Stroke Training and Awareness Resources (STARs)

Other key points to consider

Violet is now sitting in an upright position, is fully awake with the TV turned off and the room brightly lit. She has already told us that her tea has been ‘going down the wrong way’ and that she choked on her lunch yesterday. Violet has mentioned that she has lost her appetite and you notice that she has not taken her medications.

Presentation of Violet’s food

To make Violet’s food as appetising as possible you need to consider the following:

  1. Temperature – food / drinks left to go cold are not appealing. Specialist plates and cups can help to keep food and drinks warm for longer periods.
  2. Colour – try to keep foods separate and use moulds if necessary with pureed foods.
  3. Information – always tell the person what is on their plate before you give it to them.

Thickening agents in Violet’s drinks

Thickener slows down the movement of the fluids, and for some people this helps them to control it better when it passes through their mouth and throat. A Speech and Language Therapist will determine if the patient requires thickened drinks and if so, how much thickener is required.

Modified texture diet for Violet

Foods may be modified to make them easier to chew eg softer options, moist food and purees. A Speech and Language Therapist will determine the appropriate consistency.


Ensure you have plenty of time when assisting Violet with her food/drinks. Mealtimes should be seen as a therapeutic activity and the person be allowed to set their own pace.

Medications in alternative form

It may be that Violet is avoiding taking her medications as she finds them difficult to swallow and is frightened of choking on them.  In many cases an alternative form can be prescribed, and this should be discussed with the senior ward staff and the pharmacist. Medications should not be crushed without checking with the pharmacist.

Fortify Violet’s diet

This could help Violet get vital nutrients and help prevent her from losing more weight. This option would need to be discussed with senior staff and the dietician.


Having swallowing problems and being fed by somebody else can make a person feel vulnerable and/or embarrassed. If your manner is sensitive and respectful this will help to make the person feel more comfortable.


Check Violet’s records as they may give you additional information on how best to assist Violet.

Specialist equipment

Adapted utensils and cutlery may enable Violet to eat more independently and could be considered if her ability to grip is weakened by her stroke. A speech and language therapist will sometimes advise on the use of a specialist cup to help someone swallow fluids more safely e.g. a bolus-control cup, which allows only a small volume of fluids to enter the mouth at one time, to improve control and timing of the swallow. These are not suitable for everyone though, and they should not be used unless recommended by the SLT.

Oral hygiene

Regular oral hygiene should be provided to reduce the risk of oral infections and improve the person’s comfort. Consider using a sulphate-free toothpaste for patients who have swallowing issues, as this reduces the volume of foam produced when brushing the teeth.


Ensure Violet has her spectacles on so that she can clearly see you and her meal. If Violet wears dentures, consider the fit, and how comfortable she is finding them. If she has reduced jaw opening, they may make placing food in her mouth more difficult. She may need a review by the dentist for new dentures.

Page last reviewed: 16 Oct 2020