7 Things to Check Before Every Mealtime (Dysphagia Safety)

1. Positioning: Sitting Upright
   Ensure the person is seated upright (ideally 90°) with adequate support.

2. IDDSI Level (Food & Fluids)
   Confirm the prescribed IDDSI levels from the latest speech pathology recommendations.

3. Food & Fluids Match the IDDSI Level
   Do not assume, check consistency and test using the IDDSI Audit Tool.

4. Supervision Level & Mealtime Strategies
   Follow the required level of support (e.g. 1:1 feeding, supervision, verbal prompts).

5. Dentures (If Applicable)
   Ensure dentures are in place, clean, and well-fitted.

6. Environment
   Minimise distractions (e.g. noise, talking, multitasking).

7. Alertness & Readiness
   Ensure the person is awake, alert, and ready to eat.
   If drowsy, consider delaying the meal.

Taking a few moments to complete these checks before mealtime can significantly reduce the risk of choking and aspiration. Safe swallowing is not just about the food itself, but the consistency, preparation, environment, and level of support provided. Always refer to the individual’s speech pathology recommendations, as mealtime management should be tailored to each person’s needs.

About the Author

Vanessa Chan is a Speech Pathologist and the founder of Swallowing & Dysphagia Support. She works closely with aged care and disability providers to improve mealtime safety, with a focus on practical, real-world implementation of IDDSI. Vanessa is also the Chair of the Australian IDDSI Reference Group (AUIRG), supporting IDDSI implementation.

Through training, consultation, and online education, Vanessa aims to bridge the gap between clinical recommendations and everyday practice, helping teams deliver safer, more consistent care at mealtimes.