Care through catering: what I learned about choking risk in aged care

When I started working in aged care catering, I never imagined how much responsibility I would carry with every tray I served. Food, I’ve come to learn, is not just about nutrition. In aged care, it can represent safety, dignity – or danger.

One of the most difficult experiences of my early career happened at my very first job in the sector. I was a casual hospitality worker with no prior experience in aged care.

The facility was centrally managed, with procedures passed down from head office. What shocked me most was how frequently the dietary information was out of date.

During my casual shifts, I often found myself uncertain whether a resident’s food texture or fluid thickness had recently changed. The printed lists provided to hospitality staff were sometimes outdated and didn’t reflect important dietary modifications.

I worked each shift in a quiet state of anxiety. There was no consistent system for updating or notifying the hospitality team when changes occurred. I’m not sure what communication existed for carers or nurses, but for those of us serving meals, our records were often unreliable.

Even simple changes to food preferences – like a resident no longer wanting milk in her tea – were often only known by whoever was on shift at the time. There was no clear process for sharing or updating these changes with the wider team.

As a casual staff member, I usually worked alongside a permanent hospitality worker in the same wing. I simply followed whatever they told or showed me to do. But looking back now, with more experience, I realise that even some senior hospitality staff – despite having worked in aged care for over a decade – sometimes engaged in unsafe practices.

For example, one staff member thickened fluids slightly more than prescribed, “just in case.” Even more concerning, the breakfast list provided to us often included bread for residents on soft and bite-sized (SBS) diets, even though the IDDSI guidelines clearly advise against bread for those requiring SBS textures.

On days when the facility was short-staffed, I sometimes worked with hospitality staff from agencies, who often knew even less about the residents than I did. In those moments, I had little confidence that what we were offering was truly safe.

I tried to raise my concerns with the head chef, but he repeatedly dismissed them. After several attempts, I was told that the facility couldn’t implement any changes unless head office gave formal approval.

Even something as simple as posting an updated dietary list in the kitchen was ruled out due to concerns about resident privacy. While I understand the importance of confidentiality, I also believe that if you’re the one preparing food for someone, you need access to clear and up-to-date information about what is safe for them to eat.

I worried constantly. What if a resident choked because I followed an outdated plan? What if I were rostered on with only agency carers and no permanent staff were available to double-check?

Eventually, I decided to leave. That was several years ago. I hope that facility has improved since then, especially with aged care reforms underway and digital systems like Leecare becoming more widely adopted. But I carry the lessons from that experience with me everywhere I go.

My next workplace was completely different, the improvement was immediate. Dietary updates were shared clearly and promptly, and new staff were properly trained and supported.

I had three structured buddy shifts before working alone. On the first shift, I simply observed, took notes, and asked questions. On the second, I observed again and continued learning. Only by the third shift did I begin performing key tasks under close supervision.

In contrast, at my first job, I had only one buddy shift, during which I was briefly shown the task procedures and then assigned to washing dishes.

At the new site, I was encouraged to ask questions. I felt supported and safer. But that didn’t mean the job was risk-free.

In my first month, I experienced a situation I will never forget. I was working independently in one of the wings (each wing had just one catering staff member responsible for all food service).

The breakfast list indicated that one resident was on an “easy to chew” diet, with the note “bread, no crust.” Based on what I had learned previously, I toasted the bread and removed the crusts, thinking I was following the instruction correctly.

That morning, the resident choked and required emergency assistance.

The manager came to investigate. I explained exactly what I had done. He gently but firmly clarified that residents on “easy to chew” diets must never be served toast – even without crusts – because it is too dry and tough to chew.

The “bread, no crust” instruction referred specifically to soft, fresh bread only. He then asked me to go home and carefully review the IDDSI (International Dysphagia Diet Standardisation Initiative) guidelines.

I was shaken. Thankfully, the resident recovered, but the fear of what could have happened stayed with me. That evening, I read the IDDSI resources line by line. And I began to understand just how much risk I had seen – and sometimes unknowingly contributed to – at my previous job.

Thickened fluids must be precise. Too thin or too thick can both cause choking. Soft and bite-sized diets aren’t just about cutting food small, it must also be soft.

Since then, I’ve developed four simple principles I live by:

Always prioritise food safety and hygiene.
Check dietary documents at the beginning of every shift—and follow them exactly.
Don’t skim training. Take time to understand and absorb it.
Ask questions—especially if you’re new or working a one-off shift. Never assume. Never guess.

Catering in aged care isn’t difficult, but it requires precision and professionalism. Residents trust us to serve them safely. One small mistake – like offering toast instead of bread – can lead to serious consequences.

These days, with more experience and a stronger understanding of the guidelines and protocols, I support new staff through their buddy shifts whenever I can.

And when I look back on those early days filled with quiet anxiety, I remind myself that some of the most powerful lessons come from the hardest moments.

Because in the end, catering in aged care isn’t just about delivering meals. It’s about delivering care—with attention, responsibility, and the courage to keep people safe.