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Department of Nutrition and Dietetics Department of Speech and Language Therapy Thickened Fluids Stage 1, 2, and 3 Patient Name: ___________________________________________ Assessed by: Name: ___________________________ Profession: ___________ Telephone: ______________________ Date issued: ___________ This leaflet has been produced with the help of patients This leaflet is available in other languages and formats, eg CD, just ask Why do I need to thicken my drinks? 1 You have been assessed and advised to thicken your drinks to help you swallow more safely. Thickened fluids move more slowly when you swallow and therefore make it less likely for the drink to go down into your lungs. If fluid (or food) goes into the lungs it can lead to chest infections or aspiration pneumonia. There are three different fluid consistencies that can be advised to help you swallow more safely – Stage 1, 2, and 3. What is Stage 1 consistency fluid? Stage 1 consistency fluid should be prepared so that it • Can be drunk through a straw • Drunk from a cup • Leave a thin coat on the back of a spoon What is Stage 2 consistency fluid? Stage 2 consistency fluid should be prepared so that it • Cannot be drunk through a straw • Can be drunk from a cup • Leaves a thick coat on the back of a spoon What is Stage 3 consistency fluid? Stage 3 consistency fluid should be prepared so that it • Cannot be drunk through a straw • Cannot be drunk from a cup • Needs to be taken with a spoon You have been advised to thicken your drinks to Stage ___ consistency. How do I thicken my drinks? 2 Drinks are thickened by adding thickening powder. These are all available on prescription, for example: • • • • Vitaquick Resource ThickenUp Nutilis Thick and Easy You will need to add thickener to your drinks and stir until the consistency is similar to the above description. The amount of thickener needed will depend on the type of drink. There is also a guide to the amount of thickener needed on the container. Handy Hints • If you have been prescribed a milk based supplement: e.g. Fortisip or Ensure Plus, shake the drink and pour into a glass. Then whisk in the thickener. Leave to stand for 3 -4 minutes for the correct consistency. Using a shaker makes this process easier. These are available free of charge from the manufacturers of your thickening agent. • If you leave your drink to stand for a long time you may find that the consistency becomes thicker than needed, in this case it is advised that you prepare a new drink. • Take care when thickening hot drinks – try thickening the cold part of the drink first to a thicker consistency than desired, before adding the hot water. 3 • Remember to thicken sauces and gravies to the same consistency as the rest of your fluids. You can use the prescribed thickener or use corn flour to thicken sauces and gravies. General advice for eating and drinking • Make sure you are seated comfortably in an upright position. If sitting upright is difficult, prop yourself with cushions rather than reclining. Ensure that feet are on a flat surface to give a good base of support. • Ensure you take small mouthfuls . • Ensure each mouthful is cleared before you take the next. • Take your time while eating and don’t rush. • Avoid washing food down with a drink. Instead moisten the food further and swallow more often until it clears. • Try to avoid eating when feeling excessively tired. If you tire quickly whilst eating you may find it easier to eat smaller amounts more frequently. • It may help to remain upright for at least an hour after eating and drinking. • Don’t talk and eat at the same time. 4 What about cleaning my teeth? It is important to brush your teeth, tongue and gums at least twice a day; especially after meals. Swallowing saliva containing bacteria from the mouth can lead to chest infections. You are advised to use a low foaming toothpaste (e.g. Sensodyne or Biotene) as this does not stimulate excess saliva or leave the mouth dry. Put a pea-sized amount onto the bristles and brush your teeth in the normal way. There is no need to rinse; remove any residue with the toothbrush. What about my medication? Remember, if you have been advised to thicken your drinks, this guidance applies to any drink used to swallow medication. Some medications are available in syrup as well as tablet form. Some can be crushed and mixed with food to make them easier to swallow. It is essential that you ask your GP or pharmacist before changing how you take your medications. Things to look out for when eating and drinking: • Frequent coughing or choking at mealtimes or when drinking • Frequent chest infections • Difficulty breathing • Discomfort when eating or drinking • Food getting stuck in the throat Contact your doctor if you have and of the above difficulties This is a guide only. If you have any questions please see the front sheet of this leaflet for contact details of the person who assessed you. 5