**5. Strategies used by family members to cope with dysphagia**

In reponse to the pervasive effects of dysphagia, studies reported to date have identified a number of strategies and processes family members adopt to adjust and cope with their family member's dysphagia and the associated impacts on their life [24-26]. A predomi‐ nant theme across studies is the acceptance of a new normal. That is accepting that meal preparation, mealtimes, and social occassions may never be the same. In order to reach this point, family members across studies noted the need to negotiate changing roles in regards to their family members dysphagia and the need to take on more roles within the house‐ hold [24-26].

Other strategies reported by family members include maintaining a positive attitude; looking for opportunities to eat foods that their partner could not eat when they were not present; and using trial and error strategies to learn what foods their family member could and could not eat. Each of these strategies and adjustment processes were often made without the support of health professionals and family members across studies have consistently reported the need for further education, training, and support from health professionals to help them adapt and adjust to their family member's dysphagia regard‐ less of etiology or severity of dysphagia [25, 26, 29].
