1 00:00:12,384 --> 00:00:14,544 Welcome to the Swallow Your Pride podcast. I'm 2 00:00:14,544 --> 00:00:16,804 your host, Teresa Richard. I'm a board certified 3 00:00:16,864 --> 00:00:18,964 specialist in swallowing and swallowing disorders, 4 00:00:19,345 --> 00:00:21,585 a mobile thieves business owner, and founder of 5 00:00:21,585 --> 00:00:22,964 the MedSLP Collective. 6 00:00:23,345 --> 00:00:25,505 This podcast is all about delivering the latest 7 00:00:25,505 --> 00:00:27,204 evidence based practice to medical 8 00:00:27,519 --> 00:00:28,260 SLPs everywhere. 9 00:00:28,560 --> 00:00:31,039 Whether you're a new clinician seeking tangible tools 10 00:00:31,039 --> 00:00:33,119 for treatment or a seasoned vet stuck in 11 00:00:33,119 --> 00:00:35,039 a rut, my goal is to help ditch 12 00:00:35,039 --> 00:00:36,640 the old school ways of the past that 13 00:00:36,640 --> 00:00:38,799 no longer serve you or your patients, to 14 00:00:38,799 --> 00:00:41,204 reinvigorate your passion for our field, to broaden 15 00:00:41,204 --> 00:00:43,364 your knowledge about our scope of practice, and 16 00:00:43,364 --> 00:00:45,125 to inspire you to practice at the top 17 00:00:45,125 --> 00:00:47,204 of your license. So if you're listening, I 18 00:00:47,204 --> 00:00:49,524 encourage you to swallow your pride, be open 19 00:00:49,524 --> 00:00:51,684 and willing to learn because let's face it, 20 00:00:51,684 --> 00:00:54,244 your patients deserve that kind of care. With 21 00:00:54,244 --> 00:00:56,104 that, let's dive right in. 22 00:00:56,649 --> 00:00:58,810 Just a quick disclaimer that all statements and 23 00:00:58,810 --> 00:01:01,289 opinions expressed in this episode do not reflect 24 00:01:01,289 --> 00:01:04,090 on the organizations associated with the speakers and 25 00:01:04,090 --> 00:01:06,969 are their own opinions solely. Alright. Good morning, 26 00:01:06,969 --> 00:01:07,469 Diane. 27 00:01:08,409 --> 00:01:11,094 Good morning, Theresa. How are you? I am 28 00:01:11,094 --> 00:01:12,775 wonderful. Thank you so much for joining me 29 00:01:12,775 --> 00:01:13,275 today. 30 00:01:14,055 --> 00:01:15,674 You're welcome. It's my honor. 31 00:01:16,055 --> 00:01:17,655 Yeah. So tell the people a little bit 32 00:01:17,655 --> 00:01:18,314 about yourself. 33 00:01:18,775 --> 00:01:19,754 I'm an author, 34 00:01:20,055 --> 00:01:22,134 and I gave up the literary life to 35 00:01:22,134 --> 00:01:24,155 become my mother's primary caregiver. 36 00:01:24,620 --> 00:01:25,760 And that journey, 37 00:01:26,060 --> 00:01:28,299 which was something I had never thought I 38 00:01:28,299 --> 00:01:30,939 could do, led me to write, it's a 39 00:01:30,939 --> 00:01:33,420 guidebook cookbook for setting up and running a 40 00:01:33,420 --> 00:01:35,200 dysphagia kitchen. Because 41 00:01:35,900 --> 00:01:37,359 when my mother was diagnosed, 42 00:01:38,034 --> 00:01:39,795 there was nothing that told me how to 43 00:01:39,795 --> 00:01:41,715 do it. And, of course, the household is 44 00:01:41,715 --> 00:01:42,935 thrown into a tizzy 45 00:01:43,474 --> 00:01:45,174 because it's a big responsibility 46 00:01:45,635 --> 00:01:46,694 for someone else's 47 00:01:47,075 --> 00:01:48,055 health and healing. 48 00:01:48,995 --> 00:01:51,900 So that's the journey that I went on. 49 00:01:51,900 --> 00:01:54,540 I was encouraged by my mother's primary care 50 00:01:54,540 --> 00:01:57,260 physician. He said, gee, your mom is doing 51 00:01:57,260 --> 00:01:58,560 so well, and we 52 00:01:59,099 --> 00:02:01,659 health care providers, we need tools to give 53 00:02:01,659 --> 00:02:02,400 to our 54 00:02:03,575 --> 00:02:06,215 patients and their caregivers. So you have the 55 00:02:06,215 --> 00:02:07,814 skills to do this. Why don't you do 56 00:02:07,814 --> 00:02:09,275 it? And that's how it started. 57 00:02:10,134 --> 00:02:13,014 So I found out something, though, that being 58 00:02:13,014 --> 00:02:13,675 a caregiver 59 00:02:14,614 --> 00:02:17,435 taught me the caregiver's perspective. And it 60 00:02:18,060 --> 00:02:19,979 where I thought I was going away from 61 00:02:19,979 --> 00:02:22,620 my literary career, it opened up my heart 62 00:02:22,620 --> 00:02:24,780 and my writing got better because it was 63 00:02:24,780 --> 00:02:26,879 not I wasn't in my head as much. 64 00:02:27,099 --> 00:02:29,020 I was in my heart, and I was 65 00:02:29,020 --> 00:02:31,740 meeting a community of people, the community of 66 00:02:31,740 --> 00:02:32,240 caregivers, 67 00:02:33,254 --> 00:02:35,995 the community of health care providers, the SLPs, 68 00:02:36,375 --> 00:02:37,834 the the dietitians, 69 00:02:38,534 --> 00:02:41,834 they're fabulous communities. Instead of being isolated 70 00:02:42,215 --> 00:02:44,875 alone in a room with my computer 71 00:02:45,414 --> 00:02:47,514 and my research and my writing, 72 00:02:48,280 --> 00:02:49,019 I had 73 00:02:49,400 --> 00:02:49,900 people. 74 00:02:50,439 --> 00:02:51,959 It was and so it turned out to 75 00:02:51,959 --> 00:02:52,459 be 76 00:02:52,759 --> 00:02:55,080 better for my health and my own writing. 77 00:02:55,080 --> 00:02:58,039 You know? I became an independent publisher. And 78 00:02:58,039 --> 00:03:00,439 for a long time, I was the only 79 00:03:00,439 --> 00:03:02,780 publisher in the country of a line of 80 00:03:03,284 --> 00:03:04,745 ebooks for dysphagia. 81 00:03:05,604 --> 00:03:07,444 And then I wanted to reach a wider 82 00:03:07,444 --> 00:03:09,844 audience, so I wrote the book that I'm 83 00:03:09,844 --> 00:03:12,724 now speaking about, which was for a wider 84 00:03:12,724 --> 00:03:15,544 audience. From the caregiver's point of view, 85 00:03:16,210 --> 00:03:18,870 it's setting up and running a dysphasia kitchen, 86 00:03:19,490 --> 00:03:22,050 and it's to avoid caregiver burnout. It's to 87 00:03:22,050 --> 00:03:24,550 give the patient and their caregiver variety. 88 00:03:25,250 --> 00:03:25,750 And 89 00:03:26,530 --> 00:03:29,250 the single most important choice that anybody can 90 00:03:29,250 --> 00:03:32,224 make in a dysphagia household is the nutrition 91 00:03:32,444 --> 00:03:35,264 because it has the most direct effect on 92 00:03:36,525 --> 00:03:37,665 quality of life 93 00:03:38,125 --> 00:03:39,025 and mood 94 00:03:39,405 --> 00:03:41,025 and feeling cared for. 95 00:03:41,659 --> 00:03:44,400 And it's completely under the patient's control. 96 00:03:44,939 --> 00:03:47,740 So I decided to write the book where 97 00:03:47,740 --> 00:03:50,780 people could use it to adapt their own 98 00:03:50,780 --> 00:03:51,280 kitchen 99 00:03:52,219 --> 00:03:53,759 to a dysphasia kitchen 100 00:03:54,064 --> 00:03:55,745 step by step, and it's the book that 101 00:03:55,745 --> 00:03:57,745 I wish I had when my mother was 102 00:03:57,745 --> 00:03:58,245 diagnosed. 103 00:03:59,264 --> 00:04:01,344 Yeah. Yeah. Awesome. Thank thank you so much 104 00:04:01,344 --> 00:04:02,544 for sharing all that. You know, it's it 105 00:04:02,544 --> 00:04:04,064 was so interesting about one thing that you 106 00:04:04,064 --> 00:04:06,465 said was when I wrote my first book, 107 00:04:06,784 --> 00:04:07,905 you know, I wrote a book called So 108 00:04:07,905 --> 00:04:10,800 You're Having Trouble Swallowing for for patients. And 109 00:04:10,800 --> 00:04:12,240 what was interesting was I wrote it from 110 00:04:12,240 --> 00:04:14,480 the perspective of the issues that I had 111 00:04:14,480 --> 00:04:15,460 had with my son, 112 00:04:15,920 --> 00:04:18,080 and it just it flowed out of me. 113 00:04:18,080 --> 00:04:19,920 Like, so much of it just I'd say 114 00:04:19,920 --> 00:04:21,920 two thirds of it came out super, super, 115 00:04:21,920 --> 00:04:23,805 super easy because it was just from the 116 00:04:23,805 --> 00:04:26,205 heart and my experiences. You know? And then 117 00:04:26,205 --> 00:04:27,485 I had to go back and add in 118 00:04:27,485 --> 00:04:30,205 more of the technical dysphasia language from being 119 00:04:30,205 --> 00:04:31,425 an SLP, and 120 00:04:31,805 --> 00:04:33,965 that part took me forever because it was 121 00:04:33,965 --> 00:04:34,705 just so, 122 00:04:35,085 --> 00:04:37,149 like, technical, and I knew that stuff. But 123 00:04:37,149 --> 00:04:39,069 it was so much easier to just write 124 00:04:39,069 --> 00:04:41,329 from my experiences as opposed to 125 00:04:41,629 --> 00:04:43,550 the technical stuff. So I, you know, I 126 00:04:43,550 --> 00:04:44,290 I completely 127 00:04:44,670 --> 00:04:46,110 know what you mean. You know, mine was 128 00:04:46,110 --> 00:04:47,870 sort of the reverse order of your experience, 129 00:04:47,870 --> 00:04:50,910 but, like, completely understand exactly what you're saying. 