Before you start

• Carry out regular mouth care to keep the mouth as clean and healthy as possible.
• Make sure dentures are in place and secure.
• Always sit the person as upright as possible, not tilted back or leaning to one side.
• Avoid offering food or drink if the person is feeling very weak, very tired or drowsy and they cannot be roused.
• Never feed someone who has their head tilted back.
• Reduce distractions: Turn off the TV, radio and mobile phone. Relaxing music may help.
• Position the food and drink in front of the person and talk about what is being offered to them.
• Make sure that the food and drink are the correct consistency as advised by the speech and language therapist.
• If the person is on a puree diet, keep foods separate and do not mix it all together.
• Avoid straws or spouted beakers unless specifically advised.

During the meal

• Always encourage the person to feed themselves if at all possible. This helps the person to engage their brain and lets their swallow muscles have time to get ready to swallow. If appropriate offer finger foods which they can hold themselves.
• If independent feeding is not possible try assisted feeding, for example place your hand over their hand and help them take a sip from a cup or a forkful of food.
• Don’t rush when feeding someone.
• Make sure mouthfuls offered are not too big.
• Encourage the person to chew food carefully before swallowing.
• Make sure you only offer one mouthful at a time. Make sure that the swallow has finished before reloading the fork or spoon.
• Give small sips of fluid.
• Encourage the person to avoid talking or laughing when eating or drinking.
• Alternate a mouthful of food with a sip of fluid to help clear any build-up of food in the mouth and throat.
• Watch for warning signs of swallowing difficulty, such as coughing and choking, wet vocal quality. If there has been a change in swallow inform your speech and language therapist.

When you are finished

• Listen to the voice. If it sounds wet or gurgly, encourage coughs and throat clears and ask them to swallow again.
• After eating, check and clear any food remaining in the cheeks and mouth.
• Keep the person in an upright position for at least 20 minutes after intake.