Nutrition and Hydration
Food is care, and it is personal
Know the common diets so you can spot a mismatch: regular, mechanical soft (cut or ground, easy to chew), pureed, clear liquid (broth, gelatin, juice - no milk or solid food), full liquid (adds milk, custard, strained cereal), NPO (nothing by mouth), plus therapeutic modifications such as low sodium, consistent carbohydrate, renal, and thickened liquids. Thickened liquids come in levels set by a speech therapist; never thin them out to make them easier to drink - that undermines the whole order. NPO means nothing, including ice chips and water, unless the order says otherwise.
Aspiration precautions: sit the resident upright, close to 90 degrees, before any food or fluid and stay upright about 30 minutes after. Feed small bites, let them chew and swallow, alternate solids and fluids, and never rush. Watch for pocketing food in the cheek, a wet or gurgly voice, coughing, or throat clearing - stop, report, and document. Offer fluids often; older adults often lose thirst and can dehydrate quietly. Watch for dry mouth, dark concentrated urine, confusion, and poor skin turgor.
Honor preference and culture: religious restrictions, vegetarian choices, and familiar foods matter for intake. Record percent eaten, calorie counts if ordered, and intake/output accurately.
Traps. Feeding a resident who is flat in bed, spooning food in while they are still chewing, or offering water to an NPO resident because it seems kind.
Rule of thumb. Upright, unhurried, small bites, and check the mouth for pocketing.