130 00:04:50,910 --> 00:04:52,300 If you Yeah. Recall, 131 00:04:52,615 --> 00:04:54,714 the first time I was on your podcast, 132 00:04:54,774 --> 00:04:56,794 you were discussing the fact that 133 00:04:57,654 --> 00:05:00,615 I originally wrote this my mother's household was 134 00:05:00,615 --> 00:05:02,634 she had decided to age in place. 135 00:05:03,254 --> 00:05:05,495 She did have a health care facility that 136 00:05:05,495 --> 00:05:07,414 she had paid for. She didn't wanna go, 137 00:05:07,414 --> 00:05:08,669 and she asked me if I I would 138 00:05:08,669 --> 00:05:11,089 be her caregiver, which I agreed to. 139 00:05:11,470 --> 00:05:14,189 Then when I was on your podcast, you 140 00:05:14,189 --> 00:05:16,910 described to me how what your schedule was 141 00:05:16,910 --> 00:05:19,089 like, that you had a family member 142 00:05:19,470 --> 00:05:21,629 that you had to make dysphagia food for 143 00:05:21,629 --> 00:05:22,370 your son 144 00:05:22,754 --> 00:05:24,915 and then make food for the family and 145 00:05:24,915 --> 00:05:26,775 with a full time job. So 146 00:05:27,235 --> 00:05:29,895 I structured my book to be 147 00:05:30,355 --> 00:05:31,415 for the dedicated 148 00:05:32,194 --> 00:05:32,694 single 149 00:05:32,995 --> 00:05:34,215 person with dysphagia 150 00:05:34,850 --> 00:05:36,949 for family and friends. And, also, 151 00:05:37,569 --> 00:05:40,370 my recipes can be adapted if there's a 152 00:05:40,370 --> 00:05:42,790 chef in a care facility that wants to 153 00:05:43,169 --> 00:05:45,569 expand their repertoire or get some they can 154 00:05:45,569 --> 00:05:47,264 use my recipes. And I 155 00:05:47,745 --> 00:05:49,985 have the directions in the book of how 156 00:05:49,985 --> 00:05:51,685 to scale it up if they have, 157 00:05:52,225 --> 00:05:54,465 you know, more than six to eight people 158 00:05:54,465 --> 00:05:56,545 if they need it for 30 or 40 159 00:05:56,545 --> 00:05:58,324 or 50 or 200 people. 160 00:05:58,785 --> 00:06:01,185 So and then the other use which people 161 00:06:01,185 --> 00:06:03,579 don't recognize so much is when you have 162 00:06:03,579 --> 00:06:04,720 a loved one in 163 00:06:05,180 --> 00:06:06,480 a health care facility, 164 00:06:07,819 --> 00:06:10,459 many of the facilities will allow family and 165 00:06:10,459 --> 00:06:12,379 friends to bring food as long as it 166 00:06:12,379 --> 00:06:13,759 conforms to the IDDSI 167 00:06:14,504 --> 00:06:18,105 prescribed level. Yep. So my food, of course, 168 00:06:18,105 --> 00:06:19,324 is prescribed 169 00:06:19,705 --> 00:06:22,185 gone to the I give the directions for 170 00:06:22,185 --> 00:06:24,905 a webinar for the prescribed IDDSI level so 171 00:06:24,905 --> 00:06:27,064 that the family that's visiting a loved one 172 00:06:27,064 --> 00:06:29,145 in a health care care facility can bring 173 00:06:29,145 --> 00:06:31,189 approved food. I have a colleague 174 00:06:32,050 --> 00:06:33,649 who was the head of long term care 175 00:06:33,649 --> 00:06:34,789 at Aetna Insurance 176 00:06:35,169 --> 00:06:37,970 for twenty years, and she visited health care 177 00:06:37,970 --> 00:06:40,289 facilities all over the state of Florida at 178 00:06:40,289 --> 00:06:41,029 every level. 179 00:06:41,490 --> 00:06:42,389 And the single 180 00:06:42,944 --> 00:06:45,824 most prevalent complaint that she heard was a 181 00:06:45,824 --> 00:06:47,044 boring tasteless 182 00:06:47,345 --> 00:06:47,845 food. 183 00:06:48,865 --> 00:06:51,584 So when people lose interest in food and 184 00:06:51,584 --> 00:06:52,644 they stop eating, 185 00:06:53,024 --> 00:06:55,584 their immune system is affected, and they're more 186 00:06:55,584 --> 00:06:57,365 prone to getting effect infections. 187 00:06:58,019 --> 00:07:00,279 So the object is to keep the person 188 00:07:00,339 --> 00:07:02,579 interested and excited about the food. And the 189 00:07:02,579 --> 00:07:04,680 way you do this is partly its variety, 190 00:07:04,740 --> 00:07:05,399 and partly 191 00:07:05,779 --> 00:07:07,399 the first step in converting 192 00:07:07,779 --> 00:07:09,959 to a dysphasia kitchen is to 193 00:07:10,595 --> 00:07:13,475 make the menu, ask the person their 10 194 00:07:13,475 --> 00:07:14,454 favorite meals, 195 00:07:14,834 --> 00:07:17,154 then you know what you're cooking. That's where 196 00:07:17,154 --> 00:07:20,035 you start. Alright. Let's, let's let's take a 197 00:07:20,035 --> 00:07:21,954 few steps back here, Diane. I would love 198 00:07:21,954 --> 00:07:23,394 to you know, I know that you've always 199 00:07:23,394 --> 00:07:25,229 been passionate about well, not always, but since 200 00:07:25,229 --> 00:07:27,229 your experiences you've been passionate about this, how 201 00:07:27,229 --> 00:07:29,729 did this book exactly come to life? Because, 202 00:07:30,269 --> 00:07:32,110 we're we're sharing this from you know, I've 203 00:07:32,110 --> 00:07:34,269 always respected Diane's work. She always reaches out 204 00:07:34,269 --> 00:07:36,110 to me when she has great projects going 205 00:07:36,110 --> 00:07:37,629 on and and vice versa. We have such 206 00:07:37,629 --> 00:07:39,389 a great mutual respect for each other's work, 207 00:07:39,389 --> 00:07:42,154 and she invited me to write the first 208 00:07:42,154 --> 00:07:44,395 chapter of this cookbook that she just released. 209 00:07:44,395 --> 00:07:45,514 And I would love for you to tell 210 00:07:45,514 --> 00:07:47,435 people sort of how this whole thing came 211 00:07:47,435 --> 00:07:48,095 to life. 212 00:07:49,115 --> 00:07:51,835 Well, when I decided I needed to reach 213 00:07:51,835 --> 00:07:52,975 a wider audience, 214 00:07:53,595 --> 00:07:55,535 I proposed this book idea 215 00:07:56,410 --> 00:07:58,829 to the Mayo Clinic Press because 216 00:08:00,089 --> 00:08:02,490 they have what I didn't have, which was 217 00:08:02,490 --> 00:08:04,029 the ability to inform 218 00:08:05,849 --> 00:08:07,789 well, here's what happened. 219 00:08:08,714 --> 00:08:11,514 I teach and do lecture demos on the 220 00:08:11,514 --> 00:08:15,595 AARP family caregiver support group. So I speak 221 00:08:15,595 --> 00:08:17,375 directly to family caregivers. 222 00:08:17,675 --> 00:08:19,675 I know what their needs are. So I 223 00:08:19,675 --> 00:08:20,175 was 224 00:08:21,129 --> 00:08:23,289 talking about the fact that there are forty 225 00:08:23,289 --> 00:08:25,930 five million people in home health care in 226 00:08:25,930 --> 00:08:26,669 The US. 227 00:08:26,970 --> 00:08:29,689 And the woman who's the moderator, who's a 228 00:08:29,689 --> 00:08:31,689 good friend of mine and a very talented 229 00:08:31,689 --> 00:08:33,929 and brilliant woman, she said, Diane, it's forty 230 00:08:33,929 --> 00:08:34,589 eight million. 231 00:08:35,794 --> 00:08:37,495 And if you figure that 232 00:08:38,034 --> 00:08:39,894 the percentage for dysphagia, 233 00:08:40,274 --> 00:08:42,674 it's eight to twelve percent. So I figured 234 00:08:42,674 --> 00:08:45,575 ten percent. That's four point eight million people. 