Eating can become a problem if your sense of smell and taste are affected. For example, when you no longer smell or taste anything because of a corona infection, or when everything tastes like metal because of chemotherapy or food smells alone make you nauseous. 'It is important for recovery that a patient eats well, but if you have to eat against your will, it is very unpleasant,' dietician Madieke Douma tells us.
Oncologist Jacco de Haan heard from his patients struggling with this problem how big the impact is on their lives. He spoke about this with Madieke, who made a plan to introduce a taste test and a taste passport and won an Innovation Award for it.
For patients who have long-term eating problems due to changes in smell or taste, practitioners can now request a taste test via the EPD. 'You have five basic tastes: salty, sour, bitter, sweet and umami,' Madieke explains. 'To investigate which flavours a patient still tastes and does or doesn’t like, I let them taste paper strips with these flavours. I also test whether they enjoy the tingling effect from pepper, ginger or wasabi. And if their sense of smell is impaired, I also let them smell sticks with the scents of nutmeg, cinnamon, mint and basil.'
Special course in taste control
With the outcome of the test, she prepares a personal taste passport with ingredients and advice for preparing healthy meals and snacks. If a patient is admitted, it is also sent to the kitchen in the UMCG. The cooks have taken a special course in taste control to learn how to adjust the food for a patient.
'I took that course a few years ago with a small group of colleagues because we wanted to do something for patients with taste problems,' says dietary chef Ria van der Schuur. 'We just weren't sure how to put our knowledge into practice. I am very happy that an expert group has now been set up and we are no longer working separately in our own field of expertise.'
The multidisciplinary expert group includes staff from different departments. For example, oncologists, geriatricians, dieticians, nutrition assistants and cooks. Together, they look at how to help patients with taste problems best. 'Soon there will be satellite kitchens near the nursing wards, and we will be closer to the patients. If a food assistant then sees that a patient does not like his custom-made meal after all, we can immediately see what we can do about it,' Ria mentions as an example.
Outpatient clinic for taste and smell problems
'There are a few dieticians who do the tests now,' says Madieke, 'but the intention is to have more dieticians do so and to set up an outpatient clinic for patients with taste and smell problems. Also, on our initiative, a National Expert Group Taste and Smell Change Oncology has been set up so that we can share more knowledge. We also want to do research together to better help cancer patients with taste and smell problems in the future.'