During the Thanksgiving holiday, there was at least one death related to choking while the
consumer was visiting in their relatives’ home. In an effort to promote the health, safety and
well-being of all consumers during the holiday season, please take the time to reinforce the
importance of family members/friends being knowledgeable of and implementing risk plans,
especially in the area of choking prevention. This is also applicable to assuring substitute staff are knowledgeable of and can implement consumers’ dining plans. It is best practice to ensure that risk plans are consistently implemented in all settings.
Provide a written copy of the dining/choking prevention plan to any family
member(s)/friend(s) that the consumer will be visiting.
Review the plan with the family member(s)/friend(s) so that it is clearly understood.
The dining plan and visit preparations should include, but is not limited to:
o The person’s diet, including texture of food items (e.g., pureed, chopped ½ inch
cubes, ground meat, etc), prescribed consistency of any liquid (e.g., nectar thick,
honey thick, etc.), size of food items (e.g., food presented in pieces the size of a
quarter, etc.), list of any food items that should be avoided (e.g., hot dogs, peanut
butter, hard/firm fruit, etc.).
o Instructions on how to prepare the diet. If applicable, using a food processor for a
pureed diet, to ensure there are no lumps; demonstrating how to make a liquid
nectar thick, etc.
o The optimal position for eating (90 upright in a chair, etc.).
o The optimal position after eating (remaining 90 upright in a chair for 60 minutes
after eating, etc.).
o Any behavioral precautions to ensure safety during meals/snacks/medication
administration (e.g., strategies to slow down the rate of eating, reduce likelihood
of talking with his/her mouth full, avoiding distraction, etc.)
o Explanation of the level/type of supervision needed during meals/snacks/
medication administration (e.g., sit on the person’s right side at the table while
he/she is eating, etc.)
o Caution should be taken to ensure food items not prepared in the correct
texture/consistency are not available (e.g., whole rolls sitting in a basket on a
kitchen counter when the person’s food should be presented in quarter size
pieces, leaving trash can and/or waste basket content available to the consumer,
o List of any adaptive equipment/utensils to be used to promote safe
mealtime/snack time/medication administration experiences.
o Ensure the receiving family/friends have the adaptive equipment and it is in good
o Ensure the receiving family member(s)/friend(s) have thickening ingredient if that
o The family member(s)/friend(s) should be able to demonstrate the skill in creating
the correct texture of food and correct degree of thickening, if a specialized diet is