IDDSI Framework — Hong Kong Clinical Standard

SeniorDeli is built on the IDDSI framework, the international standard for dysphagia diet classification used by hospitals and care homes across Hong Kong.

What is IDDSI?

The International Dysphagia Diet Standardisation Initiative (IDDSI) is a global framework developed in 2013 and adopted worldwide by 2019. It classifies foods and drinks into 8 levels (0–7), ensuring consistent communication between speech therapists, dietitians, nurses, care home staff, and food manufacturers. Without a shared standard, a “soft diet” in one facility may be unsafe in another — IDDSI eliminates that ambiguity.

LevelNameDescriptionWho it's for
0ThinFlows like water; no resistancePeople with mild or no swallowing restriction on liquids
1Slightly ThickSlightly thicker than water; requires minimal effortMild pharyngeal dysphagia where thin liquids are borderline unsafe
2Mildly ThickFlows off a spoon; requires some effort to drinkMild dysphagia; slow oral transit
3LiquidisedSmooth, pourable; no lumps; can be drunk from a cupModerate oral or pharyngeal dysphagia; poor dentition
4PureedSmooth, pudding-like; holds shape briefly; no chewing neededSevere chewing difficulty; significant oral dysphagia
5Minced & MoistSoft particles ≤4 mm; moist; can be mashed with tongueModerate chewing difficulty; reduced tongue strength
6Soft & Bite-SizedTender pieces ≤1.5 cm × 1.5 cm; easily squashed with forkMild chewing difficulty; reduced jaw strength
7RegularAny texture; no restrictionNo swallowing or chewing impairment

Source: iddsi.org

IDDSI in Hong Kong

Hospital Authority Adoption

Hong Kong's Hospital Authority (HA) has aligned its dietary texture guidelines with the IDDSI framework across public hospitals. Speech therapists and dietitians in HA facilities prescribe IDDSI levels as standard practice for patients with dysphagia, ensuring care continuity from acute wards to rehabilitation and discharge.

Care Home Requirements

Residential care homes for the elderly (RCHEs) in Hong Kong are increasingly expected to demonstrate IDDSI-aligned food preparation practices during Social Welfare Department inspections. Standardised documentation — including staff training records and texture testing logs — reduces liability and supports quality care ratings.

Why Standardisation Matters for Patient Safety

Aspiration pneumonia is a leading cause of hospitalisation and death among elderly patients in Hong Kong. Studies show that serving the wrong texture — food that is too thin, too chunky, or inconsistently prepared — significantly increases aspiration risk. IDDSI standardisation closes the communication gap between hospital discharge instructions and care home meal preparation, directly reducing preventable aspiration events.

Free IDDSI Tools from SeniorDeli

We build free clinical tools to help families, caregivers, and health professionals apply IDDSI in practice.

AI

Snap-to-IDDSI AI Classifier

Photo-based AI tool that classifies a food item to its IDDSI level in seconds — no manual testing required.

Open AI Classifier
10

EAT-10 Swallowing Screen

Free validated 10-question screen to identify swallowing difficulty risk and suggest the appropriate IDDSI starting level.

Take EAT-10 Screen

IDDSI Matcher

Answer a few questions about symptoms and dietary history to get a suggested IDDSI level range and product recommendations.

Use IDDSI Matcher

For Care Homes

SeniorDeli supports care homes in implementing IDDSI — from staff training to compliance documentation.

Pilot Programme

Implementing IDDSI in your facility? Join our pilot programme — free app access, staff training support, and a dedicated account manager for the first 3 months.

Join Pilot Programme

IDDSI Compliance Documentation Pack

Download our care home IDDSI compliance pack — including texture testing logs, staff competency checklists, and SWD-ready documentation templates. Available inside the SeniorDeli app.

Download Compliance Pack

Start using IDDSI-aligned tools today

Free app for families and caregivers. Dedicated programme for care homes and healthcare facilities.