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❖ Palliative trajectory according to medical team however prognosis likely 12-18 months❖ Limited verbal output–communicates primarily with gestures and facial expressions and yes/no responses❖ Carers explain that Andy is on a pureed diet and moderately thick fluids however ‘sneaks sandwiches’ from other residents plates and the kitchen when carers are not looking–he thoroughly enjoys bread and a beer on Fridays (happy hour). Andy is generally compliant however refuses to eat with residents on Friday afternoons and throws his beer when he receives it (thickened)