235 00:08:45,794 --> 00:08:48,514 Mhmm. And the food that's available in the 236 00:08:48,514 --> 00:08:49,014 marketplace 237 00:08:49,714 --> 00:08:50,454 is not 238 00:08:51,169 --> 00:08:52,769 as good as the food that you would 239 00:08:52,769 --> 00:08:54,629 make it. I mean, you cannot compare 240 00:08:55,169 --> 00:08:57,110 it. So I realized there was a need, 241 00:08:57,250 --> 00:08:59,569 and that was who I started to address. 242 00:08:59,569 --> 00:09:01,750 Those the the family caregiver, 243 00:09:02,370 --> 00:09:05,845 also professional caregivers because professional caregivers, 244 00:09:06,144 --> 00:09:08,485 CNAs, who may be sent from an agency. 245 00:09:09,424 --> 00:09:11,684 My mother had a long term care policy, 246 00:09:11,745 --> 00:09:13,524 so we got to get back up 247 00:09:13,985 --> 00:09:15,845 c n professional CNAs. 248 00:09:16,464 --> 00:09:18,084 They are not allowed to cook. 249 00:09:18,610 --> 00:09:20,950 They can reheat and serve a meal. 250 00:09:21,490 --> 00:09:23,970 So my object was to get the the 251 00:09:23,970 --> 00:09:26,230 meals. You find out the menu. 252 00:09:26,690 --> 00:09:27,190 You 253 00:09:27,970 --> 00:09:31,029 make a schedule for your best cooking day. 254 00:09:32,375 --> 00:09:33,274 You get everything 255 00:09:33,575 --> 00:09:35,654 your pantry is all set up with all 256 00:09:35,654 --> 00:09:37,975 the ingredients you need so that you don't 257 00:09:37,975 --> 00:09:39,334 have to run out to the store in 258 00:09:39,334 --> 00:09:41,334 the middle of your cooking day. You do 259 00:09:41,334 --> 00:09:43,914 your shopping, and then you prepare the meal. 260 00:09:44,214 --> 00:09:45,195 Now you're integrating 261 00:09:45,654 --> 00:09:47,930 the level of IDC from the beginning, and 262 00:09:47,930 --> 00:09:49,629 I give an authoritative 263 00:09:50,730 --> 00:09:54,590 webinar teaching how to incorporate the what IDDSI 264 00:09:54,649 --> 00:09:56,350 is is the international 265 00:09:56,809 --> 00:09:57,309 standardization 266 00:09:58,009 --> 00:09:58,509 for 267 00:09:59,714 --> 00:10:02,034 the thickness of the food to aid in 268 00:10:02,034 --> 00:10:02,774 the swallow. 269 00:10:03,075 --> 00:10:06,034 And everyone is given a prescribed ITZY level 270 00:10:06,034 --> 00:10:08,355 when they're diagnosed, and your food has to 271 00:10:08,355 --> 00:10:10,434 be to that level. So you have to 272 00:10:10,434 --> 00:10:12,195 do it right. So then you make the 273 00:10:12,195 --> 00:10:13,894 food. It's to the level. 274 00:10:14,210 --> 00:10:16,470 And then what you do is you thicken 275 00:10:17,090 --> 00:10:19,269 and you test according to IDDSI. 276 00:10:19,889 --> 00:10:22,629 Then you divide the food into individual 277 00:10:23,090 --> 00:10:25,269 servings. I store them in glass 278 00:10:25,649 --> 00:10:26,549 with a lid, 279 00:10:27,024 --> 00:10:29,825 and then you freeze them. But you mark 280 00:10:29,825 --> 00:10:31,125 the food. You label 281 00:10:32,225 --> 00:10:34,485 the food with the date it was created 282 00:10:34,544 --> 00:10:37,105 and the use by date, which is I 283 00:10:37,105 --> 00:10:38,245 give with the recipes, 284 00:10:38,784 --> 00:10:40,565 and then you put it in the freezer. 285 00:10:40,625 --> 00:10:41,125 So 286 00:10:41,600 --> 00:10:43,200 by the time you've done a couple of 287 00:10:43,200 --> 00:10:46,100 cooking days, you have a variety of entrees, 288 00:10:46,160 --> 00:10:48,580 and then I have my own little specialty, 289 00:10:48,639 --> 00:10:50,580 which I call the five five five. 290 00:10:51,120 --> 00:10:53,920 You make five servings of protein, five servings 291 00:10:53,920 --> 00:10:56,100 of veggies, five servings of carbs, 292 00:10:56,605 --> 00:10:58,845 and you make different ones and you store 293 00:10:58,845 --> 00:10:59,345 them 294 00:11:00,205 --> 00:11:02,524 in zips that are labeled so that on 295 00:11:02,524 --> 00:11:03,184 a evening, 296 00:11:03,565 --> 00:11:05,404 when a loved one might not be as 297 00:11:05,404 --> 00:11:07,644 hungry, they might want a weeknight meal, they 298 00:11:07,644 --> 00:11:09,164 might want a light meal, they may not 299 00:11:09,164 --> 00:11:10,945 want a full entree. You say, 300 00:11:11,325 --> 00:11:13,720 mix and match. Here. These are the proteins 301 00:11:13,720 --> 00:11:15,799 I have. Here. These are the carbs I 302 00:11:15,799 --> 00:11:17,639 have. Here. These are the bits. What would 303 00:11:17,639 --> 00:11:20,059 you like? And let the person have control 304 00:11:20,120 --> 00:11:22,519 over the menu and how much they're eating 305 00:11:22,519 --> 00:11:24,059 and how little they're eating. 306 00:11:24,615 --> 00:11:26,075 Food is such a pleasure. 307 00:11:26,615 --> 00:11:28,855 When the person has the choice over the 308 00:11:28,855 --> 00:11:29,355 food, 309 00:11:29,654 --> 00:11:31,034 their mood goes up, 310 00:11:31,495 --> 00:11:31,995 and 311 00:11:32,695 --> 00:11:33,754 they are 312 00:11:34,615 --> 00:11:35,995 feeling cared for 313 00:11:36,455 --> 00:11:36,955 because 314 00:11:37,569 --> 00:11:38,629 there's a healing 315 00:11:39,089 --> 00:11:41,029 power in food that's been prepared 316 00:11:41,409 --> 00:11:43,809 with love. So what we say is food 317 00:11:43,809 --> 00:11:45,509 is medicine. Food is love. 318 00:11:46,289 --> 00:11:48,690 Yep. It totally is. Awesome. Thank thank you, 319 00:11:48,690 --> 00:11:50,129 Diane. One thing you said there that I 320 00:11:50,129 --> 00:11:51,730 I didn't wanna interrupt when you said that, 321 00:11:51,730 --> 00:11:54,315 but I did not realize that CNAs cannot 322 00:11:55,334 --> 00:11:57,894 make food. This is what when I had 323 00:11:57,975 --> 00:11:59,654 as I said, my mother had a long 324 00:11:59,654 --> 00:12:02,294 term care policy, so I could get we 325 00:12:02,294 --> 00:12:03,355 had caregivers 326 00:12:04,980 --> 00:12:07,700 in the house, but sometimes the agency would 327 00:12:07,700 --> 00:12:09,940 send a CNA when we needed a backup. 328 00:12:09,940 --> 00:12:11,559 It was covered by the insurance. 329 00:12:12,100 --> 00:12:14,040 And we're told by the CNAs 330 00:12:14,660 --> 00:12:16,754 that they are not allowed to cook. They 331 00:12:16,754 --> 00:12:19,174 can do what is called light cooking, 332 00:12:19,475 --> 00:12:19,975 meaning 333 00:12:21,235 --> 00:12:21,735 food 334 00:12:22,274 --> 00:12:22,774 reheating 335 00:12:23,554 --> 00:12:24,054 and 336 00:12:24,514 --> 00:12:25,014 serving. 337 00:12:25,475 --> 00:12:25,975 So 338 00:12:26,434 --> 00:12:27,335 with my 339 00:12:27,795 --> 00:12:30,455 the little list that I give of the, 340 00:12:30,639 --> 00:12:32,799 you know, the the routine that you do 341 00:12:32,799 --> 00:12:34,179 when you convert the kitchen, 342 00:12:34,879 --> 00:12:36,419 I have a little video 343 00:12:37,039 --> 00:12:40,320 for food reheating and serving because when they 344 00:12:40,320 --> 00:12:42,320 reheat, there's a way to reheat. You have 345 00:12:42,320 --> 00:12:43,299 a little steamer 346 00:12:43,804 --> 00:12:46,284 that goes on your counter, and it can 347 00:12:46,284 --> 00:12:46,784 be 348 00:12:47,404 --> 00:12:47,904 either 349 00:12:48,284 --> 00:12:50,945 a stainless steel just a stovetop steamer. 350 00:12:51,325 --> 00:12:53,245 But now there are many, many, many types 351 00:12:53,245 --> 00:12:56,044 of appliances that have steamers. So a a 352 00:12:56,044 --> 00:12:59,269 multi cooker, a rice cooker, a a an 353 00:12:59,269 --> 00:13:01,610 instant pot. They all have steaming functions. 354 00:13:02,230 --> 00:13:04,790 You put the dish that you've just taken 355 00:13:04,790 --> 00:13:05,690 from the freezer 356 00:13:06,230 --> 00:13:08,950 in the into the steamer, and you steam 357 00:13:08,950 --> 00:13:10,009 for thirty minutes. 