Observe a meal or a trial of the patient’s ordered texture where safe, watching for cough, throat-clear, a wet voice, pocketing, and multiple swallows.
Listen to the voice before and after swallowing for a wet or gurgly quality that suggests residue or penetration.
Verify the actual food and liquid textures against the ordered IDDSI level and check that thickened liquids are mixed to the correct consistency.
Confirm the patient is upright at ninety degrees for meals and remains upright afterward, and observe the caregiver’s feeding pace and bite and sip size.
Assess oral control and check for oral residue or pocketing after the swallow.
Screen for the signs of prior aspiration — recurrent pneumonia, post-meal respiratory symptoms, and unexplained low-grade fevers.
For a neurogenic pattern or a sudden change, apply the Neurological pathway; for acute choking, act immediately.
Coordinate findings with the speech-language pathologist and reinforce the recommended maneuvers and diet.
