriate menu for each patient described.

Case study- 1 ( 12.5 points)

A 69-year-old disabled gentleman who is recovering from a stroke. A swallow evaluation by his speech therapist determines he can tolerate thin liquids but has mild dysphagia requiring soft, cohesive textures.

Regular MenuType of diet/adjustments needed for Level 2 dysphagia:

Breakfast                                                                                                                   Whole-grain bagel with ham and cream cheese     Fresh orange slices                                                     Milk/coffee

Lunch Peanut butter sandwich                                             Carrot sticks                                                            Milk                                                                               Ginger snap cookies

Dinner Baked chicken                                                          Roasted potatoes                                                    Broccoli                                                                     Dinner roll with margarine                                   Coffee, tea, or milk

Case Study-2  (12.5 points)

A 43-year-old obese gentleman with a history of gastroesophageal reflux disease (GERD). He complains of severe “heartburn” after eating, especially at night.

Regular Menu Type of diet/adjustments needed for a patient with GERD:       

Breakfast                                                                                               Oatmeal with walnuts                                      Orange juice                                                       Coffee with cream

Lunch Fried chicken                                                  Mashed potatoes/gravy                                Coleslaw                                                           Roll/margarine                                              Diet soda

Dinner Pasta with cream sauce                                    Tossed salad with feta cheese/dressing        Garlic bread                                                         Ice cream                                                             Red wine

Answer 1

Case study -1

Regular MenuType of diet/adjustments needed for Level 2 dysphagia:

Breakfast

Soft pan cakes/ sweet rolls/ cooked cereals such as oatmeal

Milk/fresh juice

Lunch

Rice porridge/ health mix

Well cooked vegetables

Orange juice

Dinner

Meat salad

Custard/ pudding

Milk/ coffee

Case study - 2

Regular Menu Type of diet/adjustments needed for a patient with GERD:

Certain foods and beverages can exacerbate GERD symptoms, including heartburn and a sour taste from regurgitation.

Items that people with GERD are often advised to avoid include:

• Alcohol
• Caffeine
• Carbonated beverages
• Chocolate
• Citrus fruits and juices
• Tomatoes and tomato-based foods
• Garlic
• Mint
• Onions
• Spicy foods
• Fatty foods
• Fried foods (1,2)

Some of these items — including fatty foods, chocolate, peppermint, and alcohol — are thought to worsen GERD symptoms by relaxing the lower esophageal sphincter (LES), the ring of muscle that separates your stomach from your esophagus

Breakfast

Low fat muffins/ doughnuts

Almond milk

Orange -1

Lunch

Creamy or tomato based soup

Poultry without it's skin

Egg

Pasta with creamy

Apple juice

Dinner

Low fat pudding

Cakes/ pastries

Sliced fruits