Abstract
Managing one's dysphagia at the end-of-life is challenging for the patient and the medical care team. Decisions surrounding oral feeding safety and the use of artificially administered hydration and nutrition require the medical care team to provide its best advice, taking into consideration the patient's health-related goals and the impact the final decision will have on quality of life. For the patient who wishes to continue oral feeding despite known risks, the use of a modified barium swallow study that systematically varies bolus volume, viscosity, and rehabilitative postures or techniques may be helpful. End-of-life decisions concerning the provision of nutrition and hydration often raise ethical questions. The decisions are not automatic and should not be predicated on making the "right" choice but on doing what seems the most prudent in the given situation.