358 00:13:10,625 --> 00:13:12,464 And at the end of thirty minutes, you 359 00:13:12,464 --> 00:13:14,945 test with an instant read thermometer for a 360 00:13:14,945 --> 00:13:16,065 165 361 00:13:16,065 --> 00:13:17,504 degrees, and it has to have been at 362 00:13:17,504 --> 00:13:18,705 a 165 363 00:13:18,705 --> 00:13:19,524 degrees for 364 00:13:19,904 --> 00:13:21,284 at least fifteen minutes. 365 00:13:21,585 --> 00:13:22,725 The food is safe. 366 00:13:23,059 --> 00:13:25,139 We like to present the food. We call 367 00:13:25,139 --> 00:13:26,759 it dignity in dining. 368 00:13:27,139 --> 00:13:29,860 We like to present the food either in 369 00:13:29,860 --> 00:13:32,839 a pretty plate as they do in Asia 370 00:13:32,980 --> 00:13:34,980 when I lived in Japan and I studied 371 00:13:34,980 --> 00:13:35,480 this, 372 00:13:36,179 --> 00:13:36,679 or 373 00:13:38,394 --> 00:13:40,715 piping, where you take the food and you 374 00:13:40,715 --> 00:13:42,475 pipe it into shapes. You can do that 375 00:13:42,475 --> 00:13:44,075 before you freeze it, or you can do 376 00:13:44,075 --> 00:13:46,415 it when you take it out so that 377 00:13:46,554 --> 00:13:48,634 you pipe the the the broccoli, and it 378 00:13:48,634 --> 00:13:50,955 looks like broccoli, and the carrots and so 379 00:13:50,955 --> 00:13:51,690 that the plate 380 00:13:52,009 --> 00:13:54,350 has a look to it. It's not just 381 00:13:55,129 --> 00:13:56,429 a a bowl of puree. 382 00:13:56,809 --> 00:13:59,710 And so we have that instruction on the, 383 00:14:00,649 --> 00:14:02,429 my new website, which is 384 00:14:02,809 --> 00:14:05,445 when readers have a question for me, when 385 00:14:05,445 --> 00:14:07,205 I make a presentation and they have a 386 00:14:07,205 --> 00:14:08,965 question, they can reach me. They can ask 387 00:14:08,965 --> 00:14:11,205 me a question. And I'm gonna put up 388 00:14:11,205 --> 00:14:13,225 little short videos that instruct 389 00:14:13,684 --> 00:14:16,085 because there was so much material to put 390 00:14:16,085 --> 00:14:18,325 in this book. And you asked me about 391 00:14:18,325 --> 00:14:20,105 how the book came about. Mayo 392 00:14:20,730 --> 00:14:21,230 Clinic 393 00:14:21,769 --> 00:14:24,730 Press did a fantastic job, and they asked 394 00:14:24,730 --> 00:14:26,029 me to have 395 00:14:27,049 --> 00:14:28,589 the ITSA material 396 00:14:28,970 --> 00:14:32,110 presented by SLPs. And that's why I invited 397 00:14:32,169 --> 00:14:34,414 you to submit the chapter, and I had 398 00:14:34,414 --> 00:14:36,355 one other SLP, Karen Scheffler. 399 00:14:38,174 --> 00:14:40,414 And each approached from a different point of 400 00:14:40,414 --> 00:14:42,814 view for the information of the caregiver and 401 00:14:42,814 --> 00:14:43,554 the household. 402 00:14:44,334 --> 00:14:46,034 And the experts 403 00:14:46,495 --> 00:14:47,314 gave that 404 00:14:47,690 --> 00:14:50,250 so that the reader could rely upon the 405 00:14:50,250 --> 00:14:52,750 information as coming from a health care provider. 406 00:14:52,889 --> 00:14:54,970 I'm a home cook. I presented the best 407 00:14:54,970 --> 00:14:56,029 possible information. 408 00:14:56,730 --> 00:14:58,190 But because I included 409 00:14:58,809 --> 00:15:02,190 I've got easily 40 pages of scientific information 410 00:15:02,409 --> 00:15:03,309 in this book 411 00:15:03,745 --> 00:15:05,745 before I get to the recipes and all 412 00:15:05,745 --> 00:15:07,285 the rest of setting up the kitchen. 413 00:15:07,825 --> 00:15:10,225 So what I decided to do, because we 414 00:15:10,225 --> 00:15:12,644 did not have room in this book for 415 00:15:13,105 --> 00:15:14,965 another important thing in terms 416 00:15:15,345 --> 00:15:17,985 of health and variety is the purees of 417 00:15:17,985 --> 00:15:18,644 the seasons. 418 00:15:19,070 --> 00:15:21,009 So I'm gonna put up on my website 419 00:15:21,149 --> 00:15:21,970 little videos. 420 00:15:22,830 --> 00:15:25,470 Each one is for a difference the technique 421 00:15:25,470 --> 00:15:26,370 of the season 422 00:15:26,990 --> 00:15:29,309 and the ingredients of the season, and this 423 00:15:29,309 --> 00:15:30,370 is for variety. 424 00:15:30,750 --> 00:15:32,429 I'm keeping up with the big trends in 425 00:15:32,429 --> 00:15:34,049 the in the fine food world. 426 00:15:34,355 --> 00:15:36,355 There you're not always stuck with the same 427 00:15:36,355 --> 00:15:39,735 thing. I have holiday meals. I have specialty 428 00:15:39,955 --> 00:15:42,035 meals. I have cooking for one. In other 429 00:15:42,035 --> 00:15:42,535 words, 430 00:15:43,235 --> 00:15:44,855 you can make your kitchen 431 00:15:45,715 --> 00:15:46,455 at home 432 00:15:46,995 --> 00:15:47,495 match 433 00:15:48,279 --> 00:15:49,100 the personality, 434 00:15:49,480 --> 00:15:50,779 the needs, the desires 435 00:15:51,080 --> 00:15:53,419 of the loved one with this with the 436 00:15:53,480 --> 00:15:54,539 swallowing condition. 437 00:15:54,919 --> 00:15:56,200 Awesome. I I know. I think I think 438 00:15:56,200 --> 00:15:57,879 the book came out awesome. You know, I 439 00:15:57,960 --> 00:16:00,120 I'm obviously so proud of the work that 440 00:16:00,120 --> 00:16:01,320 we put in, and I know, you know, 441 00:16:01,320 --> 00:16:03,000 Karen and I spent a ton of time 442 00:16:03,000 --> 00:16:05,725 on on our chapters. And and it was 443 00:16:05,725 --> 00:16:06,384 it was 444 00:16:07,085 --> 00:16:09,745 grueling is not the word. It was rigorous, 445 00:16:09,805 --> 00:16:11,725 I would say, in the editing process with 446 00:16:11,725 --> 00:16:14,445 the Mayo editors and and and that group. 447 00:16:14,445 --> 00:16:16,230 And for that, you know, I appreciate that. 448 00:16:16,309 --> 00:16:17,750 So it's one thing when you're going through 449 00:16:17,750 --> 00:16:19,829 it, like, oh, you know, the the nuance 450 00:16:19,829 --> 00:16:21,990 of every single word that's used and presented, 451 00:16:21,990 --> 00:16:24,230 but I very much understand and respect that 452 00:16:24,230 --> 00:16:26,309 process for what it is because Mayo does 453 00:16:26,309 --> 00:16:28,070 have such a wide reach and a wide 454 00:16:28,070 --> 00:16:30,089 net. So If they have a newsletter 455 00:16:30,455 --> 00:16:31,995 and they have already put 456 00:16:32,455 --> 00:16:34,934 the book out on their newsletter, which goes 457 00:16:34,934 --> 00:16:37,654 out globally Oh, awesome. Their book is in 458 00:16:37,654 --> 00:16:39,274 English. But the way 459 00:16:40,054 --> 00:16:43,894 they edited, they are were absolutely top flight 460 00:16:43,894 --> 00:16:44,394 professionals, 461 00:16:45,179 --> 00:16:46,399 and they made sure 462 00:16:47,100 --> 00:16:49,179 from their point of view, they could see 463 00:16:49,179 --> 00:16:51,500 things that even as an author, I couldn't 464 00:16:51,500 --> 00:16:54,460 see or I I, you know, they had 465 00:16:54,460 --> 00:16:56,940 experts that they put in teams on the 466 00:16:56,940 --> 00:16:59,679 book. They they really did a superb job. 467 00:16:59,904 --> 00:17:02,164 I felt great because I was presenting 468 00:17:02,544 --> 00:17:04,805 your information and Karen's information 469 00:17:06,224 --> 00:17:09,025 for the mental comfort of families and the 470 00:17:09,025 --> 00:17:12,144 people with the swallow disorder. They're getting the 471 00:17:12,144 --> 00:17:14,325 best information, I think, that's available. 472 00:17:14,720 --> 00:17:17,039 I I really felt I'm very proud of 473 00:17:17,039 --> 00:17:18,099 of those chapters. 