Support the Person
Support the person to make food and drink choices even where it presents risks to them.
- Not respecting the person’s right to dignity of risk when eating and drinking.
- Denying the person the enjoyment of food and drink.
- The person not fully understanding the risks of their choices, leading to discomfort or harm.
- Provide the person (or their substitute decision-maker) with clear information about the risks of eating and drinking.
- Document discussions and decisions, especially those that may differ from health professionals’ recommendations or involve risks.
- Educate and empower staff to support the person’s right to choose.
- Use evidence-based processes to manage swallowing and choking risks.
- Review incident reports to check if mitigation strategies are working or need improvement.
- Ensure the person and their decision-maker have the information they need and feel their voice is heard.
- Use reflective practice to assess staff understanding of supporting choice and documenting risks.
Needs and preferences will likely change during the palliative phase
During the palliative phase, the focus is on quality of life, including comfort, symptom relief, and the enjoyment of food, rather than following strict dietary rules.
A key challenge is balancing respect for the person’s choices with the responsibility to provide safe and quality care.
For example, a person may choose to:
- Keep eating their favourite foods, even if there is a risk of choking or aspiration.
- Avoid a modified diet, even if it could help them eat and digest food more easily.
- Enjoy foods that are usually considered unhealthy.
- Eat or drink things not recommended for their condition (e.g. a person with kidney failure choosing to drink alcohol and eat salty chips).
It is important to listen to the person’s wishes, provide clear information, and work with them to balance enjoyment and safety.
Risk should be discussed and documented
If a person’s food and drink choices pose a risk to their health, it is important to talk with them about these risks so they can make an informed choice. They should then be supported to eat and drink in a way that brings them quality of life and enjoyment, while also reducing risk as much as possible.
Having clear processes to document:
- the risks discussed with the person
- the choices they have made
- the steps taken to reduce risk.
This helps ensure the person can exercise their right to dignity of risk while still receiving safe and respectful care.