Eating and Drinking with Acknowledged Risk (EDAR)

Eating and Drinking with Acknowledged Risk (EDAR) is a clinical approach used when individuals, often with dysphagia or other swallowing difficulties, choose to continue eating and drinking despite the associated risks.

EDAR is a decision that can be made by the individual and their care team.

Key points

• Right number 7 of the Charter of Aged Care Rights also reinforces the right to “have control over and make choices about my care, and personal and social life, including where the choices involve personal risk”.
• Standard 1 of the Aged Care Quality Standards reinforces the right to make informed choices and be supported to take risks to “live the life I choose”.

The Aged Care Quality and Safety Commission have developed a fact sheet for consumers to understand their rights and what they can expect from their care team and aged care provider.

CareSearch has compiled a clinical evidence summary on Patient Autonomy, Dignity and Choice.

How is EDAR done?

• A healthcare team works with the individual to understand the risks and support their decision.
• A speech pathologist assesses the individual's swallowing.
• The individual and their care team create an EDAR plan.
• The plan includes a nutrition and hydration support plan, and a risk management plan.

Read more on EDAR in our recent blog co-authored with Jessica Zilujko (Director/Dietitian) and Rachel Leonard (Assistant Director/Speech pathologist) Food Nutrition and Dining Advisory Unit, ACQSC. 

For allied health professionals, particularly speech pathologists and dietitians, EDAR underscores the importance of early, collaborative discussions with the person, their family, and the broader care team to balance quality of life with clinical considerations.

Eating and drinking in the final days

Building on the principles of EDAR, Taste for Pleasure is one initiative that represents a compassionate next step in supporting dignity and comfort in the final days.

The Taste for Pleasure initiative, introduced by the Shrewsbury and Telford Hospital NHS Trust (SaTH) in the UK, initiated a simple change, by removing ‘nil by mouth’ signage above the bed and replacing it with ‘Taste for Pleasure’, they shifted care from clinical to meaningful in a way that honours personal preferences and human connection.

Taste for Pleasure recognises the period at end of life where a person is no longer eating and drinking and looked to adapt comfort mouth care to a more personalised act. Families are encouraged to participate in choosing favourite drinks, such as tea, juice, lemonade, or even whiskey or prosecco to be used when providing mouth care. Taste for Pleasure fosters kindness, dignity, and a sense of celebration and connection, even in the final hours.

Read more on Taste for Pleasure in our recent blog. The Shrewsbury and Telford Hospital NHS Trust (SaTH) have also shared a copy of the Taste for Pleasure Standard Operating Procedure (SOP) (718kb pdf) to help inspire others in implementing similar initiatives.

Further learning