Nutrition and Swallowing, Tools and templates, V1.3, June 2016 16
Nutrition and Swallowing Risk Checklist
What is the purpose of the Checklist?
• The Nutrition and Swallowing Risk Checklist (the Risk Checklist) is a way of
screening people for difficulties related to nutrition and swallowing. It cannot make
a diagnosis of a medical condition. A diagnosis can only be made by a health
• The Risk Checklist was developed as a means of raising awareness of nutrition
related problems in people with disability. It has been developed to be used by
people who care for people with disability.
• By asking questions about a person’s health, weight and their ability to eat and
drink, the checklist will determine if further assessment and action is needed,
including advice or assessment by a dietitian, speech pathologist or other health
Who should complete it?
• If you are completing the Risk Checklist you should know the person with a
disability well. You may be the case manager or support worker. Collaboration with
a parent or family member may be helpful in achieving the most accurate result.
• Include the person with disability when completing the Risk Checklist.
How to complete it
Part 1 – Preliminary Profile - Gathers and evaluates information about the person’s
weight and height. In this section you have to write in the information requested for
some questions and tick the relevant box for others.
Part 2 – Nutrition and Swallowing Risk Checklist - Assesses if the person has
indications of nutritional problems or swallowing difficulties that may affect their
nutrition and health. Tick the relevant box for each question.
Part 3 – Summary of Results - Records descriptions of the risks or issues of
concerns relating to questions answered with a ‘Yes’ or ‘Unsure / Do not know’. The
GP should review the Summary of Results and prescribe action to be taken in the
shaded ‘Further Action Required’ column.
Do not guess answers
• Try to obtain all the information you need to complete the Risk Checklist. For
example, you may need to look at the person’s weight records to work out if they
have lost or gained weight over the past three months. If there are no records and
you are not able to measure height or weight, you should still complete as much of
Part 1 as you can, and then complete Part 2 to the best of your knowledge.