474 00:17:19,359 --> 00:17:21,039 Yeah. Yeah. I am too. They they came 475 00:17:21,039 --> 00:17:23,460 out great. The whole idea of using 476 00:17:24,320 --> 00:17:25,059 the whiteboard 477 00:17:25,440 --> 00:17:26,820 is important because 478 00:17:27,279 --> 00:17:29,700 you always know what you have on hand. 479 00:17:30,205 --> 00:17:32,285 You can go into the person with the 480 00:17:32,285 --> 00:17:34,525 swallow disorder and say, okay, mom. In my 481 00:17:34,525 --> 00:17:35,664 case, it was mom. 482 00:17:36,045 --> 00:17:37,565 What do you feel like eating tonight? Well, 483 00:17:37,565 --> 00:17:39,244 I'm not that hungry. Well, this is what 484 00:17:39,244 --> 00:17:41,805 I have. I've got steamed fish. I've got, 485 00:17:41,805 --> 00:17:43,725 you know, would you like some creamed spinach? 486 00:17:43,725 --> 00:17:46,089 Or how about some steamed asparagus? With you 487 00:17:46,089 --> 00:17:47,769 know, it's all there, and then all it 488 00:17:47,769 --> 00:17:49,609 has to do is be heated up if 489 00:17:49,609 --> 00:17:51,549 they're feeling like eating a light meal, 490 00:17:51,849 --> 00:17:54,009 which I I thought that was a, you 491 00:17:54,009 --> 00:17:55,149 know, a good idea. 492 00:17:55,609 --> 00:17:57,690 Yeah. Yeah. Yeah. I I think it's awesome, 493 00:17:57,690 --> 00:17:59,529 Diane. I I love and respect your work, 494 00:17:59,529 --> 00:18:01,984 and it's definitely so so needed for for 495 00:18:01,984 --> 00:18:04,565 patients with dysphagia. I tried to adapt 496 00:18:05,505 --> 00:18:08,464 the practices of the professional kitchen into the 497 00:18:08,464 --> 00:18:09,285 home kitchen. 498 00:18:09,984 --> 00:18:12,644 So you set up a little puree station 499 00:18:12,785 --> 00:18:13,684 on the counter, 500 00:18:14,619 --> 00:18:17,419 and it remains there. It's out. It's a 501 00:18:17,659 --> 00:18:20,240 it consists of a 3.5 502 00:18:20,700 --> 00:18:24,460 mini food processor, 3.5 cups for one or 503 00:18:24,460 --> 00:18:26,079 two servings of puree 504 00:18:26,700 --> 00:18:28,079 or a good blender. 505 00:18:29,005 --> 00:18:31,244 And that you will use multiple times a 506 00:18:31,244 --> 00:18:33,484 day. So I give advice on how to 507 00:18:33,484 --> 00:18:36,044 pick it, how to go and go into 508 00:18:36,044 --> 00:18:38,224 a bricks and mortar store, look at 509 00:18:38,765 --> 00:18:40,525 see what you like to use, see what's 510 00:18:40,525 --> 00:18:42,525 the right size for your counter, see what 511 00:18:42,525 --> 00:18:44,960 you feel comfortable with, you know. And I 512 00:18:44,960 --> 00:18:47,119 say, I give advice on, you know, which 513 00:18:47,119 --> 00:18:48,640 are the good ones and not. But that 514 00:18:48,640 --> 00:18:50,980 you're gonna use several times a day for 515 00:18:51,119 --> 00:18:54,480 breakfast, for lunch, for snacks, for, you know, 516 00:18:54,480 --> 00:18:56,559 so and you're gonna wash it several times 517 00:18:56,559 --> 00:18:58,095 a day. So it's it's 518 00:18:58,414 --> 00:19:00,994 like the sous chef station in a professional 519 00:19:01,615 --> 00:19:04,255 kitchen. I I adapted that as a principle 520 00:19:04,255 --> 00:19:06,734 for at home. Yeah. Yeah. Yeah. It's it's 521 00:19:06,734 --> 00:19:08,654 interesting. You know, as as long as I've 522 00:19:08,654 --> 00:19:10,414 done this podcast, we've had a few different 523 00:19:10,414 --> 00:19:12,414 speakers come on to the podcast that had 524 00:19:12,414 --> 00:19:15,429 former previous, you know, chef life or had 525 00:19:15,429 --> 00:19:17,509 cooking experience in a professional kitchen in the 526 00:19:17,509 --> 00:19:19,429 past. And the tips that they give are, 527 00:19:19,429 --> 00:19:20,710 you know, to some of us that work 528 00:19:20,710 --> 00:19:22,789 with these patients every day, even, you know, 529 00:19:22,789 --> 00:19:24,470 preparing food for my son, it's you know, 530 00:19:24,470 --> 00:19:26,069 the tips that they give is, like, mind 531 00:19:26,069 --> 00:19:26,565 blowing. 532 00:19:27,044 --> 00:19:28,884 So I always appreciate when we have people 533 00:19:28,884 --> 00:19:31,125 from other professions come in and and help 534 00:19:31,125 --> 00:19:33,764 us with those. Well, I the country as 535 00:19:33,764 --> 00:19:36,085 a whole is now becoming more aware of 536 00:19:36,085 --> 00:19:38,984 the caregiver point of view. Yep. Yep. Because 537 00:19:39,044 --> 00:19:39,625 the actor 538 00:19:40,240 --> 00:19:42,659 director Bradley Cooper did a big 539 00:19:43,759 --> 00:19:46,740 documentary on PBS about family caregivers. 540 00:19:47,200 --> 00:19:50,339 It raised people's awareness because of the importance 541 00:19:50,640 --> 00:19:51,140 of 542 00:19:52,525 --> 00:19:54,305 maintaining the health of the person 543 00:19:54,924 --> 00:19:57,184 who was in the at home medical environment, 544 00:19:57,565 --> 00:19:59,244 you know, so that they didn't wind up 545 00:19:59,244 --> 00:20:01,325 in hospitals. And they didn't wind up with 546 00:20:01,325 --> 00:20:04,065 bacterial pneumonia, which is very hard to cure. 547 00:20:04,204 --> 00:20:05,825 So what I say to 548 00:20:06,880 --> 00:20:09,039 people when I when I do the lecture 549 00:20:09,039 --> 00:20:09,539 demonstrations, 550 00:20:09,919 --> 00:20:10,659 the caregivers 551 00:20:10,960 --> 00:20:13,779 are responsible for someone else's life or death. 552 00:20:14,319 --> 00:20:16,559 Because if you don't do it right, they 553 00:20:16,559 --> 00:20:19,359 can choke to death. They can aspirate. They 554 00:20:19,359 --> 00:20:21,140 can get you know, the downside 555 00:20:21,839 --> 00:20:24,774 is that it can be life threatening. So 556 00:20:24,774 --> 00:20:27,174 this is important, and now we're beginning to 557 00:20:27,174 --> 00:20:29,755 recognize it, and we're caring about 558 00:20:30,454 --> 00:20:33,274 the needs of the caregiver. The the 559 00:20:33,575 --> 00:20:34,075 education 560 00:20:34,534 --> 00:20:35,515 of the SLPs 561 00:20:35,974 --> 00:20:36,690 and the 562 00:20:37,089 --> 00:20:37,589 dietitians, 563 00:20:37,970 --> 00:20:41,109 they educate the caregivers and the patients, 564 00:20:41,569 --> 00:20:42,629 and then the patients 565 00:20:44,049 --> 00:20:44,950 have the information 566 00:20:45,329 --> 00:20:46,950 to transform the home. 567 00:20:47,490 --> 00:20:49,409 You know? Yep. So it is a process 568 00:20:49,409 --> 00:20:50,069 of awareness. 569 00:20:50,529 --> 00:20:53,275 Yep. Yep. It really is. The piping is 570 00:20:53,275 --> 00:20:55,755 fun. You can that's the other thing. I 571 00:20:55,755 --> 00:20:58,255 say to the caregivers, I give them 572 00:20:58,875 --> 00:20:59,535 a list 573 00:21:01,275 --> 00:21:03,115 of pick the day that's light to do 574 00:21:03,115 --> 00:21:03,775 your cooking. 575 00:21:04,309 --> 00:21:06,549 In the beginning, it'll take you several days 576 00:21:06,549 --> 00:21:09,029 of cooking to get the freezer stocked. If 577 00:21:09,029 --> 00:21:11,109 you need help, don't be afraid to ask 578 00:21:11,109 --> 00:21:13,929 for it. Let somebody else chop the onions 579 00:21:13,990 --> 00:21:16,454 or, you know, peel the carrots or whatever. 580 00:21:16,694 --> 00:21:18,694 If you make a mistake, you can fix 581 00:21:18,694 --> 00:21:21,174 it. Don't get upset. You know? It's a 582 00:21:21,174 --> 00:21:24,134 learning process. But the whole idea of when 583 00:21:24,134 --> 00:21:26,454 you make the food at home, you're using 584 00:21:26,454 --> 00:21:27,434 the other senses 585 00:21:27,894 --> 00:21:30,054 of the person with the swallow disorder. And 586 00:21:30,054 --> 00:21:32,430 I had this advice from a psychiatric nurse. 