Just last year, Madam Chan Chin Chia was struggling to eat. The 83-year-old used to take more than an hour to finish a bowl of porridge.
But now, her appetite is back because of a change in diet.
When The Straits Times visited her during lunchtime recently, she was having porridge with scallop chawanmushi (a type of egg custard), and spinach and sesame pudding, with grape jelly for dessert.
These dishes are specially imported from Japan.
A growing number of nursing homes and eldercare centres in Singapore are tapping Japanese food technology and expertise to serve their senior citizens food that looks and tastes appealing, yet is safe enough for them to swallow without choking.
In Madam Chan's case, nurses at the Peacehaven nursing home where she lives, noticed that she was losing interest in eating and had lost 1kg in a month.
So they started serving her special meals last year.
The former odd-job worker used to have mostly porridge or milk in the past. Now, for breakfast, she is able to have bread porridge - something that tastes like bread, yet has a semi-liquid consistency for easier swallowing. The porridge she eats now is also different as it has been treated to remove stickiness, so that it does not cling to the back of the throat.
For dessert, the jelly given does not release water even after a long time. This is crucial as some of the seniors can choke on the moisture released from regular jelly.
In an ageing population where the number of Singaporeans older than 65 will increase to one in four by 2030, demand for such senior-friendly food is rising.
Econ Healthcare, for instance, started experimenting with a special Japanese food thickener called Suberakaze late last year. The cooked food is blended and the Suberakaze powder is added. The resulting mixture is poured into moulds to create shapes that mimic their original form. So if steamed broccoli is blended, it will be reshaped to look like a piece of broccoli. Econ intends to offer full Suberakaze menu options to its nursing home residents later this year.
Changi General Hospital is also working with local nutrition company Health Food Matters (HFM) to produce ready-to-eat texture-modified Asian foods.
Ms Magdalin Cheong, deputy director of food services at Changi General Hospital, said: "Dysphagia (swallowing difficulties) is a common problem among the elderly and a growing health concern in Singapore."
According to a 2012 study, dysphagia affects up to 68 per cent of elderly nursing home residents, 64 per cent of patients after stroke, and 30 per cent of the seniors who are admitted to hospital.
But come September, people in Singapore can buy special meals such as seafood otak, ginseng chicken or nonya fish that are suited for loved ones with dysphagia. Different natural ingredients will be used to thicken the food while ensuring that the taste and texture of the food are kept.
In Japan, where meals are often prepared with great attention to detail, firms there are developing special products that make it possible for chefs to reshape food into visually pleasing dishes. Besides using special thickeners, some work to modify food with elderly or dysphagia patients in mind. For instance, the gellant Suberakaze is able to eliminate the stickiness in food rich in starch, reducing risk of choking and aspiration.
Meanwhile, many eldercare or healthcare institutions here simply blend or chop their food before serving it to the elderly. Chopped pieces can accidentally slip into the lungs while blended food does not have the texture needed to stimulate the appetite.
Another problem is malnourishment.
Peacehaven dietitian Marsha Tan said: "We used to add water or soup... before blending but that means the resulting puree is not nutrient-dense. They have to swallow a huge volume of it to get the nutrients they need but some cannot do so and end up being malnourished."
Peacehaven buys its special food products from HFM, which imports them from Japan. The dishes can be eaten straight from the packaging or upon adding hot water to powder. Last year, Peacehaven did a small trial and offered the special meals to 17 residents. Out of these, 12 gained an average of 1kg. So now, about 20 to 30 of its residents are on these meals.
"Eating is an important part of what it means to have quality of life and we don't want that enjoyment to be taken away," said Ms Tan.
Although Madam Chan was not able to talk much when ST visited, she was clearly enjoying her lunch that day. Without much coaxing, she opened her mouth wide enough to allow Filipino nurse Doien Cocjin to feed her.
In 30 minutes, the four-course meal was slurped up. "Nice?" Ms Cocjin asked her.
Madam Chan nodded, her eyes smiling.