How to get Dad off a mechanically altered diet in nursing home?

I suspect that your father already received a chewing/feeding evaluation upon entry and he was deemed a choking risk. This can be due to missing dentures, ill-fitting dentures, dexterity issues that would prevent him from being able to manipulate a knife and fork to cut up his own food, etc.

If a senior is unable to manage normal self-feeding, chewing, or swallowing, then they are ordered a "mechanical soft diet." This includes things that are easy to chew such as macaroni & cheese, hamburger, or finger-foods. This is an appropriate diet for a person with any impairment at all.

Either you or your father may be "overestimating" his ability to chew or self-feed so-called "normal" foods. I don't know how old he is - but do you honestly think that he can manage to eat a T-bone steak?

At Moms NH her dietician specified that her meat should be cut into small pieces. The aids had to do it when they served her meal, it didn’t come that way from the kitchen. She was able to manage that but it took forever to eat. We figured out her dentures are pretty old, and she was starting to have trouble chewing her food. I requested to the dietician that her large meats be ground. We tried it and what a difference! Ground still has a good texture, unlike puréed. For example, hamburgers are ground and served on the bun, and a ham steak is ground but served with pineaple sauce over it. Maybe you can suggest this to the dietician.

Some NH's have weekly menus that the patient chooses from.

My friend (92) was supposed to be on puréed a year and half ago. He was astute enough to refuse to eat baby food. So I just had to tell the speech therapist and nursing staff that I wanted him on pleasure eating. They did not give me a hassle. He ate well for a year, then got sick and was hospitalized for a week. They started him on puréed in the hospital and because of his mental decline, when he got back to the SCF, he accepted the puréed. I don’t think he could remember what real food was anymore. Bottom line, a year on pleasure eating (normal food) probably kept him alive. I think if I forced the puréed he would have stopped eating. I am also there 6 days a week at lunch and dinner to assist him eating. Let you father choose how he wants to live the rest of his life. Miserable eating mechanical or happy eating regular food. I would vote for happy. Good luck!

One of the Federal/State Regulations is "the right to refuse." Residents have a "right to refuse" anything. This includes, medications, diet, doctor's orders, and therapy. If your dad is competent and does not want a mechanical soft diet he has a right to refuse this diet.

The home must do several things:

Offer the refused item more than once;
Explain the consequences of what may happen if the resident refuses (he may chock);
And they must document in his medical record the refusal.

Once this is done they are required to honor the refusal!

If I were you I would tell the home that you are aware of your dad's "right to refuse" and let them know that he is exercising his right! If you continue to have a problem let me know and I will post the regulation on this site.

Hm, what I've seen is more akin to the texture of loose hamburger meat, chopped fine but not fine enough to become a cohesive "blob". They don't cut things into bite sized pieces here either and I've thought that it is ridiculous that the aides have to run around taking meat off the bone and cutting things up when it would make more sense for the kitchen to do it, but it is supposedly to preserve the resident's dignity 🙄.
It could be that they are being cautious with a new resident and will alter his diet plan as they observe how capable he is, keep your eyes open and bite your tongue for the first few days then ask for a meeting with whoever is in charge to bring up your concerns.

Mechanically altered seems to be the stage in food prep before it is pureed. It is basically mashed down to a pulp or an unappetizing lump on a plate. He was eating from a pretty typical menu at the assisted living on Saturday afternoon, with some things cut up into "finger food" sized pieces. He moved to the nursing home Saturday evening, and by Sunday they were giving him mechanically altered meals. He does not have bottom dentures, but he never has in his 96 years. I'm not sure how to make this work, short of being there for every meal & cutting up his food. He is very good at knowing what he can and can't chew, so he always orders his meals accordingly. They did say the kitchen will not cut up his food. Is it just this nursing home that doesn't want to cut up his food, or is that typical for most nursing homes? Thanks for your help. The lumps of mush on his plate are not helping with his attitude regarding having to move to a nursing home.

In mom's time at the nursing home I've seen more than one person whose family insisted that they should have regular food and in every case I watched them struggle and fail to eat - the recommendation to modify their food was the correct one. Unless there is a treatable cause (like poorly fitting dentures or some other problem with teeth) then I doubt your desire is realistic. My mom is on a puree diet and at first that was incredibly hard to accept, compared to that a mechanically soft diet is nothing to fuss about.

Please explain what you mean. Is it mechanically altered by being pureed or liquidised? Or what? Have you asked the nursing home what is done to the food and why?