What is Dysphagia in Hong Kong?

While coughing, choking, and obvious swallowing difficulties are well-recognized signs of dysphagia, several less apparent symptoms are frequently overlooked. These include needing extra time to chew and swallow food, which may not seem concerning at first. A persistent bad odor from the mouth due to trapped food particles often gets mistaken for poor oral hygiene rather than a swallowing problem. Occasional drooling or minor spills while eating might be dismissed as normal aging. The sensation of food sticking in the throat may occur without complete obstruction, leading patients to drink more fluids to compensate. Moreover, gradual, unexplained weight loss and dehydration sometimes develop so slowly that they aren’t immediately connected to swallowing difficulties.

Source:

https://www.cuhkmc.hk/health-programmes/averting-degenerative-and-chronic-diseases/swallowing-well

When preparing food for a dysphagia patient, it is essential to follow the International Dysphagia Diet Standardisation Initiative (IDDSI) Framework, which classifies food textures into 8 levels (from Level 0 “thin liquids” to Level 7 “regular food”). For patients requiring Level 4 (pureed) or Level 5 (minced and moist) diets, caregivers should blend food into a smooth paste and use thickeners to achieve the right consistency. Two common thickeners available in Hong Kong are modified starch-based (coarser texture, starchy taste, cheaper) and gum-based (tasteless, more stable, but pricier).  While gum-based thickeners cost more per packet, they require smaller amounts per serving, making them more economical for some consistencies. However, modified starch-based thickeners may affect blood sugar levels in diabetics if consumed in large quantities.

For Level 6 (soft & bite-sized) and Level 7 (regular/easy to chew) diets, hard foods like meat and root vegetables should be pre-softened before cooking. Food gellants can also be used to improve texture and appearance. Regardless of the level, caregivers must test food thickness using IDDSI Testing Methods to ensure safety.

Pre-packaged “care food” is another option, but consumers should verify that products follow IDDSI standards, as some imported brands use different labeling systems.

Source:

https://www.consumer.org.hk/en/press-release/p-549-dysphagia-diet 

Sustaining balanced nutrition for a dysphagia patient with food allergies requires careful planning to prevent deficiencies while ensuring safe, easy-to-swallow foods. Since food allergies restrict dietary options, key nutrients must be replaced with allergy-friendly, whole-food alternatives that also meet dysphagia texture needs. For protein, soft-cooked meats, pureed legumes (if safe), or blended seed butters (like sunflower seed butter) can replace allergenic sources like nuts or dairy. Calcium can come from pureed leafy greens or fortified non-dairy milks (if tolerated), while iron-rich foods like mashed lentils or finely ground seeds (pumpkin, flax) can compensate for restricted grains or meats. For fiber, cooked and pureed quinoa, oats, or peeled fruits (apples, bananas) are gentle on swallowing yet nutritious. Since processed foods should be minimized, homemade purees and mashed vegetables (potatoes, carrots) are ideal for controlling ingredients and texture. It’s crucial to diversify safe foods, such as blending fruits, soft grains, and hypoallergenic proteins to cover all nutritional gaps.  Without proper substitutions, eliminating food groups (like dairy or wheat) risks deficiencies, so you can consult a dietitian to tailor meals based on the patient’s allergies and dysphagia severity to ensure adequate calories, vitamins, and minerals through safe and nutrient-dense alternatives.

Source:

https://cpdonline.co.uk/knowledge-base/health-and-safety/diet-nutrition-allergy-prevention/#:~:text=It%20is%20important%20to%20meet,food%20alternatives%20with%20similar%20nutrients 

Yes, there are specialized food delivery services for dysphagia patients, such as CookEasy’s “Comfort Soft Food” by the Tung Wah Group of Hospitals in Hong Kong. This service provides nutritious, IDDSI-compliant soft meals designed for individuals with swallowing difficulties, ensuring safe and enjoyable dining. The meals retain the original flavors and textures of home-cooked food while meeting strict dietary standards.

Another option is Yee Hong’s Care Food Initiative, which promotes visually appealing and tasty pureed meals for seniors and dysphagia patients. While Yee Hong focuses on education and community support, CookEasy offers convenient delivery of pre-packaged, easy-to-reheat soft meals, including bento packs and bulk options. These services prioritize safety, nutrition, and affordability, making them valuable resources for caregivers and patients.

Sources:

https://www.yeehong.com/centre/community-services/community-services-online/care-food/ 

https://www.tungwahcsd.org/en/service-plans/service-plans/youth-and-family-services;news/17668/CookEasy-of-Tung-Wah-Group-of-Hospitals-Launches-Comfort-Soft-Food-br-A-Delicious-Taste-of-Home-for-Frail-Elderly-and-Dysphagia 

Feeding a dysphagia patient requires patience, safety awareness, and attention to their comfort. If the patient can self-feed, encourage independence but offer assistance if they tire. Ensure they sit upright (90 degrees) during meals and for at least 30 minutes afterward to aid swallowing and digestion. Choose a quiet, relaxed setting and minimize distractions like TV or excessive conversation, as these may disrupt concentration. Some patients prefer eating alone, while others benefit from light social interaction, so it is better to observe their preferences.

Before eating, check that their mouth is clean and dentures (if worn) are secure. Try to offer smaller, manageable portions and adjust feeding frequency if fatigue or swallowing difficulties arise. Moreover, keep meals unhurried and avoid standing over the patient, which may make them feel rushed. Maintain eye contact and a calm demeanor to create a supportive atmosphere.  Additionally, hydration is key, so ensure fluids are offered throughout the meal.   Lastly, if the patient struggles, experiment with portion sizes, meal times, or frequency to find a sustainable routine.

Sources:

https://www.upstate.edu/whatsup/2012/0315-caregiving-advice-how-to-feed-someone-with-a-swallowing-difficulty.php#:~:text=Sitting%20the%20person%20upright%20in,the%20esophagus%20to%20the%20stomach. 

https://www.fresubin.com/nutrition-you/nutrition-and-dysphagia/dysphagia-patient-care 

https://www.elderly.gov.hk/english/carers_corner/caring_skills/swallowing.html