F.A.Q.

Dysphagia may be accompanied by disorders affecting the muscles and nerves of the tongue and mouth, making coordination during swallowing difficult; in other cases, it may be caused by occasional problems, such as incorrect chewing, or depend on certain conditions, such as oesophageal diseases, which require specific treatments. Dysphagia is particularly prevalent among the elderly, as ageing can lead to weakened jaw muscles, tooth loss, disorders of smell and taste and reduced salivation. People affected by dysphagia for whom food and fluid intake is limited (whether hospitalised, institutionalised or home care patients) should be considered at high risk of nutritional deficiencies and treated accordingly.

Malnutrition is defined as a condition of structural/functional and developmental changes to the body caused by an imbalance between nutritional needs, intake and nutrient utilization to the extent that it leads to increased rates of morbidity and mortality or impaired quality of life.

Nutritional frailty is very common in the elderly (it affects about 25 per cent of people aged 85 and over), characterised by decreased physiological reserve, low resilience and an imbalance between caloric intake and energy expenditure. It is a syndrome in which the nutritional state can be the cause of illness or its worsening and indicates the close link between the physical condition and a more existential aspect that is the frailty of the elderly person, seen in their weakness as a vulnerable person. Identifying frailty is necessary to prevent a decline in the health and functional status of the elderly person, which is often followed by a condition of malnutrition.

Often the elderly do not eat properly. With advancing age, there is a tendency, on the one hand, to follow a monotonous and meagre diet and, on the other hand, one or more factors may arise that adversely affect the way one eats. These factors can be different and vary from person to person:

• loneliness: eating is a social event and often loses its value when an elderly person is left alone
• physical disability: may reduce or prevent the ability to shop, prepare food or even eat
• impaired dentition or edentulism
• taking medication: some medicines may affect appetite, cause nausea or loss of nutrients
• Refusal or ignorance regarding the preparation of food
• economic situation
• dysphagia

Poor nutrition may lead to cases of malnutrition and weight loss (it becomes significant when the loss exceeds 10 per cent within six months), asthenia, lack of resistance to infections. Malnutrition is often associated with increased dehydration due to insufficient water intake. In the elderly, the sense of thirst is reduced, resulting in reduced daily water intake.

Nutritional risk assessment makes it possible to identify those characteristics that, individually or in combination, may contribute to malnutrition. Generally, there is a systematic and standardised procedure to identify over- or under-nutrition, and it is carried out taking into account several parameters including weight, height, BMI, and waist circumference. There are also tests to detect the nutritional status through simple questions to which a score is associated: Nutrition Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST).

Effective nutrition intervention significantly reduces the risk of complications, length of hospital stay, readmission rates as well as mortality rates. The purpose of nutrition intervention is to improve the patient’s therapeutic outcome. In cases of preventative malnutrition, for example, high-protein/energy diets are required.

Achieving an optimal level of care requires a continuous process of innovation and transformation. For the purpose of improving the quality of care it is essential to integrate all the different views on how a healthcare food and hospitality service should operate as well as all the different skills of the professionals involved, and to facilitate communication between all the stakeholders, including information provided to users/patients. There is a need for a systematic quality review by identifying consistent and measurable indicators (structure, process, outcome) and a possible reward system for those healthcare providers that adopt QRM paths demonstrating an improvement in every aspect of the quality of the care they provide.

H.a.r.g. researches, develops and markets nutrient-enriched texture-modified dehydrated food and drinks for the dietary treatment of malnutrition in the frailest patients. From natural foodstuffs, our technology gives the product the right density, viscosity, and consistency, leaving flavours, aromas and colours intact. What sets us apart is the fact that we enrich our foods with the necessary nutrients; our formulations are all balanced and in full compliance with international guidelines.

The answer is yes. They are specially formulated, complete meals; with no added drugs or supplements. This product can be used as a sole source of nutrition or to supplement the usual diet and should be used under medical supervision.

They can be purchased in participating pharmacies or via our online shop www.dysphameal.com

The answer is yes. They can be administered to children, but are not to be used for children under three years of age.

For oral use only.

Dysphameal products can be bought without a prescription; they are not drugs, but ‘dietary foods for special medical purposes’.

The answer is yes. Dysphameal products can also be administered to diabetic patients because they are low in simple sugars.

Dysphameal meals can be adjusted; you can obtain the consistency best suited to your degree of dysphagia by adjusting the amount of water added. The recommended amount results in an IDDSI-level 4 product.

The answer is yes. They can be heated or cooled. The consistency remains the same, without creating a layer on top.

One of its advantages is the stable consistency, which retains its properties over time.