This article has been medically reviewed by Dr. Martin Duggan in 2021
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
As a caregiver, you may have been told that your loved one needs a mechanical soft diet. This type of diet can be a bit more work than preparing a typical meal, but with some good tips and recipes, you will get the hang of it in no time. Typically someone will transition to a mechanical soft diet because they have difficulty with chewing or swallowing. This transition may be a temporary change prescribed by a doctor, but some elders with dementia, cancer, or other long-term chronic or terminal illnesses may need to be on such a diet permanently.
Changing a diet can often be difficult for older adults as well as the caregiver who is tasked with making new recipes. However, with some knowledge, planning, and preparation you can ensure your loved one eats safely and nutritiously. You can even learn how to make their food delicious too!
What is a mechanical soft diet?
If your loved one has been prescribed a temporary or long-term mechanical soft diet, they will need to eat food that requires less chewing, yet maintains excellent nutritional value. “Mechanical” means making food softer, and smaller so it is safer and easier to eat than solid food. It is done through the process of chopping, grinding, blending, whipping, or mashing the food. Having kitchen gadgets such as blenders/one portion hand- held blenders, food processors, a mesh strainer/sieve, or baby food grinders can make the job of softening foods easier; but you can use a fork and knife to mash and chop too.
Many foods can be softened by adding liquids such as gravy, tomato sauce, melted butter, oil, broth, milk, or water. For example, mashed potatoes can be eaten in place of a baked potato. A mechanical soft diet focuses more on texture than ingredients, so the good news is your loved one can eat many of the food items they liked eating before, just softened. A mechanical soft diet does not have to be bland, it can be flavorful! You can still use seasoning, herbs, spices, sweeteners, and salt and pepper as you like.
How is a mechanical soft diet different from a soft foods diet?
A soft foods diet is prescribed for people with gastrointestinal disorders or bowel surgery. A soft foods diet focuses on foods that are easy to digest rather than on the ease of chewing. Typically, it is low in fiber, low in fat, low in acid, lacking in spices, and avoids hard to digest foods like whole wheat and beans. The difference between someone on a mechanical soft diet and someone on a soft foods diet is that if you are on a mechanical soft diet you may have trouble chewing or swallowing, but not digesting.
Dysphagia
Dysphagia is a word doctors use to describe the impairment of the ability to swallow. Swallowing is something we all take for granted and we think about it as simple. But in reality, many muscles and structures have to move with near-perfect coordination in order to transfer a bit of chewed food from the back of our mouth to the esophagus while keeping our windpipe covered.
Dysphagia is usually caused by either nerve damage from a disease or -more commonly – brain damage from a stroke or disease. Common causes of dysphagia include dementia, strokes, Parkinson’s disease, multiple sclerosis, and ALS/ Lou Gehrig’s disease.
Signs your loved one is having trouble chewing or swallowing
There are typically signs that your loved one is having trouble chewing or swallowing their food. They might:
- Take a longer time to eat
- Seem to be in pain or discomfort while chewing
- Drop pieces of food
- Not be able to chew harder foods anymore
- Lose weight because they cannot eat properly and are ashamed or scared to tell anyone.
- Cough right after eating
- Have trouble drinking liquids
- Choke on their food frequently
- Have pain while swallowing.
If you think your mom or dad, or another elder you care for, is having a swallowing problem, talk to their doctor. There are various imaging tests, such as an endoscopy, that can help diagnose the problem. A mechanical soft diet may be part of the solution.
Reasons people have trouble chewing or swallowing
There are several reasons that someone may need a soft diet:
- missing teeth
- new dentures
- recently had oral or throat surgery
- recently had radiation treatment
- esophageal narrowing caused by acid reflux
- recent stroke that causes dysphagia
Mechanical Soft Diet Meal Options
The goal of the mechanical soft diet is to avoid food that requires a lot of chewing. For example, tough meats, raw vegetables, hard cheeses, crusty bread/toast, nuts, seeds, dry crackers/chips, raisins, and candy, whole fruits such as apples with tough skin, pits/seeds are difficult to chew and eat.
Breakfast
- Applesauce
- Oatmeal
- Grits
- Scrambled eggs
- Pancake pieces
- Yogurt
- Bananas
- Cottage cheese
Lunch/Dinner
- Creamed soups
- Meats mixed with gravy
- Soft flaky fish
- Egg and chicken salad with mayonnaise
- Soft pasta
Dessert
- Icecream
- Sorbet
- Pudding
- Melted chocolate
Ensuring proper nutrition
It may be helpful to work with a registered dietician or nutritionist to ensure your loved one is getting good nutrition when starting a mechanical soft diet. Caloric intake and hydration and two things to watch.
People who are older or less active need fewer calories, but when eating soft foods, it can be difficult to figure out how many calories they are getting. They may need a higher caloric intake if they are losing weight. In order to boost calories, consider high supplement shakes such as Ensure and Boost. These types of shakes can be both nutritional and high in calories, vitamins, and minerals.
We all need to drink about eight 8 ounces of water a day to stay hydrated. If your loved one has trouble swallowing it may affect their ability to drink thin liquids such as water or juice, and they may start to avoid drinking. It may be necessary to thicken liquids for swallowing. The University of Toledo suggests different types of thickeners in order to find one that works best for the person your care for.
Planning Meals
Memorial Sloan Kettering Cancer Center provides some tips for planning meals for someone who is on a mechanical soft diet. They suggest the person eat 6-8 small meals a day, instead of 3 big ones. This can mean more frequent meal preparation for you, so plan ahead. Prepare several foods or meals for the diet ahead of time and keep in the refrigerator or freezer. When eating out at a restaurant, call ahead to ask if they can puree your loved one’s food or order sides of broth or gravy to moisten the food yourself.
Sources:
- Dysphagia, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/dysphagia/symptoms-causes/syc-20372028
- Eating guide for pureed and mechanical soft diets, Memorial Sloan Kettering Cancer Center, https://www.mskcc.org/cancer-care/patient-education/pureed-and-mechanical-soft-diets
- Swallowing problems, WebMD, https://www.webmd.com/digestive-disorders/swallowing-problems#1
- What is the mechanical soft diet? Very Well Health, https://www.verywellhealth.com/what-you-can-eat-on-a-mechanical-soft-diet-2507158
- Understanding mechanical soft diets, University of Toledo, https://www.utoledo.edu/depts/csa/caringweb/softdiet.html
- https://www.dysphagia-diet.com/Images/Level%202%20Dysphagia%20Mechanically%20Altered%20Diet.pdf