587 00:21:32,430 --> 00:21:33,330 She said, we 588 00:21:34,110 --> 00:21:35,950 like, they have the sense of smell. They're 589 00:21:35,950 --> 00:21:38,110 smelling the food cooking. That you let them 590 00:21:38,110 --> 00:21:40,029 see the veggies that you're using or the 591 00:21:40,029 --> 00:21:43,309 the food when it's prepared before you begin 592 00:21:43,309 --> 00:21:44,444 to modify the texture and 593 00:21:48,684 --> 00:21:50,845 lasagna. I'm gonna, you know, puree this for 594 00:21:50,845 --> 00:21:53,345 you type of thing so that you're engaging 595 00:21:54,365 --> 00:21:56,304 their other senses. And then 596 00:21:57,839 --> 00:21:59,679 the other thing that I think is very 597 00:21:59,679 --> 00:22:01,599 important in some of the videos that I'm 598 00:22:01,599 --> 00:22:03,619 gonna be putting up, my my new website 599 00:22:03,679 --> 00:22:08,000 is just www.cookingfordysphagia.com. 600 00:22:08,000 --> 00:22:10,400 It's not quite up and running yet. And 601 00:22:10,400 --> 00:22:12,974 you can reach me, diane at cooking for 602 00:22:12,974 --> 00:22:16,994 dysphagia dot com. I had a very eminent 603 00:22:17,375 --> 00:22:18,994 speech language pathologist 604 00:22:19,535 --> 00:22:22,654 locally here in Florida, which is my county 605 00:22:22,654 --> 00:22:25,295 is ground zero for geriatric medicine in The 606 00:22:25,295 --> 00:22:26,434 US. He said, 607 00:22:26,894 --> 00:22:27,714 as long 608 00:22:28,390 --> 00:22:31,109 as the guidelines are met for the safe 609 00:22:31,109 --> 00:22:31,609 swallow, 610 00:22:32,630 --> 00:22:33,609 it is alright 611 00:22:35,269 --> 00:22:36,569 for the loved one 612 00:22:39,029 --> 00:22:40,730 to join in activities 613 00:22:41,109 --> 00:22:42,650 with family and friends 614 00:22:43,664 --> 00:22:46,225 as long as you're observing the guidelines for 615 00:22:46,225 --> 00:22:48,545 the safe swallow so that the person does 616 00:22:48,545 --> 00:22:51,744 not become isolated and depressed eating alone all 617 00:22:51,744 --> 00:22:52,404 the time. 618 00:22:52,945 --> 00:22:55,105 So that's why I have in in one 619 00:22:55,105 --> 00:22:56,244 of my little videos, 620 00:22:56,659 --> 00:22:58,440 a game day buffet 621 00:22:59,140 --> 00:23:01,539 where the family and friends can eat, but 622 00:23:01,539 --> 00:23:03,880 also the loved one gets their texture modified. 623 00:23:04,579 --> 00:23:06,819 So one of the things that I'm hoping 624 00:23:06,819 --> 00:23:09,399 to do with all the health care providers, 625 00:23:11,025 --> 00:23:11,765 when dysphagia 626 00:23:12,065 --> 00:23:14,085 awareness month comes up in 627 00:23:15,025 --> 00:23:18,325 June of every year, I'm going to suggest 628 00:23:19,025 --> 00:23:21,825 David Fagan, who's an eminent SLP here, he 629 00:23:21,825 --> 00:23:24,325 said that he would like it if 630 00:23:25,059 --> 00:23:26,759 restaurants could have a designation 631 00:23:27,059 --> 00:23:29,240 on the menu of a puree designation 632 00:23:29,539 --> 00:23:32,200 because we have diabetic foods, 633 00:23:32,980 --> 00:23:33,480 gluten, 634 00:23:34,660 --> 00:23:35,400 free foods, 635 00:23:36,099 --> 00:23:38,964 lactose intolerance foods, and he said that he 636 00:23:38,964 --> 00:23:40,244 thought it would be great if there were 637 00:23:40,244 --> 00:23:42,265 one or two dishes that could be pureed 638 00:23:42,964 --> 00:23:45,285 and and brought to the table where they 639 00:23:45,285 --> 00:23:47,285 could be thickened by the family and friends. 640 00:23:47,285 --> 00:23:48,825 But the whole idea that 641 00:23:49,285 --> 00:23:51,365 one did not have to be isolated from 642 00:23:51,365 --> 00:23:51,690 the restaurant 643 00:23:52,970 --> 00:23:55,210 because that leads to depression. You know? They 644 00:23:55,210 --> 00:23:56,649 get depressed. They don't get to go everybody 645 00:23:56,649 --> 00:23:58,569 else is going out and having fun, and 646 00:23:58,569 --> 00:23:59,769 they have to stay home alone and eat 647 00:23:59,769 --> 00:24:02,089 in the bedroom all by themselves. Yep. Yep. 648 00:24:02,089 --> 00:24:03,549 Boring. Yep. Boring. 649 00:24:04,329 --> 00:24:04,829 Yep. 650 00:24:05,265 --> 00:24:07,265 Yeah. You're right, Diane. I mean, honestly, it's 651 00:24:07,265 --> 00:24:09,025 a it's I would say probably was the 652 00:24:09,025 --> 00:24:11,285 biggest issue with my son of, you know, 653 00:24:11,984 --> 00:24:13,984 we would just never go out for a 654 00:24:13,984 --> 00:24:15,984 few reasons, but also he could just never 655 00:24:15,984 --> 00:24:17,585 eat, you know, what we were eating or 656 00:24:17,585 --> 00:24:19,779 on the menu or just, you know? His 657 00:24:19,779 --> 00:24:21,299 school does a really good job of taking 658 00:24:21,299 --> 00:24:22,820 him. You know? They go on field trips, 659 00:24:22,820 --> 00:24:24,099 and they make sure they take them to 660 00:24:24,099 --> 00:24:26,180 places where the kids can get, you know, 661 00:24:26,180 --> 00:24:28,099 mashed potatoes or they know it's a macaroni 662 00:24:28,099 --> 00:24:30,259 and cheese that's very, very, you know, easy 663 00:24:30,259 --> 00:24:30,759 to 664 00:24:31,234 --> 00:24:32,595 to mash up very well. You know? And 665 00:24:32,595 --> 00:24:34,195 I and it's it's interesting because I think, 666 00:24:34,195 --> 00:24:35,634 you know, you're dealing with your mom as 667 00:24:35,634 --> 00:24:37,634 a you're the caregiver for your mom. I'm 668 00:24:37,634 --> 00:24:39,394 the caregiver for my son, but across the 669 00:24:39,394 --> 00:24:41,634 lifespan, we all have the same needs. You 670 00:24:41,634 --> 00:24:43,234 know? We all wanna do the same things. 671 00:24:43,234 --> 00:24:44,994 We all wanna take our family members out 672 00:24:44,994 --> 00:24:46,980 to eat. And, you know, I I commend 673 00:24:46,980 --> 00:24:48,980 my son's school. They do a fabulous job 674 00:24:48,980 --> 00:24:51,619 of of always trying to include him in 675 00:24:51,619 --> 00:24:54,019 in social activities with with his peers and 676 00:24:54,019 --> 00:24:55,940 and order the food that he can eat, 677 00:24:55,940 --> 00:24:58,259 and it's it's tough. You know? There there 678 00:24:58,259 --> 00:24:59,700 does need to be a lot more awareness 679 00:24:59,700 --> 00:25:02,024 and a lot more guidance around it because, 680 00:25:02,024 --> 00:25:03,304 you know, like, it's easy to just order 681 00:25:03,304 --> 00:25:05,065 a side of mashed potatoes, but every kid 682 00:25:05,065 --> 00:25:07,464 doesn't wanna eat mashed potatoes. Well, that's that's 683 00:25:07,464 --> 00:25:08,524 why we were suggesting 684 00:25:08,825 --> 00:25:10,585 that they have they have a couple of 685 00:25:10,585 --> 00:25:13,484 dishes on the menu that are pureed, and 686 00:25:13,704 --> 00:25:16,659 they could be a regular diet and then 687 00:25:16,659 --> 00:25:19,000 for the vegans, you know, for the vegetarians 688 00:25:19,059 --> 00:25:21,299 or vegans. But that would only be I 689 00:25:21,299 --> 00:25:21,799 mean, 690 00:25:22,819 --> 00:25:25,399 if the timing were right, you could bring 691 00:25:25,619 --> 00:25:27,319 one of your meals from home 692 00:25:27,865 --> 00:25:29,544 if they would puree it when you get 693 00:25:29,544 --> 00:25:31,384 there. If you know? And then you thicken 694 00:25:31,384 --> 00:25:33,065 it at the table. If 695 00:25:33,464 --> 00:25:36,345 but or now they have wireless, you know, 696 00:25:36,345 --> 00:25:38,825 like BlendJet blenders that you could blend right 697 00:25:38,825 --> 00:25:40,904 at the table. But the whole idea is 698 00:25:40,904 --> 00:25:43,019 to, you know, make it accommodating. 