If a patient is a silent aspirator...how would you know when to upgrade their diet? Xray shows lower right lobe infiltrates but patient presents with no signs or symptoms otherwise. Would I need to do another VSS? Deficit is reduced posterior tongue retraction causing vallecular pooling. Implemented chin tuck, effortful swallow, and alternating solids and liquids. PLOF was regular, patient is now on m/s. Reason for hospitalization is hip fracture. Thanks for help!