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VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Even I tried the powder and it's not something I'd drink. He needs nectar consistency. Naked juice works but way too sugary for his diabetes. Is there any other tips you guys have?
Simplythick is a good thickener. It's not a powder. My husband uses it. It's a little pricey, but worth it. Because it lasts quite a while. My husband doesn't like the powders either.
My Patient was also diagnosed with dysphagia. I was told by the dietary nurse that he needed thicken drinks, however, if he could be “managed” to drink very slowly he could drink regular drinks. It also did not matter if he drank with a straw or by an open glass/cup. Sometimes medical conditions situations are diagnosed as black or white when they are actually grey.
I'm just curious - how did you know he wasn't aspirating?
The point that might dangerously be overlooked is that a patient with an impaired swallowing reflex may not cough if liquid enters the trachea instead of the oesophagus. You can't assume (and I'm sure you personally didn't assume) that because a person doesn't cough or splutter as long as he goes slowly then all is well.
My husband had the same problem...but they make it in liquid form (Amazon gallons-also at some drug stores), and then I put some (no sugar-Wiler's Iced tea or berry flavor packets into it), with straw. My husband only liked the flavored water. Also I had Boost or Ensure Plus (many flavors), which are somewhat nectar-thickened by shaking, and gives vitamins at same time. Wishing you patience and health...it's good you care for your Grandpa.
TaylorUK queried: "I have no idea why anyone would want to thicken liquids up." Perhaps you're not familiar with dysphagia and the different levels, which require specific diets as well as thickening for specific liquids.
It's been some years since we had to thicken liquids for my father's diet (he's now deceased), but I still have the guidelines, which might help in understanding as well as provide inspiration to others dealing with dysphagia accommodations.
Speech therapists gave us guidelines from the American Dietetic Assn., Residential Home Health, and one of the hospital chain Rehab Institutes. They address the then 4 levels of liquid consistency: thin, nectar-like, honey-like, and spoon-thick, and provide examples of each.
These combined guidelines are the best I've seen for addressing dysphagia.
Doreooo, I found the same problem with the Thik-it powders. I don't know if I could force myself to drink some of the concoctions, but others have raised good alternatives, including nonsugary applesauce.
In fact, one of the therapists recommended it to soften treats which would otherwise be unacceptable. Applesauce softened ginger cookies enough that Dad could literally slurp them, and it was a nice change from the bland food.
You might want to contact the speech pathologist who diagnosed your father and ask for additional suggestions, or at least the charts listing the various levels and acceptable foods and drinks.
I checked those guidelines, but they're for Levels 1 and 2, and given the time and the fact that I believe some guidelines have changed, I'm not sure if either of these are equivalent to nectar-thick.
CWillie, that's the best guide for thickening agents that I've ever seen! I saved it, in the event that I (hopefully will not) one day reach that stage.
The thickener gels work better than the powder ones in my experience. Resource has thicken-up clear, it is more expensive but dissolves much easier in all thin liquids including ice cream and soda which usually is impossible to thicken with the powder.
I don’t know about USA but in the UK we have a setting gel that can go on sweet flans that’s sugar free. gelatine. Non flavoured . Can mix to your choice of thickness and quick gel sugar free for sweet items again would need to put more water to it as it can set like jelly. I think you may need to add hot water and make in advance. Trial and error! For savoury cornflour. Mix to a paste and add water to required thickness, but think you need to bring that to the heat and then let cool. all ok I think for diabetes.
My mom (who is very picky) still did okay with Thick It. She also did okay with the Thick It brand of bottled juices/water. But she does even better with Simply Thick, a gel-like liquid that we add to all of her liquids. A speech therapy specializing in swallow disorders recommended it. It is not inexpensive, but it's worth it for us. I order it regularly from Amazon. I highly recommend it.
