Feeding assistance & swallowing problems (dysphagia)

Seat the client fully upright, offer small bites slowly, and follow the care plan's diet texture exactly. Coughing, choking, a wet gurgly voice, or pocketing food during meals are dysphagia signs — stop and report them; they can lead to aspiration pneumonia.

1. 1Before the meal: upright at 90°, alert and awake — never feed a drowsy or lying-down client.
2. 2Follow the care plan's texture exactly: pureed, minced, soft, or thickened liquids are medical instructions, not preferences.
3. 3Offer small bites, let them fully swallow before the next, don't rush, minimize distractions.
4. 4Watch for warning signs: coughing or throat-clearing while eating, wet/gurgly voice after swallowing, food left in cheeks, drooling, complaints of food 'sticking'.
5. 5If choking (can't breathe, can't speak): this is an emergency — call 911 and follow your training.
6. 6Keep the client upright 30 minutes after meals; report any warning sign the same day.

Aspiration (food or liquid entering the airway) can happen silently — repeated low fevers or a wet cough after meals are also reportable. Never thicken or change the diet on your own; texture changes come from the care team.