Focusing on the "International" in IDDSI: ensuring relevance in all care-settings and cultures |
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- How do you thicken liquids when you might not have easy access to clean water, thickener products and 10 ml syringes?
- How do you provide texture modified foods when your access to food is limited, you have no power or equipment to blenderize or modify this food?
These were some of the challenging questions posed by Dr Mershen Pillay in his recent webinar entitled “A Community-based Approach to Diet Modifications in Vulnerable Contexts”.
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Dr. Pillay described a common scenario for many clinicians where a person with dysphagia presents at a health care facility, is assessed and provided with a variety of recommendations which may include modifying food texture and liquid consistency. But what about many of those who have no easy access to health care facilities and poor access to food? Ongoing global inequalities need to addressed when thinking about dysphagia diets.
So is IDDSI applicable across Low, Middle and High income contexts and countries?
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Dr. Pillay suggests that IDDSI can be applied and implemented in all contexts but requires a different approach for low and middle income contexts and countries. The Community Based Rehabilitation matrix (WHO) is a framework that can be used to achieve this.
Going with a Community Based model makes sense because:
- The majority world is underserved – disability, poverty and lack of resources
- It focuses on food and modification within the context including social and cultural factors affecting mealtimes.
Dr. Pillay then described a research and innovation project demonstrating how one could apply this approach.
THRIVE: Tackling Hunger via Research and Innovation with Vulnerable Environments – a framework on how to work with people with swallowing disability. This project focused on a “Train the Trainer” with education sessions for community health workers.
Four strategies formed the underpinning of the approach
- Food Production,
- Food Preparation,
- Textural measurement and classification (IDDSI)
- Primary care management of those with the swallowing disability.
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Most clinicians would be familiar with addressing textural measurement and classification (IDDSI) and primary management of a swallowing disorder but would not necessarily consider food production and food preparation as needing to be addressed. |
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Content for the Food focused areas included:
Food Preparation
- Understanding textural properties (rheology)
- Natural and non-commercial thickening agents options (cornstarch, potato, rice, taro, agar etc)
- Food preparation methods (use of aeration, dehydration options)
- Food economics – cheap, accessible solutions and equipment
- Food ergonomics-easy to use methods and equipment (whisks, forks)
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Food production to consumption
- Home/families for people living with disabilities. Recommendations must take into consideration that the whole family is food insecure so must make sense for the family as well as the individual.
- Home gardens are typically providing much of the food source, not supermarkets. Discussion on growing dysphagia friendly foods that are also indigenous and familiar to the individual and family.
- Pharmacy farms-food as healing. The important of understanding how different foods may be viewed as healing within that cultural context.
Dr. Pillay also outlined some exciting research projects that are looking into food services as well as food development and preparation. These studies include:
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Research into the therapeutic value of multisensory eating focusses on crispy/crunchy foods like transitional biscuits (e.g., see Karani & Pillay, 2021)
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Focusing how caregivers make/prepare food to match IDDSI levels (e.g. see deVilliers, et al, 2019)
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Decolonising practice with swallowing disability and diet modifications in relation to people’s food security/sovereignty (e.g. see Quarmby & Pillay, 2018; and see the section on THRIVE in Pillay & Kathard, 2018)
Community based IDDSI implementation allows us to re-think the ‘human’ when we manage swallowing safety and eating pleasure, ensuring that mealtimes are inclusive of all, especially those in vulnerable environments.
Contact Dr. Pillay if you would like to talk about community based IDDSI implementation or an ‘EPIC’ project (click here).
A recording of Dr. Pillay’s webinar will be available for viewing in early 2022.
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IDDSI Back Live at the American Speech and Hearing Association (ASHA) Conference |
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An IDDSI booth, hosted by volunteer members of the USIRG, was in full force at the recent ASHA conference in Washington DC Nov 18-20, 2021. Many thanks to ASHA for the opportunity to promote IDDSI at the 2021 conference. And, kudos to Karen Sheffler, Rob Melchionna, Mary Rybicki for coordinating, setting up and managing the booth. Reports from the USIRG volunteer team indicated the booth was very popular with those attending. Thanks to those who volunteered their time at ASHA to share information about IDDSI. |
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IDDSI at the European Society of Swallowing Disorders (ESSD) Online Congress |
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Congratulations to the European Society of Swallowing Disorders (ESSD) for a most successful online congress: Optimising management of dysphagia across the etiological spectrum – new tricks for an old problem (Nov 4-6, 2021). It was wonderful to see the many presentations of current research using IDDSI at the congress. |
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If there is IDDSI implementation activity happening in your part of the world and you do not see the information on the IDDSI website or mentioned in the e-bite, please contact us and let us know, We will be most happy to acknowledge your contribution and let the rest of the world know what you are doing.
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Canada: The Canadian IDDSI Reference Group (CIRG) hosted two very successful IDDSI Long Term Care forums in November to discuss the tips & tricks for IDDSI implementation. Both forums were full within days of announcement. Participants provided incredibly valuable feedback which will help CIRG to strategize and plan future activities to even better support those working in Long Term Care. Canada is aiming to transition from dual labeling towards using IDDSI labels by December 2022 to align with proposed Health Canada labeling change requirements.