699 00:25:43,320 --> 00:25:43,640 And, 700 00:25:44,519 --> 00:25:45,900 that's why in the 701 00:25:46,920 --> 00:25:49,320 game day book that I'm putting up, it 702 00:25:49,480 --> 00:25:50,779 I'm gonna put up 703 00:25:51,480 --> 00:25:52,619 the special occasion 704 00:25:53,000 --> 00:25:53,500 meals, 705 00:25:55,154 --> 00:25:56,934 with the instructions because 706 00:25:58,514 --> 00:26:00,194 what I put in there in one of 707 00:26:00,194 --> 00:26:01,815 them I have, the Japanese 708 00:26:02,194 --> 00:26:04,595 they call it where it's a hot pot 709 00:26:04,595 --> 00:26:07,380 where everybody's cooking in one. You put whatever 710 00:26:07,380 --> 00:26:09,059 you want into a bowl of broth, and 711 00:26:09,059 --> 00:26:10,440 then you spoon your 712 00:26:10,820 --> 00:26:12,820 serving into your bowl, and that could be 713 00:26:12,820 --> 00:26:15,320 pureed with so that the person could participate 714 00:26:15,380 --> 00:26:18,019 in a in an activity where other people 715 00:26:18,019 --> 00:26:19,640 were there. But they they're gonna 716 00:26:20,674 --> 00:26:23,394 puree. They'll have a little wireless blender. They're 717 00:26:23,394 --> 00:26:25,714 gonna puree and thicken their own. The whole 718 00:26:25,714 --> 00:26:27,494 idea is not to become isolated. 719 00:26:27,795 --> 00:26:29,335 You know? Yep. Yep. 720 00:26:29,634 --> 00:26:32,134 Yep. So I think it's a question of 721 00:26:33,690 --> 00:26:35,069 once people realize 722 00:26:35,690 --> 00:26:36,910 we have the situation, 723 00:26:38,089 --> 00:26:39,970 then they're willing to work with us. They 724 00:26:40,089 --> 00:26:41,609 they've been willing to work with us. So 725 00:26:41,609 --> 00:26:43,450 what I'm trying to do is maybe this 726 00:26:43,450 --> 00:26:43,950 year, 727 00:26:44,809 --> 00:26:47,210 because the health care providers are the ones 728 00:26:47,210 --> 00:26:49,234 who have the the professional organizations 729 00:26:49,535 --> 00:26:50,994 where they can make suggestions 730 00:26:51,295 --> 00:26:51,795 like 731 00:26:52,174 --> 00:26:53,394 that across a profession. 732 00:26:54,414 --> 00:26:56,115 And when the restaurants see 733 00:26:56,654 --> 00:26:58,994 become aware of this, then they can respond 734 00:26:59,214 --> 00:27:01,474 to the influence of the health care providers. 735 00:27:02,015 --> 00:27:04,679 You know? Yep. Which is better than just 736 00:27:04,679 --> 00:27:06,920 one individual saying, gee, can I puree a 737 00:27:06,920 --> 00:27:09,000 meal for so and so? You know? What 738 00:27:09,000 --> 00:27:11,640 I really wanted to include was the whole 739 00:27:11,640 --> 00:27:12,140 idea 740 00:27:12,519 --> 00:27:13,740 of if you follow 741 00:27:14,920 --> 00:27:17,319 the handout I gave a handout to you 742 00:27:17,319 --> 00:27:19,355 that people could request and 743 00:27:19,894 --> 00:27:20,394 have 744 00:27:20,695 --> 00:27:23,835 where I outline the steps for the transformation. 745 00:27:24,775 --> 00:27:26,295 I give you the setting up of the 746 00:27:26,295 --> 00:27:27,914 puree station plus 747 00:27:28,695 --> 00:27:31,035 the making of the what I call 748 00:27:31,970 --> 00:27:33,349 it's the batch cooking. 749 00:27:33,730 --> 00:27:35,829 Cook once, eat five times. 750 00:27:36,450 --> 00:27:38,930 You know? Cook once, eat five times. And 751 00:27:38,930 --> 00:27:41,890 then that goes from beginning to end. So 752 00:27:41,890 --> 00:27:43,349 if you have that handout, 753 00:27:43,809 --> 00:27:46,130 and then I put a little slideshow up 754 00:27:46,130 --> 00:27:46,630 there 755 00:27:47,009 --> 00:27:47,509 for 756 00:27:48,025 --> 00:27:49,704 the tools that you would have for the 757 00:27:49,704 --> 00:27:50,684 puree station, 758 00:27:51,304 --> 00:27:52,825 what you would need. And then I have 759 00:27:52,825 --> 00:27:55,244 additional tools for the kitchen so that 760 00:27:55,785 --> 00:27:56,285 instead 761 00:27:56,904 --> 00:27:58,125 of getting the diagnosis, 762 00:27:58,664 --> 00:28:01,369 in my case, I had to research everything. 763 00:28:01,369 --> 00:28:03,369 I had no idea. My sister who was 764 00:28:03,369 --> 00:28:04,029 an RN 765 00:28:04,649 --> 00:28:07,450 and a very highly educated woman, she used 766 00:28:07,450 --> 00:28:10,190 to assist at open heart surgery. She said, 767 00:28:10,329 --> 00:28:12,669 well, we can just give mother baby food. 768 00:28:12,904 --> 00:28:15,144 Well, you cannot give mother baby food because 769 00:28:15,144 --> 00:28:17,224 it doesn't have the nutrients for an adult. 770 00:28:17,224 --> 00:28:18,924 You know? So even 771 00:28:19,304 --> 00:28:20,284 health care professionals, 772 00:28:21,065 --> 00:28:23,144 some of them need this. But, anyway, if 773 00:28:23,144 --> 00:28:25,164 you follow from beginning to end, 774 00:28:25,630 --> 00:28:28,429 you have a step by step introduction to 775 00:28:28,429 --> 00:28:30,210 to transforming a home kitchen 776 00:28:30,750 --> 00:28:31,250 to 777 00:28:32,589 --> 00:28:34,690 what I call a dysphagia kitchen. 778 00:28:35,069 --> 00:28:36,289 You're saving time. 779 00:28:37,309 --> 00:28:38,450 You're saving money. 780 00:28:39,595 --> 00:28:40,815 You're saving labor. 781 00:28:41,275 --> 00:28:42,955 And when you make it yourself, you know 782 00:28:42,955 --> 00:28:45,195 what's in it. There are many ways that 783 00:28:45,195 --> 00:28:46,654 people get food now. 784 00:28:47,035 --> 00:28:49,295 They have home meal service delivery. 785 00:28:50,315 --> 00:28:52,255 They have ingredient delivery. 786 00:28:54,109 --> 00:28:56,349 I'm not judging anything. I'm telling you, once 787 00:28:56,349 --> 00:28:58,589 you you can use your own recipes, you 788 00:28:58,589 --> 00:29:01,169 can use my recipes, you can get takeout. 789 00:29:02,029 --> 00:29:04,190 But the trick is to prepare the food 790 00:29:04,190 --> 00:29:06,369 and store the food, make it 791 00:29:07,235 --> 00:29:10,195 dignified, dignity in dining. Make it look good 792 00:29:10,195 --> 00:29:11,335 so that it's appealing. 793 00:29:11,955 --> 00:29:14,914 So that's basically and as I said, I'm 794 00:29:14,914 --> 00:29:17,154 gonna put little videos up for the little 795 00:29:17,154 --> 00:29:19,335 questions of, like, how to use a particular 796 00:29:19,795 --> 00:29:21,440 appliance, a a kitchen appliance, 797 00:29:22,619 --> 00:29:23,119 namely 798 00:29:23,819 --> 00:29:25,519 the other thing I wanna say is 799 00:29:26,940 --> 00:29:28,000 I have named 800 00:29:28,380 --> 00:29:29,119 the best 801 00:29:30,539 --> 00:29:31,039 techniques 802 00:29:31,339 --> 00:29:32,079 of cooking 803 00:29:32,380 --> 00:29:35,099 for the dysphagia kitchen, and those are the 804 00:29:35,099 --> 00:29:38,335 techniques which render foods moist and tender. 805 00:29:38,794 --> 00:29:41,515 You do not wanna use roasting, you know, 806 00:29:41,515 --> 00:29:43,835 heavy duty baking, heavy duty grilling because it 807 00:29:43,835 --> 00:29:44,335 makes 808 00:29:44,714 --> 00:29:46,634 particles on the food that are bad for 809 00:29:46,634 --> 00:29:47,294 the swallow. 810 00:29:48,819 --> 00:29:51,000 So, each one of those techniques 811 00:29:51,379 --> 00:29:52,200 comes with 812 00:29:53,539 --> 00:29:55,960 a set of ingredients of the season, 813 00:29:56,579 --> 00:29:58,980 and that prevents boredom. You can look at 814 00:29:58,980 --> 00:30:01,059 them in any order. You can adapt them 815 00:30:01,059 --> 00:30:03,159 in the whole idea is variety, 816 00:30:04,234 --> 00:30:06,174 so the patient doesn't get bored, 817 00:30:06,715 --> 00:30:07,375 and then 818 00:30:07,674 --> 00:30:08,174 versatility 819 00:30:08,475 --> 00:30:11,115 so that the home cook can also have 820 00:30:11,115 --> 00:30:11,775 the choice 821 00:30:12,154 --> 00:30:14,015 and everything. So that's what 822 00:30:14,394 --> 00:30:17,299 the way I've organized it is by when 823 00:30:17,299 --> 00:30:19,299 you go through the seasons, you can go 824 00:30:19,299 --> 00:30:22,099 through in order. Cooking for one, I have 825 00:30:22,099 --> 00:30:24,579 a little video where you're somebody has a 826 00:30:24,579 --> 00:30:26,919 desire for something and you're cooking for one. 827 00:30:27,220 --> 00:30:27,880 I have 828 00:30:28,660 --> 00:30:31,375 desserts, which is a big thing. Desserts are 829 00:30:31,375 --> 00:30:32,575 a big thing, and there are not that 830 00:30:32,575 --> 00:30:33,555 many available. 