The short answer
- Build meals around the Eatwell GuideRoughly a third vegetables or fruit, a third starchy carbohydrates, a smaller portion of protein, and some dairy. It is the same guide used for any adult, just in the portions your client can manage.
- Patience and the family's backing beat pushingBeing clear and warm about why a food is worth trying does more than repeating the offer. Getting a family member or GP on side before changing what a client eats does the rest.
- Know the signs a diet needs to change textureCoughing while eating, a wet voice afterwards, or food held in the cheek are signs to raise with a GP, not to manage by trial and error yourself.
- Write down what changes, and say who needs to knowLosing weight without trying, or eating noticeably less for more than a few days, is worth a note and a call to the GP or family rather than a wait and see.
Checked against NHS, NICE, BAPEN and Diabetes UK guidance in September 2026. Where this page names a company, it describes what kind of service it offers rather than its prices or terms, which change.
Building the plate
Building a client's meal around the Eatwell Guide
The building blocks of a good diet are the same for everyone, whatever their age. What changes for many clients is the portion size and how easy each part is to prepare and eat.
Fruit and vegetables
About a third of the plate
Starchy carbohydrates
About a third of the plate
Protein foods
A smaller portion
Dairy, fluids and a little fat
The rest of the meal
The government's Eatwell Guide sets out these proportions in full, and the NHS version is the easier one to talk a client or their family through. Where appetite has shrunk, smaller meals more often usually work better than three full plates, and stirring extra butter, cheese or cream through ordinary food adds calories without adding bulk. For the fuller picture on vitamin D, calcium and iron in later life, and how much fluid an older client needs each day, nutrition and hydration for the elderly covers the reference amounts in detail.
If your client has diabetes, the same balanced plate applies. Diabetes UK is clear that there is no special diabetic diet, just attention to portion size and how much starchy carbohydrate sits on the plate, and any specific plan should come from their GP or a dietitian rather than general advice alone.
Encouraging eating
Encouraging a client who has gone off their food
A change in appetite is worth a patient response rather than a quick fix. Most people respond better to a calm, repeated offer than to being told what is good for them.
What tends to help
- Being clear and warm about why a food or meal is worth trying, then leaving it at that
- Getting the family or GP's backing before introducing a bigger change to what a client eats
- Offering food little and often rather than three big meals if appetite is small
- Sitting with the client while they eat, so the meal is not done alone
- Building the rest of the meal around a food the client already enjoys
What tends to backfire
- Pushing the same food again after it has been turned down once at that meal
- Changing a client's diet without telling their GP or family first
- Treating a full plate as the goal when a smaller, finished plate is doing more good
- Assuming a loss of appetite is just old age rather than mentioning it to a GP
- Leaving a client to eat alone every time, when company is often what is missing rather than the food itself
Eating alone is one of the strongest drivers of poor appetite in older people, so company at the table can do more than any change to the food itself. Where a client's memory or mood is behind the change, managing clients with dementia goes further into what else tends to shift around meals and routine.
Texture and safety
Recognising when food needs to be prepared differently
Some clients develop trouble chewing or swallowing safely, and food then needs to be prepared to a specific consistency rather than left to guesswork. The levels below come from the International Dysphagia Diet Standardisation Initiative, the framework the NHS uses to describe texture-modified food and drink.
- 7
Regular
Ordinary food of any texture, chewed and swallowed as usual. Most clients eat at this level throughout.
- 6
Soft and bite-sized
Soft and tender, cut into pieces no bigger than about 1.5cm, so there is less to chew and nothing large enough to choke on if it is swallowed before being fully chewed.
- 5
Minced and moist
Food minced into small, soft lumps and held together with sauce or gravy rather than served dry, so it does not need much chewing.
- 4
Pureed
Smooth and lump-free, thick enough to hold its shape on a spoon, with no thin liquid running off that would need swallowing at a different speed to the food.
- 3
Liquidised
Thick enough to drink through a wide straw rather than eat with a fork, used for the most severe swallowing difficulties.
A speech and language therapist or GP decides which level a client needs after a swallowing assessment. Your role is to notice the signs a review is overdue, coughing while eating or drinking, a wet or gurgly voice afterwards, food held in the cheek rather than swallowed, or weight loss with no other explanation, and to serve food at the level already set rather than choosing or changing it yourself. Food hygiene and safe preparation sit alongside this and are covered in full in preparing food safely when caring for others.
