Eating and Drinking with Acknowledged Risk (EDAR)
Date issued: March 2025
For review: March 2027
Ref: C-613/RMR/Speech and Language/Eating and Drinking with Acknowledged Risk (EDAR)
PDF: Eating and Drinking with Acknowledged Risk (EDAR).pdf [pdf] 269KB
Risks of Eating and Drinking:
It is common for people to experience problems with their eating, drinking and swallowing (this is called dysphagia). This means food/drink/saliva may be ‘going down the wrong way’ for example, entering the lungs rather than the stomach. This is called aspiration. Aspiration can cause coughing, choking, discomfort and chest infections.
Often, dysphagia may result from dementia, stroke, various neurological disorders (such as Parkinson’s disease, multiple sclerosis, motor neurone disease), brain injury, COPD, learning disability and a range of other health conditions.
What is Eating and Drinking with Acknowledged Risk (EDAR)?
Eating and drinking with acknowledged risk refers to the decision to continue eating and drinking despite an identified risk of aspiration/malnutrition and dehydration. This is often to maintain the person’s quality of life.
What happens if the person becomes poorly?
It is important to understand that it is very common for a person who is EDAR to become poorly with a chest infection and/or experience weight loss, poor nutrition and dehydration.
Plans should be made with the person’s doctor regarding how this would be treated or managed and where e.g. at home or in hospital.
Are there alternatives to EDAR?
Many people who have dysphagia may not be suitable for tube feeding or alternative nutrition and hydration.
This may be decided against for the following reasons:
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The risks may not outweigh the benefits.
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It may reduce the person’s quality of life.
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The person may not want to have alternative nutrition and hydration.
When people who have an unsafe swallow with all food and drink and are not suitable for tube feeding, feeding with acknowledged risks should be considered.
Can an EDAR decision be changed?
An EDAR decision can be reviewed. If the person’s presentation changes or the person feels differently about the risks, they should speak to their doctor, who will liaise with the relevant professionals including a Speech and Language Therapist (SLT) to review the decision.
How can the risks of eating and drinking be reduced?
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Ensure the person sitting fully upright when eating and drinking.
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Ensure the person is awake, and aware of the food and drink in front of them.
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Ensure eating is at a slow pace, and the person has finished their mouthful before putting another in their mouth.
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Encourage independence with eating and drinking, support the person with hand-over-hand assistance if this is needed.
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Follow the guidelines given by the Speech and Language Therapist (SLT) regarding the most comfortable consistencies/textures of foods/drinks for the person (see IDDSI Framework for more information on the different textures: www.iddsi.org).
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Regularly clean the person’s mouth.
Glossary
Aspiration: When food or drink passes the vocal folds and enters the lungs.
Dysphagia: Problems with eating, drinking and swallowing.
Eating and drinking with acknowledged risks: Continuing to eat and drink despite the associated, known risks of having dysphagia.
Risk feeding: When a person continues to eat and drink despite a risk of aspiration (another term used to describe EDAR).
Speech and Language Therapist (SLT): Allied health professional who helps people with difficulties in communication and/or eating, drinking and swallowing.