831 00:30:34,015 --> 00:30:35,775 So you can pick and choose what, you 832 00:30:35,775 --> 00:30:37,295 know, what you like and what you need. 833 00:30:37,295 --> 00:30:39,455 And as I said, I'm I'm available to 834 00:30:39,455 --> 00:30:41,855 consult. I'm available to coach. You can ask 835 00:30:41,855 --> 00:30:42,595 me questions, 836 00:30:43,119 --> 00:30:45,440 and I'll answer your questions. It's a it's 837 00:30:45,440 --> 00:30:46,579 a question of 838 00:30:46,880 --> 00:30:47,380 education. 839 00:30:47,919 --> 00:30:51,039 It's it's it's caregiver and patient education. That's 840 00:30:51,039 --> 00:30:52,640 what it is. Well, thank you, Diane. This 841 00:30:52,640 --> 00:30:54,319 is this is a a great book. It's 842 00:30:54,319 --> 00:30:56,924 such a great resource for anybody that's, you 843 00:30:56,924 --> 00:30:58,684 know, starting out with their journey with dysphagia 844 00:30:58,684 --> 00:31:00,924 or caregiving for somebody with dysphagia. It's very, 845 00:31:00,924 --> 00:31:02,845 very thorough. Like I said, Karen and I 846 00:31:02,845 --> 00:31:05,184 wrote the first few chapters of the technical 847 00:31:05,325 --> 00:31:07,965 swallowing language, and Karen did an awesome job 848 00:31:07,965 --> 00:31:09,359 with her chapter too. And then, 849 00:31:09,759 --> 00:31:11,920 Diane, everything that you added and and the 850 00:31:11,920 --> 00:31:14,319 whole Mayo Clinic team that, you know, jumped 851 00:31:14,319 --> 00:31:16,480 in to do all the editing. So, do 852 00:31:16,480 --> 00:31:18,079 you know where people can purchase the book 853 00:31:18,079 --> 00:31:20,400 if they're interested? Or yeah. I'd like to 854 00:31:20,400 --> 00:31:22,319 say one more thing about that. Those two 855 00:31:22,319 --> 00:31:22,819 chapters 856 00:31:23,200 --> 00:31:23,859 are critically 857 00:31:24,234 --> 00:31:26,095 important for everyone to read 858 00:31:26,714 --> 00:31:27,855 because it takes 859 00:31:28,394 --> 00:31:29,214 the mystery 860 00:31:30,634 --> 00:31:32,234 of IDDSI, and it 861 00:31:32,954 --> 00:31:34,875 for example, in your chapter where you talk 862 00:31:34,875 --> 00:31:37,194 about what are the questions a person can 863 00:31:37,194 --> 00:31:38,815 ask if they've received a diagnosis? 864 00:31:39,289 --> 00:31:41,450 It was an obvious thing that you put 865 00:31:41,450 --> 00:31:43,450 there, but people don't think about that. The 866 00:31:43,450 --> 00:31:45,849 caregiver has a lot of questions. So does 867 00:31:45,849 --> 00:31:48,190 the patient. And your chapter 868 00:31:48,490 --> 00:31:50,890 had all that. Then what are the tests? 869 00:31:50,890 --> 00:31:52,829 What are the what are the best practices? 870 00:31:52,890 --> 00:31:54,944 You answered all those questions. So by the 871 00:31:54,944 --> 00:31:56,884 time the person gets done reading that, 872 00:31:57,505 --> 00:32:00,244 they're more relaxed. Then they get the technique 873 00:32:00,384 --> 00:32:00,884 of 874 00:32:01,345 --> 00:32:04,865 here's the test. Here's the measurement. Here's how 875 00:32:04,865 --> 00:32:06,164 you do it. And then 876 00:32:06,580 --> 00:32:09,640 what we always do in my book, following 877 00:32:09,700 --> 00:32:13,240 the Mayo Clinic practice, is we offer further 878 00:32:13,700 --> 00:32:14,200 resources 879 00:32:15,299 --> 00:32:17,380 so that the person who needs more in 880 00:32:17,460 --> 00:32:18,920 I'm giving them the basics, 881 00:32:19,220 --> 00:32:20,984 but I give them where they can get 882 00:32:21,224 --> 00:32:24,184 authoritative information that can be relied upon. And 883 00:32:24,184 --> 00:32:25,565 among the things are 884 00:32:25,865 --> 00:32:27,964 every ethnic cuisine in the world 885 00:32:29,304 --> 00:32:31,244 has IDDSI applied to it. 886 00:32:31,625 --> 00:32:34,349 It's in multiple languages of the world. So 887 00:32:34,349 --> 00:32:37,650 for the ethnic cuisines, you refer to itsy.org. 888 00:32:37,710 --> 00:32:39,789 It has all the information and all the 889 00:32:39,789 --> 00:32:41,410 videos posted up there. 890 00:32:41,869 --> 00:32:44,029 The other thing that's very important is for 891 00:32:44,029 --> 00:32:47,054 lower income families who need help. We give 892 00:32:47,054 --> 00:32:49,954 them the the connection to dysphagia outreach. 893 00:32:50,494 --> 00:32:51,875 For example, a refurbished 894 00:32:52,255 --> 00:32:54,174 top of the line blender, which is very 895 00:32:54,174 --> 00:32:56,815 inexpensive. But for lower income people to get 896 00:32:56,815 --> 00:32:58,654 help, we want everyone to be able to 897 00:32:58,654 --> 00:33:00,755 get the information and implement it. 898 00:33:01,180 --> 00:33:01,680 Yep. 899 00:33:02,059 --> 00:33:04,700 Yep. Awesome. Well, thank you, Diane. Oh, where 900 00:33:04,700 --> 00:33:06,240 can they buy the book? Amazon 901 00:33:06,779 --> 00:33:07,279 or 902 00:33:07,820 --> 00:33:09,820 Barnes and Noble or any place books are 903 00:33:09,820 --> 00:33:11,580 sold. You just either put the title of 904 00:33:11,580 --> 00:33:13,099 the book or put my name in, and 905 00:33:13,099 --> 00:33:14,700 it will come up. You can it's it's 906 00:33:14,700 --> 00:33:15,680 widely available. 907 00:33:16,085 --> 00:33:18,565 Yep. And I hope I hope that, I 908 00:33:18,565 --> 00:33:20,805 dedicate this to my mother's memory. I do 909 00:33:20,805 --> 00:33:22,505 this work in her memory because 910 00:33:22,805 --> 00:33:25,285 I created this for her, and I I 911 00:33:25,285 --> 00:33:26,724 know that she would love it if what 912 00:33:26,724 --> 00:33:28,325 I created for her was of help to 913 00:33:28,325 --> 00:33:31,140 others. It that's my memorial to my mom. 914 00:33:31,380 --> 00:33:33,140 Oh, awesome. Thank you, Diane. Yeah. So the 915 00:33:33,140 --> 00:33:34,900 title of book is Cooking for Dysphasia and 916 00:33:34,900 --> 00:33:37,700 Other Swallowing Disorders, a 101 Delicious Recipes and 917 00:33:37,700 --> 00:33:40,099 Techniques for Safe Easy Eating, and it is 918 00:33:40,099 --> 00:33:42,259 published by the Mayo Clinic Press. So thank 919 00:33:42,259 --> 00:33:43,380 you for all of your hard work on 920 00:33:43,380 --> 00:33:45,140 this, Diane, and thank you for including me 921 00:33:45,140 --> 00:33:47,964 in the project. I was eternally, eternally grateful 922 00:33:47,964 --> 00:33:50,365 for that for that opportunity. So thank you. 923 00:33:50,365 --> 00:33:51,105 Thank you. 924 00:33:51,964 --> 00:33:53,984 And that's a wrap for this episode. 925 00:33:54,365 --> 00:33:56,625 As always, thank you so much for listening. 926 00:33:56,924 --> 00:33:58,525 If you'd like to download the show notes 927 00:33:58,525 --> 00:34:01,680 from this episode, please visit swallowyourpridepodcast.com. 928 00:34:02,619 --> 00:34:04,140 There you can also sign up for our 929 00:34:04,140 --> 00:34:06,140 email list so that you'll never miss another 930 00:34:06,140 --> 00:34:06,640 episode. 931 00:34:07,099 --> 00:34:08,780 If you do like what you hear, then 932 00:34:08,780 --> 00:34:11,440 please subscribe and leave a review on iTunes 933 00:34:12,059 --> 00:34:13,739 or share it on social media with your 934 00:34:13,739 --> 00:34:15,980 friends and colleagues because that is what keeps 935 00:34:15,980 --> 00:34:16,640 these episodes 936 00:34:17,634 --> 00:34:19,255 coming. If you'd like to be a guest, 937 00:34:19,315 --> 00:34:21,795 share feedback, or request a topic to be 938 00:34:21,795 --> 00:34:26,674 discussed on the show, please email podcast@TeresaRichard.com. 939 00:34:26,674 --> 00:34:28,755 Thank you so much for listening, and we'll 940 00:34:28,755 --> 00:34:29,974 catch you next week.