Mealtime Management Plans – Explained by a Speech Pathologist

Have you or a loved one recently been advised of the need to develop a mealtime management plan? If you’ve never come across one before, Mealtime Management Plans can sound daunting. Today, our team of passionate Speech Pathologists will guide you through the most important things you need to know about Mealtime Management Plans when you are first starting out with one.

If you have any further questions, we’d always recommend speaking with your treating Speech Pathologist or even completing online training to learn about all the elements of supporting someone with Dysphagia. 

What is a Mealtime Management Plan?

Mealtime Management Plans are formal documents, developed by Speech Pathologists, that provide key stakeholders with clear instructions on how to approach all aspects of mealtimes for someone with swallowing difficulties. This document is usually given to family members, carers, support workers, and anyone else involved in the care of someone with clinical swallowing difficulties (known as Dysphagia). 

Mealtime Management Plans are tailored to each individual, with recommendations based on a combination of informal and formal assessment results to ensure that the person with swallowing difficulties is able to maintain safe swallowing during mealtimes. 

Why Are Mealtime Management Plans Created?

Dysphagia is the clinical term for swallowing difficulties, and it is one of the main reasons that Mealtime Management Plans are developed. People with swallowing difficulties often are concerned with food, fluids, and even saliva ‘going down the wrong way’ and entering the airway. When this happens, it can contribute to the risk of chest infections and choking. 

There are many aspects of mealtimes that can be adjusted to reduce the risk of food and fluids ‘going down the wrong way’, including changing the way meals are prepared, where and how meals are given, as well as how support team members can engage with the individual with swallowing difficulties before, during, and after meals.

Speech Pathologists will also outline any other important information that carers and support workers may need to know to support safe swallowing at mealtimes. This can include positioning changes, equipment that may need to be used, how medications should be given, and how to perform oral care and secretion management. 

Overall, the goal of a Mealtime Management Plan is to maximise the dignity of the individual with swallowing difficulties, and ensure that they can have consistently safe and enjoyable mealtime experiences.

Who Needs a Mealtime Management Plan?

Dysphagia or swallowing difficulties are a symptom, not a stand-alone diagnosis. Therefore swallowing difficulties can co-occur with a variety of conditions, including:

  • Multiple Sclerosis (MS)
  • Muscular Dystrophy 
  • Parkinson’s Disease (PD)
  • Motor Neuron Disease (MND)
  • Huntington’s Disease
  • Cerebral Palsy
  • Stroke
  • Obstructive Sleep Apnoea 
  • Spinal Cord Injury
  • Cancer
  • Orofacial Myofunctional Disorders
  • And many more – please note, this is not an exhaustive list.

Mealtime Management Plans may also be recommended for ageing individuals whose swallowing function has changed due to natural ageing and wear and tear on the swallowing mechanism. However, a professional assessment from a multi-disciplinary team is required to determine the cause of Dysphagia if it is not already known. 

Do Mealtime Management Plans Change Over Time?

Mealtime Management Plans need to be regularly reviewed and adjusted based on an individual’s progress and changing needs. For some, after completing ongoing swallowing rehabilitation after an acute condition, they may see some improvement and be able to tolerate foods and fluids of a more regular texture. For others, progressive conditions may result in a deterioration of swallowing function and Mealtime Management Plans must be updated to ensure they remain safe at mealtimes. 

Mealtime Management Plans are updated based on the results of Speech Pathology assessments and collaboration with other healthcare professionals. Updates may include changes to the recommended diet modifications, as well as adjustments to feeding and compensatory techniques and strategies.

We hope you’ve found this article helpful in your search for more information on Mealtime Management Plans. If you care for someone with Dysphagia and you’d like to equip yourself with the knowledge to be able to identify mealtime risks, understand all aspects of a Mealtime Management Plan, and provide support during meals to increase safety, take a look at our online Dysphagia training.

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*Please note that the information shared in this article is general in nature and is not tailored to any specific diagnosis or condition. For personalised guidance please seek the support and recommendation from a registered Speech Pathologist.