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Guidance for care homes

Adult Community Speech and Language Therapy

Oxford Health NHS Foundation Trust
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Guidance for care homes

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    • Aspiration pneumonia or recurrent chest infections (3 or more in the last year)
    • Eating and drinking difficulties due to a baseline respiratory condition
    • Chewing difficulties
    • Choking (complete obstruction of the airway which required back slaps/Heimlich manoeuvre)
    • Coughing when eating
    • Coughing when drinking
    • Drowsiness: not alert enough to eat and drink safely
    • Fast rate of eating and drinking/cramming
    • Food residue seen in mouth after eating
    • Medications: difficulty swallowing tablets
    • Positioning difficulties
    • Refusing to eat and drink
    • Regurgitation of food or fluids or symptoms of reflux in the absence of swallowing difficulties
    • Improvement in swallow. Resident has been placed on thickened fluids, is tolerating these well and their general condition has improved
    • Resident is struggling on current diet texture
    • Saliva Management: Thick saliva and/or dry mouth
    • Saliva Management: excess thin/watery saliva
    • Weight loss due to significant reduction in fluid/food intake
    • Wet Voice after eating or drinking
  • Referral flowchart
    • Choking
    • Mouth holding or spitting out food
    • Recurrent coughing on food/fluids
    • Resident or family report of swallowing difficulties
    • Reduced oral intake or weightloss
    • Chewing difficulties
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