Here in Britain I find the best thickener is Nutilis. Agreed, any thickened doesn't taste the greatest. However, I follow it immediately with 150 ml of coconut water (not coconut milk) and 50 ml of Kefir--which tastes good and is quite nutritious, with no sugar. A useful trick is to give a quick taste of this BEFORE the thickener and then follow immediately with the thickener. This works well with my wife who is 12 years into Alzheimer's.
The value of the thickener is that it coats the stomach lining and prevents throwing up--quite important.
Life as a caregiver has its challenges, but is worthwhile.
I'm confused by your post - while kefir may be thick enough isn't the coconut water much too thin? And what do you mean about having a taste of something before the thickener, it isn't given like a dose of medicine. The point of thickeners is to prevent thin fluids from going the wrong way into the lung, they haven't anything to do with coating the stomach 🤔
There are sponges on a stick that hospitals use to give patients water who might aspirate. I think they would work for other liquids things-melted ice cream, juice, broth.
Somewhere I've got a lovely brightly-coloured chart about "what contributes to my fluid intake" - can't lay my hands on it, but don't forget that as well as drinks, as in drinks as such, lots of other things count. E.g.
Ice cream Jello Soup Fruit such as watermelon Milk puddings like rice pudding, semolina etc.
If he likes the taste of yoghurt, you could try offering lassi, a yoghurt drink that doesn't have to be sweetened.
Is the swallowing impairment the result of a recent stroke?
Nestle makes a thickner that is more expensive but seems a LITTLE better. My poor father had to have thickner, I always felt so badly. The Nestle is more expensive, but it also holds its consistency and does not keep getting thicker the longer it sits. I used to get it at walgreens, but I am sure it is available on line. Best of luck to you. Just an FYI, V8 is probably fine on its own as far as thickness!
Perhaps - and I have no idea why anyone would want to thicken liquids up - you could try something like a collagen powder, it has no taste but may supply some protein as well. Or maybe better than that would be a protein powder from a sports store? or Health food store? Something that actually has some benefit as well as making whatever thicker.
Regarding the diabetes - you say your Grandfather cannot have fruit juice due to his diabetes, and he cannot hold things anymore, I don't know what his life expectancy is but he is obviously not a well man. Talk to his doctor about adjusting his diabetes treatment to account for the sugar in fruit juice if this is what he would like to have, there is a huge range of options for treating the diabetes and changing that may make life easier and more pleasant for him rather than stopping him having what he would like.
A lot of elderly have swallowing problems, there is a danger of aspiration thin liquids into the lungs and causing pneumonia. Thickened liquids are less likely to cause this.
I used Thick It and never had a problem with my Husband refusing to eat or drink anything. How about pureeing fruits for him to drink. Some are more dense so they would not need to be thickened. If you process a blend you might get the right consistency. It would be like a smoothie. You can thin it down with a fruit juice if it becomes thicker than he needs. Avoid giving things that will melt to a watery consistency though. Ice cream, popsicles, even yogurt gets thin in your mouth all of these can be easily aspirated. Because you are concerned about the sugar and his diabetes I would try different brands of thickeners. (contact his doctors office and ask if they have samples of different ones, or ask at the pharmacy) Also do not think only of fluids to help hydrate. There are lots of foods that can be given that will help. meals can be soups, stews, hot breakfast cereals like oatmeal, cream of wheat, even polenta, rice pudding can help. There are also protein drinks that are formulated for diabetics that are a bit thicker than drinking water, juice or milk.
Just an FYI - If he is in danger of aspirating thin fluids I'd be very cautious trying anything like popsicles, they will melt into a thin liquid in his mouth and cause a choking hazard.
Was it the product Thick It that your grandpa didn't like? I used that for my husband for the last 22 months of his life, and he never complained that it made his drinks taste different. Are you sure it's just not the consistency that he's not liking, instead of the taste, as Thick It is tasteless?
Not thick it, it was a generic one from Walgreens. It just sats Thickening Powder. Maybe I should switch brands. It makes the drink taste watered down if that makes sense?
