153,000+ FDH Caregivers in Hong Kong
Dysphagia Care Guide for Foreign Domestic Helpers in Hong Kong
Practical IDDSI guidance for FDH caregivers supporting elderly residents with swallowing difficulties — texture preparation, thickener use, and daily safety checklists.
Understanding Dysphagia
1 in 8
Elderly have dysphagia
Dysphagia (swallowing difficulty) affects an estimated 1 in 8 elderly persons — often undiagnosed.
Top 3
Causes: stroke, dementia, Parkinson's
The three leading causes of dysphagia in elderly care home residents in Hong Kong.
#1 Risk
Aspiration pneumonia
Aspiration pneumonia — caused by food or liquid entering the airway — is the leading cause of mortality in HK care homes.
Daily Caregiver Checklist
Follow this daily checklist to safely prepare and serve meals for residents with dysphagia.
- ✓Check IDDSI level on resident's care plan before each meal
- ✓Prepare correct texture according to IDDSI level
- ✓Run Flow Test before serving thickened liquids
- ✓Never leave resident unattended during meals
- ✓Record any meal incidents or refusals in the care log
- ✓Notify nurse immediately if signs of aspiration worsen
- ✓Use SeniorDeli products at correct dosage per pack label
- ✓Attend the next IDDSI training session at your care home
IDDSI Texture Levels (0–7)
The International Dysphagia Diet Standardisation Initiative (IDDSI) defines 8 levels of texture modification. Always follow the level specified in the resident's care plan.
L0
Thin
Normal unmodified liquids — water, juice
L1
Slightly Thick
Slightly thicker than water — flows through a syringe
L2
Mildly Thick
Flows off spoon slowly — nectar-like
L3
Liquidised
Smooth, pourable liquid — no lumps
L4
Pureed
Smooth, thick — holds shape slightly, no lumps
L5
Minced & Moist
Soft lumps max 4mm — easily mashed with tongue
L6
Soft & Bite-Sized
Tender pieces max 15mm — can be mashed with tongue
L7
Regular
Normal texture — no modification needed
How to Use Clear Thickener
Step-by-step guide to preparing IDDSI-compliant thickened liquids using SeniorDeli Clear Thickener.
- 1
Measure the liquid
Pour 200ml of the liquid (water, juice, soup) into a clean cup. Check the resident's care plan for the required IDDSI level.
- 2
Add Clear Thickener
Add the dosage of Clear Thickener as specified on the pack label for the required IDDSI level (e.g. 1.5g for Level 2, 3g for Level 3).
- 3
Stir vigorously
Stir vigorously for 30 seconds with a spoon or fork until the thickener is completely dissolved. No lumps should remain.
- 4
Wait and run Flow Test
Wait 1 minute for the liquid to reach the correct viscosity. Run the IDDSI Flow Test (10ml syringe, 10 seconds) to verify the level before serving.
How to Make Soft Meals with Food Gellant
Step-by-step guide to preparing soft, moulded meals using SeniorDeli Food Gellant — suitable for IDDSI Levels 3–5.
- 1
Heat food to 80°C
Cook or reheat the food (fish, meat, or vegetables) to at least 80°C. Soft or blended food works best. Do not use raw or hard foods.
- 2
Add Food Gellant
Add 1 sachet of Food Gellant per 200g of prepared food. Sprinkle evenly over the food while hot.
- 3
Stir thoroughly and pour into mould
Stir thoroughly until the Food Gellant is fully dissolved. Pour the mixture into a food mould or container for shaping.
- 4
Cool and serve
Allow to cool at room temperature for 15 minutes, or refrigerate for firmer texture. Demould and serve — the food retains its shape while remaining soft and safe to swallow.
Frequently Asked Questions
- What is IDDSI and why does it matter?
- IDDSI stands for the International Dysphagia Diet Standardisation Initiative. It is a globally recognised 8-level framework (0–7) that defines safe food and liquid textures for people with swallowing difficulties (dysphagia). Using the correct IDDSI level prevents choking and aspiration pneumonia — the leading cause of care home mortality in Hong Kong.
- How do I know which thickener level my resident needs?
- Always check the resident's care plan or ask the nurse-in-charge. The care plan will specify the IDDSI level (e.g. Level 2 Mildly Thick). Never change the level without clinical approval.
- Is Clear Thickener safe for diabetic residents?
- Yes. SeniorDeli Clear Thickener is xanthan gum based — it adds no calories, sugar, or starch. It is suitable for diabetic and low-calorie diets. Always confirm with the resident's care plan or dietitian if in doubt.
- How do I do the Flow Test?
- The IDDSI Flow Test uses a 10ml syringe. Fill it with 10ml of the thickened liquid, hold it upright for 10 seconds, then measure how many ml flowed out. Level 1: 8–10ml; Level 2: 4–8ml; Level 3: 1–4ml; Level 4: 0–1ml. A syring is available from your care home supplies.
- Where can I get IDDSI training in Hong Kong?
- SeniorDeli offers IDDSI staff training for care homes. Visit /care-homes/staff-training to request a session. You can also access free online resources on softmeal.org and the IDDSI website at iddsi.org.
Ready to Upgrade Your Care Home's Dysphagia Practice?
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