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Nursing Home says patient may not refuse however they do allow any kind of food to be ordered or sent to patient. They said that would be acceptable but they could not serve the patient anything other than a mechanical diet. The patient in question has been eating regular foods he has personally ordered or that has been sent to him. He would like to sign a form taking responsibility/consequences for his refusing a mechanical diet. Are there laws for nursing homes to abide by patients wishes? Than you.

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I’m wondering if instead of a purely soft food / puréed food diet that he gets mechanized proteins? So the proteins go thru a machine similar to a tenderizer to get flatten out more, has lil pinholes in it, so easier to cut, and swallow. Dietary should be able to do this and have the equipment.

My mom was bedfast her last 18 months and went on mechanized protein diet. Like boneless chix thighs, veal cutlets, thin sliced pork chops. Add in thin sliced catfish or soft omelettes, it was pretty varied menu with no real choking opportunity & easy on digestion.
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I will be visiting him soon and will see if he can request that. Than you .
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Alva, an RN by the way, is correct. If the doctor ordered a soft diet then that is what kitchen staff must serve. What they can't do is keep the resident from ordering in food or having someone bring it to them. There is a reason the resident is not suppose to be eating regular food. If a swallowing problem is involved he could aspirate the food into his lungs causing pneumonia or worse, death.

If the resident is of sound mind, he needs to talk to the Doctor who ordered the diet. Me personally, I sympathize with the person. I would not want to eat my food like this either.
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Pam167 Sep 2022
He is mentally competent. I understand that the Nursing Home does not want to be liable if he chokes and aspirates in his lungs. He has Cerebral Palsy and has dysphasia. He had heard that there is something called “Patients Right to Refuse” waiver that he could sign that would release the Nursing Home from liability. He said his only pleasure is food and says that purée the diet tastes bad. He is losing weight because he doesn’t eat very much. The Nursing Home staff lets him order outside food (which he pays for) and I send him food that he asks for. He hasn’t had a problem with outside food. He has been getting Vitalstim Therapy, which I believe is helping swallowing issues. I think I will urge him to request another swallow test reevaluation.
Thank you for your reply.
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Are there swallow difficulties here that are diagnosed? If there are, and the facility is aware of that, and an MD has ordered a mechanical soft diet, then that home would be held liable for allowing the patient to have a dangerous diet. I don't think it is enough for the patient to say that he will be responsible because he may not be completely competent nor qualified to make that decision.
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Pam167, I read your profile and I am curious why the person, who is only 67 years old, is living in a nursing home. The health issues mentioned don't qualify. There must be something more.

Plus I am surprised that a nursing home would accept carry-out delivery of food for a patient.

Can you provide more information.
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Pam167 Sep 2022
He has Cerebral Palsy. He has asked me to inquire for him. He had heard that a patient has a right to refuse this diet. He does have some swallowing issues due to dysphasia.
He says he wants to enjoy food and does not like the puréed diet. The Nursing Staff has said he can order outside of facility (and pay for himself) any type of food he would like. I have been sending him whatever food he asks for and bring him food when I visit. He has been tolerating the food he orders (and I send) without any issues. His wish is to sign a “Right to Refuse” waiver, if such a thing exists.
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Hiw about getting a new swallow study to determine if the reside t actually requires a modified diet?
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Clairesmum Sep 2022
sounds like a good idea, especially if the previous one was done at a time when he was recovering from an acute illness or was very stressed out.
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