Symposium 3 - CareFood in Hong Kong

Texture modified diet is commonly prescribed to individuals with swallowing difficulties, with the aim to maintain swallow safety, nutrition and quality of life. It is important that the texture modified diet is accurately prepared in terms of its consistencies (thickness), hardness, adhesiveness (stickiness) and size. Recently, the Hong Kong Council of Social Service, the Swallowing Research Laboratory (HKU) and the Food Research Centre (CUHK) jointly adapted the International Dysphagia Diet Standardisation Initiative (IDDSI) framework into a local guideline: Care Food Standardization Guideline (照護食標準指引). The Guideline follows the IDDSI framework and classified food and drink into 8 levels (from 0 to 7), with clear description and simple testing methods for each level. In addition, the Guideline also includes quantitative textural and rheological data on 62 common Chinese ingredients and dishes that were prepared across the IDDSI levels (Wong et al., 2023). The aim of the Guideline is to provide standardized terminologies, descriptions and subjective and instrumental testing methods for texture modified diet across settings in Hong Kong. In the presentation, the speaker will highlight the benefits of having a standardised care food framework across settings and the implementation of IDDSI globally and locally.

The provision of care foods has emerged as a significant focus in Hong Kong, owing to the collaborative endeavors of diverse industry stakeholders in recent years. With the Hong Kong government allocating funds to subsidize the procurement of care foods within NGO settings, individuals residing in residential care homes for the elderly and persons with disabilities can now access these specialized meals. However, it's important to acknowledge that the development of care foods in Hong Kong is still in its early stages compared to countries like Japan, where it has seen more extensive advancement.
Beyond governmental financial support for acquiring care foods, several other pivotal factors require attention to effectively implement care food provision within NGO settings. These encompass initiatives to enhance organizational capacity for producing care foods adhering to the IDDSI level, comprehensive training programs aimed at increasing awareness and advocating for the significance of care foods among frontline staff and caregivers and fostering interdisciplinary discussions to address concerns about care foods across various disciplines.
During this presentation, we will delve into the journey of Haven of Hope Christian Service as we embarked on the implementation of care food provision through our "Eating in Dignity" project initiated in 2017, which now regularly supplies care foods to service users in various settings. We will explore the challenges encountered during implementation and the strategies employed to overcome them. Furthermore, we will evaluate the project's effectiveness thus far, highlighting tangible outcomes and identifying areas for further enhancement. Moreover, we will illustrate how the overarching concept of "Eating in Dignity" is realized through the provision of care foods to service users within Haven of Hope Christian Service, showcasing its transformative impact on the quality of life for those we serve.

Dysphagia is estimated to affect 8% of the general population in the world. Texture modified foods and thickened drinks (i.e. Care Food) are commonly used in the management of patients with dysphagia. The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded with the mission to set up a common language and system of practical and valid measurement techniques for naming and describing food texture and drink thickness. The IDDSI framework consists of a continuum of 8 levels (level 0-7). Drinks are categorized into level 0-4 while foods are categorized into level 3-7. In Hong Kong, more NGOs and Residential Care Home for Elderly are adopting IDDSI for the desired food texture to their clients. Hospital Authority (HA) has adopted the IDDSI framework for drinks since July 2021 while patient’s food provision is using Dietetic Catering Management System (DCMS). In order to enhance the communication between healthcare professionals, caregivers and the community, Kowloon East Cluster (KEC) started the pilot of matching DCMS and IDDSI for patient’s food in 2023. In our talk, we will share how catering colleagues, speech therapists and dietitians worked together to achieve the goal, the challenges that we encountered and how the obstacles could be overcome. Also, we will share the experience of using different methods to enhance the oral intake of our patients (e.g. moulded food for patients taking pureed diets, colorful utensil).