Colombia: El abordaje de la disfagia requiere de acciones multidisciplinares que se concentren en las características clínicas de cada paciente; estas acciones exigen una regulación esquemática y estandarización de sus componentes para un manejo adecuado. La propuesta de cambio o modificación de las consistencias generada por IDDSI es una de esas acciones en la que se deben capacitar los profesionales para propender por el manejo seguro de la alimentación en el paciente. En Colombia buscamos un grupo de profesionales para el fortalecimiento de la implementación de estas acciones seguras bajo la evidencia científica. Únete al grupo y construyamos IDDSI COLOMBIA.
The approach to dysphagia requires multidisciplinary actions that focus on the clinical characteristics of each patient. These actions require a schematic regulation and standardization of its components for a proper approach for clinical intervention. The proposal of change or modification of the consistencies generated by IDDSI is one of those actions in which professionals must be trained to promote the safe handling of feeding in the patient. In Colombia we are looking for a group of professionals to strengthen the implementation of these safe actions based on scientific evidence. Join the group and let's build IDDSI COLOMBIA.
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France: IDDSI has created a France IDDSI Reference Group! Translations in European French are available since 2018, and we are currently working on a global French harmonisation with french speakers around the world. Our group will be in charge of spreading and advocating IDDSI tools on our territory. Registrations for volunteers will open soon. Contact the France IDDSI reference group by email.
L'IDDSI a créé un groupe de référence IDDSI France! Les traductions en français européen sont disponibles depuis 2018, et nous travaillons actuellement à une harmonisation globale du français avec les francophones du monde entier. Notre groupe sera en charge de la diffusion et de la défense des outils IDDSI sur le territoire. Les inscriptions seront ouvertes prochainement aux volontaires. N’hésitez pas à contacter le groupe de référence IDDSI France par mail.
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Slovenia: Dear future fellows, dysphagia enthusiasts in Slovenia! It is our great pleasure to invite you to join the Slovenian IDDSI Reference Group! Yeah, you heard it right! IDDSI has established a reference group to present, promote and spread the IDDSI's good practice across the entirety of Slovenia.
Dragi bodoči sodelavci, entuziasti na področju disfagije v Sloveniji! Z veseljem vas vabiva, da se pridružite referenčni skupini IDDSI Slovenija! Ja, slišali ste prav! IDDSI je v Sloveniji ustanovil referenčno skupino, ki bo dobro prakso IDDSI predstavljala, spodbujala in širila po celotni Sloveniji.
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United States: This month, the USIRG explores what universities are teaching students about IDDSI. Several dietician and SLP university programs have filled out a mini-survey, and the group is looking for more responses from colleagues who instruct or supervise at the university level. If you, or anyone you know, who would be willing to share their IDDSI educational experience, fill out the survey here. Learn more in their update here.
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Take a look at our IDDSI Reference Group page to see what different reference groups are doing to supporting IDDSI Implementation.
Interested in starting an IDDSI reference group to help support IDDSI implementation in your regional or practice area? Contact us.
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Both documents of the IDDSI 2.0 framework, the Detailed Definitions and the Testing Methods, have now been translated (and checked thoroughly) into Dutch and are now available on the IDDSI website. The translation was done in the Netherlands, has been checked by colleagues in Flanders and was facilitated by Nestlé Health Science BeNeLux. On the last page of the documents we have acknowledged all contributors of the translation of the 1.0 version, which was still under discussion when the 2.0 version was newly published in 2019.
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Webinars & IDDSI Learning |
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Holidays for Patients with Dysphagia with NFOSD
December 2, 2021
9:00 AM UTC-7 (Arizona time)
IDDSI and Laura Michael, Board Member of the National Foundation of Swallowing Disorders (NFOSD) presents a special webinar focusing on patients with dysphagia and what they may face during the holiday season. Come hear tips on how the holiday celebrations can be successfully managed with a little thought, planning, and cooking techniques.
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Previous Webinars and Recordings |
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Missed any of our other webinars? All our webinars are recorded and can be found on here, but please note rewatching the webinars on YouTube will not provide you with a Certificate of Attendance.
If you register and then cannot attend a webinar, PLEASE make sure to cancel so we may open another spot up for someone else. Thank you very much for your consideration.
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IDDSI in Action
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Hong Kong IDDSI Implementation Virtual Symposium, December 8, 2021
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Join the teams from the HKIRG and the SGIRG at this online symposium. English translation will be provided for talks done in Cantonese. Email for more information.
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MacKay Memorial Hospital & Taiwanese Dietetics Association Conference, December 11, 2021
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8th Turkish Swallowing Disorders Congress, February 24 - 26, 2022
Upcoming Conferences
- United Kingdom Swallowing Research Group Virtual Conference (UKSRG), February 3 & 4, 2022
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The conference programme topics will include: Supporting clinical care/service development – international approaches, Blended diets, Rehabilitation, what is in our evidence-based tool bag, Framing of Illness, Applying physiology techniques to practice, Feeding on CPAP/HFNC – what is the evidence and what are the controversies? Register here.
- Dysphagia Research Society (DRS) Annual Meeting in San Juan, Puerto Rico, March 15-18, 2022.
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Due to ongoing uncertainty about COVID-19 and world travel restrictions, this meeting will be a hybrid (virtual and in-person) event. Register here.
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