Nutrition and Hydration
Know the diet before the tray
Diets are ordered by the provider and written on the care plan: regular, mechanical soft, pureed, clear or full liquid, consistent carbohydrate, low sodium, renal, and thickened liquids (nectar, honey, or pudding thick). Before feeding anyone, verify the tray matches the resident's name and diet card, confirm dentures and glasses are in place, and check the consistency of the liquids. Never add salt, sugar, or seasonings unless the diet allows it, and never trade food between trays.
Preventing aspiration
Sit the resident upright, ideally 90 degrees, with the head slightly forward and chin tucked. Sit at eye level, offer small bites, let the resident finish before the next spoonful, and alternate with fluids as the plan indicates. Do not feed a resident who is lying down, drowsy, or short of breath. Stop immediately if the resident coughs, chokes, has a wet or gurgly voice, or pockets food in the cheek; keep them upright and report.
Fluids and intake
Offer fluids frequently, record intake and output accurately in milliliters, and know which residents are on fluid restrictions or NPO status. Signs of dehydration include dark urine, dry mouth, thirst, and new confusion. Encourage independence with setup and adaptive utensils, but never force food or drink, and document refusal along with how much was eaten.
Rule of thumb
Upright, unhurried, one bite at a time, and stop at the first cough.