Daddy lived on popsicles the last month of his life. No problem with sugar, he was not diabetic, but he did get hydrated (to a degree) with 4-6 popsicles a day. He knew he wouldn't choke on them, that's why he liked them.
What kind are you using, I thought it was pretty much tasteless although the thickened texture can take getting used to. My go to was ThickenUp clear (made with xanthan gum) - that's what they used at mom's nursing home too.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
My husband uses it. It's a little pricey, but worth it. Because it lasts quite a while. My husband doesn't like the powders either.
The point that might dangerously be overlooked is that a patient with an impaired swallowing reflex may not cough if liquid enters the trachea instead of the oesophagus. You can't assume (and I'm sure you personally didn't assume) that because a person doesn't cough or splutter as long as he goes slowly then all is well.
It's been some years since we had to thicken liquids for my father's diet (he's now deceased), but I still have the guidelines, which might help in understanding as well as provide inspiration to others dealing with dysphagia accommodations.
Speech therapists gave us guidelines from the American Dietetic Assn., Residential Home Health, and one of the hospital chain Rehab Institutes. They address the then 4 levels of liquid consistency: thin, nectar-like, honey-like, and spoon-thick, and provide examples of each.
These combined guidelines are the best I've seen for addressing dysphagia.
Doreooo, I found the same problem with the Thik-it powders. I don't know if I could force myself to drink some of the concoctions, but others have raised good alternatives, including nonsugary applesauce.
In fact, one of the therapists recommended it to soften treats which would otherwise be unacceptable. Applesauce softened ginger cookies enough that Dad could literally slurp them, and it was a nice change from the bland food.
You might want to contact the speech pathologist who diagnosed your father and ask for additional suggestions, or at least the charts listing the various levels and acceptable foods and drinks.
I checked those guidelines, but they're for Levels 1 and 2, and given the time and the fact that I believe some guidelines have changed, I'm not sure if either of these are equivalent to nectar-thick.
https://www.dysphagia-diet.com/Images/ThickenerComparison_2013.pdf
gelatine. Non flavoured . Can mix to your choice of thickness and quick gel sugar free for sweet items again would need to put more water to it as it can set like jelly. I think you may need to add hot water and make in advance. Trial and error!
For savoury cornflour. Mix to a paste and add water to required thickness, but think you need to bring that to the heat and then let cool.
all ok I think for diabetes.
The value of the thickener is that it coats the stomach lining and prevents throwing up--quite important.
Life as a caregiver has its challenges, but is worthwhile.
All the best
Love and Prayer
Ice cream
Jello
Soup
Fruit such as watermelon
Milk puddings like rice pudding, semolina etc.
If he likes the taste of yoghurt, you could try offering lassi, a yoghurt drink that doesn't have to be sweetened.
Is the swallowing impairment the result of a recent stroke?
Regarding the diabetes - you say your Grandfather cannot have fruit juice due to his diabetes, and he cannot hold things anymore, I don't know what his life expectancy is but he is obviously not a well man. Talk to his doctor about adjusting his diabetes treatment to account for the sugar in fruit juice if this is what he would like to have, there is a huge range of options for treating the diabetes and changing that may make life easier and more pleasant for him rather than stopping him having what he would like.
How about pureeing fruits for him to drink. Some are more dense so they would not need to be thickened. If you process a blend you might get the right consistency. It would be like a smoothie. You can thin it down with a fruit juice if it becomes thicker than he needs.
Avoid giving things that will melt to a watery consistency though. Ice cream, popsicles, even yogurt gets thin in your mouth all of these can be easily aspirated.
Because you are concerned about the sugar and his diabetes I would try different brands of thickeners. (contact his doctors office and ask if they have samples of different ones, or ask at the pharmacy)
Also do not think only of fluids to help hydrate. There are lots of foods that can be given that will help. meals can be soups, stews, hot breakfast cereals like oatmeal, cream of wheat, even polenta, rice pudding can help.
There are also protein drinks that are formulated for diabetics that are a bit thicker than drinking water, juice or milk.