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Question for RNs and LPNs. I was told today by representatives of a private duty home care company that pureeing food for a client is considered skilled nursing and can only done by someone qualified as such. Any input on this? I asked a relative about this but was confused at the time and can't recall her answer!

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I've been a RN for over 20 years and have never heard of this either. I will check the AZ Board of Nursing to see if there is any truth to it. I know in the hospital, we have trained family on how to do complex dressing changes, Run long term IV antibiotics, and other such IV fluids. How to connect and flush feeding tubes....Never ever heard anything about pureed food. Really, if that's the case would people need special licenses to feed babies?
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I imagine this is more of a liability issue than a health one since nurses have no more training in dietary modifications than CNAs do, but if a client aspirates or chokes on improperly prepared foods or beverages the company can claim due diligence.
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I have never heard of this or had any mandatory training on how to puree food. I have never seen it as a requirement or listed in a skill set.  
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Never heard of this either. There has to be more to the reasoning.
A Speech therapist and interventional Radiologist have to do the testing for dysphagia. Maybe this testing has not been done and the agency does not want to run the risk of the patient choking. Actually come to think of it the reason is right there. Only a skilled professional is able to handle the treatment for a dysphagia patient who aspirates. So it is not actually the use of the blender that is the problem
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Laws may vary by state but mom's memory care - considered assisted living by state - has the kitchen staff purée the food

I've seen regular caregivers take a jar of thickener and pour unmeasured into a glass of juice

I would think if meal prep is part of the service then putting it into a blender shouldn't be an issue - if so can you purée ahead of time so they are merely heating up in the microwave ?
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I should think it's not the puréeing per se as the supervising of a person with impaired swallowing reflex that puts this into the "skilled" category.

Sounds to me like one of those unintended consequences of well-intentioned guidelines. In a similar way, only nurses or SLTs who had done the specific training were allowed to assess swallowing reflexes in stroke patients in our local hospital. The upshot - apart from my turning into a gremlin and biting metaphorical chunks off people - was that my mother lay on a a specialist stroke ward for seven hours without water because none of the many nurses and doctors present were "qualified" to assess her swallow reflex. Of course they were bloody qualified! - just not on the right list.

What about if you purée the food yourself, put it in sealed containers in the fridge, and ask the HCAs to warm it through in the microwave?
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Easiest way to find out is call another Home Health company and tell them what you need done. If you get the same answer 3 times, I'd say that's the answer in your state.
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MsMadge, that is a real plus for your mom, having personal caregivers allows her some personalized care options, even if it is only occasionally!
Understandably when you are assigned a special diet in the NH they do not even attempt to stray from it, even though some people can handle forbidden items occasionally. My mom always liked her crunchy snacks and never choked on them, so last week I took some potato chips and warily fed her little nickel sized pieces... she gobbled them up!
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I am a RN and haven’t ever heard this. I will have to research the Nurse Practice Act. What state are you in?
My curiosity is piqued.
Did you ask the agency if this is so and why?
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Thanks to everyone who's posted since I last posted - lots of good advice. I just got home from a pureeing session and am ready for some Motrin and a heating pad, but wanted to thank everyone and acknowledge more posts which I'll get to tomorrow.
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