As mentioned, we moved my dad from a MC to a SNF. I think this SNF is much much better and should have put him in in the first place. But even they get some things wrong. The first couple days they were giving him honey thick liquids, which he spit out, versus the nectar thick. The dietician claimed the orders said honey thick, but after talking to hospice, we confirmed it was nectar thick. Based on the advice of the hospice nurse, we have told the SNF we want my dad waken for meals. We do not want him to sleep through. Yet my brother was there earlier and once again they said if he is sleeping they let him sleep. Maybe there are good points for that. But there are two issues here. 1. What is better? I would think patients need to eat at times, and the hospice nurse said that. She said have him waken, then if he doesn't eat, don't force him but at least wake him up. I suppose the opposing view is if they are sleeping they are sort of at peace, and why wake him up and agitate him. They say if he is hungry he will wake up. 2. The other issue more basic. Despite what may or may not be better, I would assume it is ultimately up to the family. I have instructed this to them a couple times yet the word does not get through to all shifts. I know that has its limits. Like if we say we want him to drink coca cola, they can't do that. But the way I understood it from hospice was it's up to us. And the hospice nurse, who we have come to trust more than anyone, has recommended waking up for meals. Not forcing food down, but at least wake them up. My dad is somewhere in stage 7. I am assuming and therefore has limited life ahead of him in any event. But I would like him to eat to keep strength up as long as possible. Also, just feel these care facilities don't get their communications out like they should. Its like we have to train each new shift as they come on as our instructions are not passed on to them.