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IDDSI Explained

aged care diet dysphagia health nutrition Dec 06, 2022

What is dysphagia?  
Affecting approximately 8% of the world’s population, dysphagia is the medical term used to describe difficulty swallowing.  

Dysphagia weakens the muscles and nerves that control the tongue and mouth, making it difficult for those affected to suck, swallow, chew, eat and even close their lips. When they do manage to swallow food or fluids, those suffering dysphagia often aspirate (when food and/or fluids go down their trachea rather than their oesophagus).  

Most common amongst the elderly, dysphagia can look like:   

  • Food or drink getting stuck in the throat or going down the wrong way. 
  • Taking more than 30 minutes to finish a meal 
  • Coughing or clearing of the throat after eating or drinking 
  • Regular heartburn 
  • Shortness of breath while eating or drinking 
  • Specifically avoiding certain foods that are hard to swallow 
  • Getting chest infections with no explanation 

Due to the difficulty and pain associated with swallowing, many suffering from dysphagia often also experience long-term health issues dehydration, malnutrition and pneumonia.  

How is dysphagia treated? 
Thankfully there are a number of methods that can be used to help treat dysphagia, including:  

  • Modifying the textures of foods or drinks 
  • Introducing new swallowing techniques 
  • Focusing on exercises to help the muscles and stimulate nerves – triggering the swallowing reflex 
  • Reducing stomach acid reflux through medication 

Healthcare professionals including doctors, speech pathologists, dietitians and occupational therapists should be consulted when treating dysphagia, to ensure the adjustments meet resident’s individual needs. 

What is a texture-modified diet?  
Following a texture-modified diet is one of the easiest and most direct ways to help treat those suffering from dysphagia.  

A texture modified diet varies for person to person, depending on their individual needs. In essence however, the foods and fluids prepared by catering staff, chefs and cooks are adjusted in specific ways to produce a particular consistency or texture. Adjusting the consistency of each food makes it easier for those suffering from dysphagia to swallow, while reducing the risk of choking during meal times.  

Each meal should be adjusted on a case-by-case basis so that it not only meets the individual’s unique dietary requirements but also nutrition requirements. Incorporating extra vitamins, protein and calcium into appealing and tasty texture-modified meals can be essential in ensuring those suffering dysphagia are receiving the nutrition they need to stay fit and healthy.  

The IDDSI Framework  
The simplest and most effective way to follow and prepare texture modified diets is by following the International Dysphagia Diet Standardisation Initiative (IDDSI guidelines). The IDDSI framework is a standard set of guidelines that describe texture-modified foods and thickened liquids globally.   

It caters for those of all ages living with dysphagia including aged care and across different cultures. The framework consists of a continuum of 8 levels (0 - 7). Drinks are measured from levels 0 - 4 and foods are measured from levels 3 - 7. 


These food and fluid modifications are a strategy used to help people with difficulties swallowing. Changing the thickness and texture allows people with dysphagia to enjoy their food and drink without complications all while receiving the required nutrients. 




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