The golden rules of swallowing (PEARS)


  • Sit upright, at 90 degree angle.
  • The head should never be tipped back.


  • Reduce distractions, such as television, noise or lots of people around


  • Only offer food and drink to someone who is awake and alert.

Regular mouthcare

  • Ensure the mouth is clear and clean at the end of a meal. This may involve removing bits of food from the mouth.

Small mouthfuls, slowly

  • Watch, wait and listen for the swallow before offering another mouthful
  • Encourage people to feed themselves whenever possible.
  • Sometimes a drink can help food go down, but do not mix food and fluids in the same mouthful.
  • Avoid straws and spouts whenever possible; give fluids from an open cup.
  • Smaller, more frequent meals may be less tiring.
  • Softer foods are generally easier to manage than dry or chewy textures.

Encourage a big, strong cough and extra ‘empty’ swallows if there are any wet or gurgly sounds after eating or drinking.

I have difficulty swallowing food or drink