There is evidence to suggest that the older adult is at risk of malnutrition. A number of factors are associated with this, including those living in care homes, and people with long-term or progressive neurological conditions. With the growing number of people surviving into older age, these risk factors needs to be considered. An additional risk factor is those who have dysphagia. This may restrict the choice of foods available and reduce the pleasure of eating. Assessment and management of dysphagia can help patients enjoy their food intake safely and in a nutritious manner. This article discusses the complexity of managing an adequate nutritional intake for those with dysphagia.