Symptom: Eating, Difficulty

Initial Grading Reminder

Grade 1 (Mild): Symptomatic, able to eat regular diet
Grade 2 (Moderate): Symptomatic and altered eating/swallowing
Grade 3 (Severe): Severely altered eating/swallowing; tube feeding or TPN or hospitalization indicated
Grade 4 (Life-threatening): Life-threatening consequences; urgent intervention indicated

Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient:

Have you had any difficulty eating in the past? Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly?

Grade the symptom

Ask the patient:

How severe is your eating problem? Is eating painful? Do you have sores in your mouth? Are you able to swallow? Are you able to drink?

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Are you feeling faint? Have you passed out?

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?