Picture this: a wizened old man lying in bed, thin and frail, a shadow of his former self. The clock strikes twelve. A hospital attendant wheels in lunch: lumps of mushy purée, unrecognisable by form or taste. The old man picks listlessly at his food, then slumps back with a sigh of resignation, leaving the plate virtually untouched.
What sounds like a dismal prospect is in fact the harsh reality for millions of people in hospitals and nursing homes worldwide who have difficulty swallowing, a condition known medically as “dysphagia”.
The Silver Connection
Dysphagia is a common affliction in the elderly population, particularly amongst those who are toothless or suffer from stroke, certain cancers and neurological conditions like dementia.
For the dysphagic, mealtimes are to be dreaded, not savoured. Eating a proper meal is a tricky, often painful, affair; not helped when the food is presented as unappetising globs of bland, shapeless purée. Unsurprisingly, many patients lose their appetite and end up suffering from more serious health problems in the long run, such as malnutrition, dehydration and weight loss.
“It’s super depressing,” empathises Yiru Shen. “These people are already sick, and they’re deprived of the chance to even enjoy the food the way they used to. Can you imagine eating nothing but mash for the rest of your life?”
Upon seeing the dearth of palatable offerings, the biochemist felt compelled to take action. In July 2019, she launched GentleFoods with medical technologist Jeannie Ong, to serve up ready-to-eat culinary creations that are safe, nutritious and above all, appetising.
“We create puréed food and mould them into familiar dishes that look, taste and smell like the original,” explains Yiru. Their chicken rice, for instance, has the chicken puréed and served in a shape similar to that of real chicken thigh or breast. The same goes for puréed carrots, broccoli and staples like rice and noodles. To complete the meal, gravies and sauces are added for extra flavour.
With their gentle foods, both Yiru and Jeannie hope to stimulate the appetite of a growing group of elderly dysphagic patients, who might otherwise be consigned to eating plain porridge or fed through feeding tubes.
Dining with Dignity
GentleFoods offers an Asian-inspired menu, which runs the gamut from sweet and sour fish rice to rendang chicken rice to black pepper chicken noodles. Each bento set is priced affordably at $7.90 and comes with a serving of rice or noodles, a protein (chicken or sutchi fish), two sides (vegetables) and a complementary dressing.
Apart from shaping each component, which is done using custom-made silicon and plastic moulds, Yiru and Jeannie channel their scientific know-how into making the meals healthier and more wholesome. Meals are customisable with different levels of salt, fat, fibre and nutrients, depending on individual dietary requirements. For example, a patient who has recently undergone surgery would require more protein in his diet to aid in recovery.
Yiru explains, “Our food is made as kosong as possible, without any MSG or preservatives. We work closely with speech therapists to refine the texture, and with dieticians and nutritionists to improve the nutritional content.”
Every batch produced undergoes stringent food safety and nutrition tests before it is sent for clinical trials. Then, based on feedback from patients and consultation with healthcare professionals, it undergoes further fine-tuning before it is rolled out officially.
Doing Good through Food
Currently, GentleFoods supplies meals to two local healthcare partners – Tan Tock Seng Hospital and Assisi Hospice. Feedback so far has been positive, and both Yiru and Jeannie are happy to report that their meals have also been certified suitable for patients with swallowing difficulties, meeting level 4 on the International Dysphagia Diet Standardisation Initiative (IDDSI) framework of puréed foods.
The duo are already in talks to extend their offerings to Khoo Teck Puat Hospital and Woodlands Health Campus within the next few years. But before that, they are keen to expand their menu range and work on automating and scaling up their production process.
“We’re looking into producing a premium range of meals using better quality ingredients like salmon,” Yiru shares. “We’re also working on desserts, like bread pudding. We’ve even gotten requests to do durian purée!”
If things go according to plan, the new and improved GentleFoods will soon be found not just nationwide, but also in other healthcare institutions around Asia. And the two ladies behind it all will feel gratified at having achieved their goal: to restore the joy of eating into the lives of the elderly dysphagic patients.
“By 2050, almost half of our population will consist of elderly folks above the age of 65, including myself,” muses Yiru. “As far as possible, we want these folks to recover and go back to eating normal food. If they do, that’s our satisfaction. But in the meantime, for those who can’t swallow, we’ll do our best to help by bringing back their appetite for life.”