Eating and drinking for comfort and quality of life ‘Feeding at Risk’

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What is a safe swallow?

Safe swallowing is the coordinated transfer of food and drink from the mouth into the stomach. Although we are all at risk of food and drink ‘going the wrong way’ (entering the lungs) or choking, chances of this happening with a safe swallow are small.

What is an unsafe swallow?

Swallowing becomes unsafe when nerves that transmit messages to the muscles of the mouth or throat, or the muscles themselves, are affected. There are many causes of swallowing difficulties (known as dysphagia). When a person has dysphagia there is a greater risk of food/drinks entering the lungs. This is called aspiration and is serious as it can lead to chest infections and pneumonia.

What is ‘feeding at risk’?

If the person cannot swallow safely and other options for feeding are not suitable (e.g tube feeding) feeding at risk of aspiration may be an option. They may also choose to continue to eat and drink ‘at risk’ for quality of life and comfort.

What if the person cannot make their own decisions?

If the person does not have capacity to make this decision, their medical team, with advice from family or next of kin, carers and relevant professionals, will make a decision in the person’s best interest.

Who is involved in the decision?

• The person with an unsafe swallow, their family/next of kin, carers
• Medical Team
• Health Care Power of Attorney
• Speech and Language Therapist
• Dietitian
• Social Worker

What precautions can be taken?

• Follow advice from the Speech and Language Therapist to reduce the risks. This may include changing food and drink consistencies, feeding strategies and positioning
• Sit upright, be alert. Eat little and often to reduce fatigue
• Oral care after each meal reduces bacteria building up in the mouth that risks falling into the lungs

Contact details

Speech and language therapy