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 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 gurgled, 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.