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Setting up a safer mealtime
Simple ways to set up a meal for someone you care for, and what to watch for.
Awaiting clinical review. This page is written from general, widely accepted background on how eating and swallowing work. It has not yet been signed off by a named clinician, and it is not a substitute for asking one.
Before the meal
- Check they are awake and alert. Wait if they are drowsy.
- Help them sit fully upright, in a chair if they can.
- Put in dentures, glasses and hearing aids.
- Turn off the TV. A quiet room helps them focus.
- If a food or drink level was agreed, have that ready.
During the meal
- Sit at eye level beside them, not standing above.
- Offer small bites and small sips.
- Let them finish one mouthful before the next.
- Go at their pace. Keep talk light, and wait with questions until their mouth is empty.
- Use any swallowing tips they have learned and chosen to use.
After the meal
- Staying upright for a while after eating is often advised. Ask the SLP how long.
- Check the mouth for leftover food.
- Brush teeth or clean dentures.
What you might notice
- Coughing, throat clearing or watery eyes while eating.
- A wet or gurgly voice.
- Food held in the mouth or left in the cheeks.
- Meals taking much longer, or eating less.
- Getting tired partway through the meal.
What can help
The meal belongs to the person eating. Their wishes about food matter, even when choices carry some risk.
- Talk choices through with them: what they want, what worries them, and the trade-offs.
- Write down what you notice. A log helps everyone see the pattern.
- Ask an SLP to show you the set-up in person.
- Take a first aid class. The American Red Cross runs them.
- Look after yourself too. Helping at every meal is tiring.
Questions to ask your care team
- What set-up and pace make sense for them?
- Which signs mean something has changed?
- What are their options if meals get harder, and the trade-offs of each?
- How can I support what they choose, safely?
- Can someone show me in person?
When to get help
Get checked soon if you notice any of these. A doctor or SLP can look at what is going on.
- Coughing or choking when you eat or drink.
- Food or pills that feel stuck.
- Losing weight without trying.
- Pneumonia or chest infections, especially if they come back.
When this is worth asking about
- They cannot breathe, speak or cough. Call 911.
- Coughing or choking at many meals.
- Eating or drinking less, or losing weight.
- Chest infections or pneumonia keep coming back.