Meal delivery help
Meal delivery services and supplement drinks worth knowing about
Cooking from fresh at every meal is not always realistic, for you or for the client's family, and frozen or ready-made meals are a reasonable answer rather than a compromise.
Oakhouse Foods
Frozen ready meals
Wiltshire Farm Foods
Frozen ready meals
iCare Cuisine
Hot and frozen meals
Parsley Box
Ready-to-eat, no freezer needed
None of these replace a GP or dietitian's advice, and PrimeCarers does not endorse one service over another. Mention a couple as options for the client or their family to compare rather than choosing on their behalf. If your client is losing weight or struggling to eat enough despite this, their GP can prescribe nutritional supplement drinks, which are assessed and reviewed by a healthcare professional rather than bought over the counter.
Recording and reporting
What to record, and who to tell
Nutrition is taken seriously across the care sector for good reason: the Care Certificate's Standard 8 covers fluids and nutrition for exactly this, and registered providers must follow the Care Quality Commission's Regulation 14 on meeting nutritional and hydration needs. As a private carer you are not inspected against it, but the same habits protect your client.
- 1
Notice the pattern, not one bad day
OngoingA skipped lunch or a plate left half-finished happens to everyone occasionally. What matters is a change that lasts: less food eaten over several days, the same meal repeated because nothing else appeals, or clothes and rings that have become loose. - 2
Know the point worth flagging
NICE and BAPEN guidanceLosing 5 to 10% of body weight over 3 to 6 months without trying is the threshold NICE's malnutrition guidance and BAPEN's MUST screening tool use to recommend a review. You do not need a scale to notice the signs; looser clothes and a slow recovery from a cold are reason enough to mention it. - 3
Tell the GP, dietitian or family
Same weekA GP can weigh a client, check for a treatable cause and refer to a dietitian if needed. Tell the family too, since they may have already noticed something and can help with the conversation. - 4
Write it down
Every visitA short note of what was cooked, what was eaten, and anything unusual protects both you and the client, and gives the GP something concrete to work from rather than a general impression.
Where a client is refusing food and drink altogether rather than simply eating less, and their memory or understanding is in question, mental capacity: MCA and DoLS covers how a best interests decision is made and by whom, which is not a decision for a carer to make alone.
Questions
Questions carers ask about food and nutrition
Build it around the Eatwell Guide: roughly a third vegetables or fruit, a third starchy carbohydrates such as potatoes, rice or bread, a smaller portion of protein like fish, eggs, beans or meat, and some dairy for calcium. Government guidance recommends at least 5 portions of fruit and vegetables a day and 6 to 8 drinks. The Eatwell Guide, on nhs.uk, sets it out in full.
Start by ruling out a simple cause: a new medicine, sore teeth or ill-fitting dentures, low mood, or eating every meal alone. Offer smaller amounts more often rather than three big meals, sit with them while they eat if you can, and tell their GP or family if the change lasts more than a few days rather than assuming it will pass on its own.
Losing 5 to 10% of body weight over 3 to 6 months without trying is the point at which NICE guidance and the BAPEN screening tool used across the NHS recommend a review. You do not need to weigh your client to notice the signs; clothes and rings becoming loose, or a slow recovery from a cold, are worth mentioning to their GP just as much as a number on a scale. BAPEN's MUST screening tool explains what a GP or dietitian looks for.
It is food prepared to a specific consistency, from soft and bite-sized down to pureed or liquidised, for someone who has trouble chewing or swallowing safely. A GP or speech and language therapist decides the level after an assessment. Your role is to notice the signs, coughing while eating or drinking, a wet or gurgly voice afterwards, or food left held in the cheek, and to serve food at the level already set rather than choosing one yourself.
Yes, as one option among several rather than a personal endorsement. Services such as Oakhouse Foods, Wiltshire Farm Foods, iCare Cuisine and Parsley Box deliver ready-made meals, some with texture-modified options, which can help when cooking from fresh is no longer realistic. Compare a couple together with the family rather than choosing on their behalf.
Less than people expect. Diabetes UK's guidance is that there is no special diabetic diet, and the same balanced meals recommended for everyone else apply, with attention to portion size and how much starchy carbohydrate is in a meal. Any specific plan should come from their GP or a dietitian rather than being worked out from general advice alone. Diabetes UK's guidance on eating well covers it in more detail.
No specific nutrition qualification is required to work as a private carer, but the Care Certificate, the standard framework for new care workers, includes a module on fluids and nutrition that is worth completing even if you are self-employed. Training for private carers covers what else is worth doing early.