Selecting the Right Thickener: A Guide for Caregivers

What are Thickeners and Why are They Used?

Dysphagia is a medical term that describes swallowing difficulty, and can range from mild sensations of food getting stuck in the throat to the complete inability to swallow and painful blockage. In Australia, over 1 million people experience dysphagia and can impact anyone at any age.

Part of dysphagia management is ensuring your care recipient is having the right amount of nutrients throughout the day which may include the use of thickeners. Food and beverage thickeners are additives that increase viscosity, allowing those with dysphagia to have control over swallowing. Thickeners are commonly used in drinks and food to modify the texture without significantly altering taste. 

Types of Thickeners

Starch-Based Thickeners: 

Starch-based thickeners, typically made from modified corn or potato starch, can develop a grainy texture over time and may alter the flavor or clarity of the liquid they’re added to.

Gum-Based Thickeners: 

Gum-based thickeners, like xanthan gum or guar gum, create a smoother and more stable texture that remains consistent over time and under varying temperatures. Caregivers often favor these options for their reliable consistency.

Factors to Consider When Choosing a Thickener

When choosing a thickener it’s important to consider how it will be used, desired texture and consistency. 

Consistency and Texture Needs:

When selecting a thickener, it's important to consider the desired consistency and texture based on the individual's needs. Some people may require a nectar-like thickness, while others may need a honey-like or pudding-thick consistency. The right thickener should produce a texture that is easy to swallow, palatable, and appropriate for the person’s swallowing ability. Additionally, the final texture should remain stable over time and not separate or become too thick or thin after sitting.

Dietary Restrictions and Allergies:

It's essential to account for any dietary restrictions or allergies. Some thickeners may contain common allergens such as gluten, dairy, or soy, while others might not be suitable for individuals following vegan, low-sodium, or low-carb diets. Always check ingredient labels and consult with a healthcare professional or dietitian to ensure the thickener aligns with the individual’s nutritional needs and health conditions. Selecting a hypoallergenic or allergen-free option may be necessary for safe and effective use.

Ease of Use:

Ease of use is a key consideration when selecting a thickener, especially for caregivers or individuals managing their own dietary needs. Some thickeners require precise measuring and mixing, while others come in pre-measured packets or ready-to-drink thickened beverages forms for added convenience. A good thickener should dissolve easily without clumping, work quickly, and require minimal effort to achieve the desired consistency. Choosing a user-friendly option can save time, reduce frustration, and ensure more consistent results.

How to Use Thickeners Safely

Using thickening agents correctly is essential for the thickener usage and safety, as well as for the hydration of individuals with swallowing difficulties, such as those with dysphagia. As a caregiver, understanding how to prepare and serve thickened liquids can help reduce the risk of aspiration and improve quality of life.

To begin with, always read and follow the manufacturer's instructions for the thickener you're using. Each brand may have different mixing ratios for achieving specific consistencies. Use a measuring spoon or scale to ensure accurate quantities of both liquid and thickener. It’s important to add the thickener slowly to the liquid while stirring continuously with a fork, whisk, or shaker bottle to prevent clumping. Let the mixture sit for the recommended time (usually 1–5 minutes) to fully thicken before serving.

It’s important to never guess measurements or skip the mixing instructions. Incomplete mixing can leave clumps that are hard to swallow and may pose a choking hazard. Also, avoid adding thickener directly to very hot liquids unless the product is heat-stable, as high temperatures can affect how well it dissolves. Do not use expired thickening agents, and be cautious when using liquids like ice cream or gelatin, which may change texture as they melt and could become unsafe to swallow. All of these considerations fall under proper thickener usage and safety.

Hydration is another critical concern for individuals on thickened fluids. People may drink less when fluids have a different texture, increasing the risk of dehydration. Thickened fluids still count toward daily hydration goals, so offer a variety of options like thickened water, juice, broth, and flavored beverages to encourage fluid intake. Keep an eye out for signs of dehydration such as dry mouth, dark urine, dizziness, or confusion, and monitor how much fluid your loved one consumes each day.

Proper thickener usage and safety is a key part of managing dysphagia. By following these best practices, caregivers can help ensure that individuals receive the nutrition and hydration they need.

Best Thickener Brands: Product Comparisons 

Thickener Product Comparisons Table:

Summary:

• Stability: All thickeners offer good stability, with most maintaining consistency for at least 24 hours. Precise Thick-N Instant stands out with up to 48 hours of stability when refrigerated.
  
  

• Ease of Use: Precise Thick-N Instant offers the simplest application with its pump system, reducing the risk of clumping. Nestlé Resource ThickenUp Clear and Flavour Creations Instant Thick Ultimate also provide ease of mixing, while Supercol and Bulk Serve may require more careful preparation.
  
  

• Taste: All products are designed to be neutral or taste-free, ensuring they do not alter the flavor of the liquids.
  
  

When choosing a thickener, consider the specific needs of the individual, including the types of liquids they consume, their swallowing abilities, and any dietary restrictions.

Thickened Foods and Beverages: A Convenient Option

For individuals with dysphagia, thickened foods and beverages offer a safe and practical solution for maintaining adequate nutrition and hydration. Shelf-stable options are especially convenient for travel or quick meals, and refrigerated or frozen varieties provide a wider range of flavors and nutrition. 

While homemade thickening is still useful and flexible, pre-thickened products offer an added level of reliability and convenience, especially for caregivers managing multiple daily meals. Always check labels to ensure the product meets the specific consistency recommended by a healthcare provider.

Conclusion

Ultimately, thickened foods and beverages are more than a medical necessity—they are a means of supporting dignity, enjoyment, and health in everyday eating and drinking. By staying informed and attentive, caregivers can ensure mealtime remains a safe and nourishing part of daily life.