IDDSI (International Dysphagia Diet Standardisation Initiative) is a global framework for describing food textures and drink thicknesses for people with dysphagia. It defines 8 levels (0–7) with standardised testing methods, adopted in Hong Kong, Australia, the UK, Canada, and 50+ countries.

How many IDDSI levels are there?

IDDSI has 8 levels numbered 0 to 7. Levels 0–4 describe drinks (Thin to Extremely Thick / Puréed), while levels 3–7 describe foods (Liquidised to Regular). Levels 3 and 4 overlap between drinks and foods.

What is the fork pressure test for IDDSI Level 4?

The fork pressure test for IDDSI Level 4 (Puréed) requires applying approximately 140g of pressure with the back of a fork. Food should flatten completely and not spring back, indicating it requires no chewing and can be mashed with the tongue.

What IDDSI level should a care home's soft diet be?

Different institutions define 'soft diet' differently. Always ask care homes and hospitals to specify the IDDSI level clearly — typically Level 5 (Minced and Moist) or Level 6 (Soft and Bite-Sized). Do not assume a 'soft diet' label means a specific IDDSI level.

Which foods are dangerous for people with dysphagia?

High-risk foods for dysphagia patients include hard or dry foods (nuts, biscuits), fibrous foods (celery, pineapple), chewy or sticky foods (mochi, glutinous rice), round foods (whole grapes, peas), mixed-texture foods (bubble tea, watermelon), and konjac products. In Hong Kong, xiao long bao, water spinach, and noodle soups are also high-risk.

Community Resources for Dysphagia Caregivers in Hong Kong

Caregivers Are Not Alone

Caring for a person with dysphagia is an intensive, long-term commitment. Research shows that primary caregivers face levels of physical and emotional exhaustion that can rival the patient’s own health challenges. Hong Kong has a range of government programmes and NGO services designed to support caregivers — but many families are unaware of what is available or how to access it.

This guide maps Hong Kong’s community support landscape for dysphagia caregivers, so you can find the right help at the right time.

District Elderly Community Centres (DECC)

District Elderly Community Centres (DECC) are subsidised by the Social Welfare Department and provide one-stop community services for residents aged 60 or above and their caregivers.

Key services

Case management: a social worker assesses needs and coordinates services
Home support referrals: applications for home help and personal care assistants
Day care referrals: applying for Day Care Centre placements
Caregiver support groups: peer sharing and emotional support
Community education: caregiving skills workshops and information sessions

How to find your local DECC Search by district on the SWD website at www.swd.gov.hk, or call the SWD hotline: 2343 2255.

Elderly Community Centres (ELC)

Elderly Community Centres (ELC) serve a larger catchment area than DECCs and typically offer a broader range of programmes, including meal delivery services and day centre activities.

Home Support Services

Home Help Service

The SWD-subsidised Home Help Service provides in-home assistance for elderly and disabled individuals, including:

Personal care (bathing, dressing)
Household tasks (cleaning, laundry)
Meal preparation (some operators)
Accompaniment to medical appointments

How to apply

Referral through your local DECC social worker
Arrangement by a Medical Social Worker at hospital discharge
Direct application to participating NGOs (some accept self-referrals)

Note: Subsidised places are limited and waiting times can be lengthy. Some families opt to purchase private home care services while waiting.

Integrated Home and Community Care Services (IHCCS)

IHCCS, also subsidised by the SWD, provides more intensive in-home care for frail elderly individuals, including nursing support, rehabilitation training, and caregiver coaching. This is a particularly valuable option for caregivers managing complex care needs at home.

NGO Support Services

Caritas Hong Kong (明愛)

Caritas is one of Hong Kong’s largest social service organisations, offering multiple services relevant to dysphagia care:

Elderly services: community centres across multiple districts providing case management, home support, and day care
Caregiver support programmes: caregiving skills training, respite services, and counselling
Home help services: covering multiple districts, with both subsidised and private-pay options

Contact: www.caritas.org.hk; district elderly service centres can be located through the website.

Hong Kong Red Cross (HKRC)

The Hong Kong Red Cross provides services relevant to caregivers including:

Home medical services: including nursing support
Rehabilitation services: equipment loan programme covering wheelchairs, walking aids, and medical beds
Volunteer services: some programmes offer volunteer home visits

Contact: www.redcross.org.hk; hotline 2802 0021.

Hong Kong Family Welfare Society (HKFWS)

Family counselling and caregiver emotional support services
Presence across multiple districts in Hong Kong
Contact: www.hkfws.org.hk

Medical Social Workers (MSWs) are key connectors between the healthcare system and community services. While a patient is hospitalised, caregivers should proactively request a meeting with the ward MSW to plan post-discharge community support.

Service	Description
Home care referral	Arrange in-home nursing or caregiving services
Community care applications	Apply for DECC, IHCCS, and other community programmes
Residential care assessment	Evaluate whether subsidised care home placement is needed
Financial assistance	Apply for Disability Allowance, CSSA, or medical fee waivers
Caregiver training referral	Arrange caregiving skills courses

Residential Care Options and Waiting Lists

For some caregivers, full-time home care is not sustainable in the long term. Hong Kong’s residential care options include:

Government-Subsidised Residential Care Homes (RCHE)

Application requires a Standardised Care Need Assessment through a hospital or DECC social worker
Waiting times are typically measured in years for the most subsidised places
Fees are means-tested based on the resident’s income

Enhanced Bought Place Scheme (EBPS) Homes

Shorter waiting times than fully-subsidised places; fees fall between subsidised and private rates
Apply through the SWD’s unified care need assessment mechanism

Private Care Homes

No waiting list; fees at market rates
Quality varies significantly — visit in person and check licensing records at the SWD before placing a family member

Respite Services for Caregivers

Long-term caregivers have a legitimate need for regular respite. Options in Hong Kong include:

Short-term residential services: temporary care home placement to give the caregiver a break (requires unified assessment referral)
Day Care Centres: the patient attends the centre during the day, giving the caregiver up to a full day’s rest
Volunteer companion visits: some organisations provide volunteers to sit with patients, freeing the caregiver to rest or run errands

Key Contacts and Hotlines

Organisation / Service	Contact
Social Welfare Department hotline	2343 2255
Senior Citizen Home Safety Association (emergency alert)	1878 000
Hospital Authority Nurse Hotline	1836 115
Hong Kong Red Cross	2802 0021
Caritas Elderly Services	2744 2744
Hong Kong Family Welfare Society	2342 9070

Summary

Caring for a person with dysphagia over the long term demands substantial physical and emotional resources. Hong Kong’s community support network — spanning SWD-funded DECCs, major NGOs such as Caritas and the Red Cross, and the hospital’s Medical Social Workers — exists to share that burden. The key is to ask early, ask often, and not wait until the situation reaches a crisis point.

Reaching out proactively is the single most effective thing a caregiver can do to sustain quality care over time.