“Adults with intact swallowing reflexes make food choices that reflect their attitudes towards health, spiritual beliefs, cultural norms and life experiences.” (Kenny 2015). The same opportunity is necessary for patients with dysphagia of all cultural and spiritual backgrounds to experience autonomy and as much pleasure and comfort as possible with eating and drinking. As speech-language pathologists, we need to work with patients and their caregivers to make the best decision regarding diet, taking into account both nutrition and cultural preferences. We have our own perceptions of health with feeding, and must be aware of the potential influence of those beliefs when counseling the patient. Kenny outlines four health professional skills for shared decision making with dysphagia treatment: “communication, imagination, courage and reflection” (Kenny, 2015). We need to participate in “open communication, creative problem solving, leadership, and reflection during patient/health professional interactions.” (Kenny 2015). Beyond what The best practice for a situation like this is to incorporate shared decision making. This method allows clinicians to develop rapport and the risks and benefits of dysphagia management to provide the best plan of care for individual patients.