Allergy Safe Adult Care Facilities

HealthLinkBC File Number: 
Last Updated: 
May 2016

Food allergy affects about 3 to 4 adults out of every 100. While care facilities cannot be expected to be completely free of the foods that cause allergic reactions, they can aim to be safe environments for adults with food allergy. Creating an allergy safe facility involves:

  • Following policies and procedures to reduce the risk of accidental exposures to foods known to cause allergic reactions among the residents in care.
  • Having a care plan in place for each resident with a food allergy that includes a copy of their Anaphylaxis Emergency Plan. The plan explains what to do in case of an allergic reaction. To get a blank copy of an Anaphylaxis Emergency Plan, visit Canadian Society of Allergy and Clinical Immunology
  • Regular staff training to ensure everyone has the knowledge and skills to respond to and care for a resident who is having an allergic reaction.

What is an allergic reaction?

An allergic reaction is when a person’s immune system acts as if a protein (an allergen) in a food is harmful. Allergic reactions to foods can be mild or severe. A severe allergic reaction is called anaphylaxis (an-nah-fil-axe-is). It often happens quickly and can cause death if left untreated.

What are the symptoms of a severe allergic reaction?

Symptoms of a severe allergic reaction can start within minutes of eating or being exposed to the food, but usually occur within 2 hours. Do not ignore early symptoms. When a reaction begins, it is important to respond right away.

Symptoms can vary from person to person. The same person can have different symptoms each time and they can include any of the following:

  • Skin: hives, swelling (including of the tongue, lips or face), itching, warmth, redness, rash, pale or blue coloured skin.
  • Breathing: coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (such as runny, itchy nose, watery eyes and sneezing), trouble swallowing.
  • Stomach: vomiting, nausea, abdominal pain, or diarrhea.
  • Heart: weak pulse, passing out, dizzy or lightheaded, shock.
  • Other: anxiety, headache, metallic taste, or uterine cramps in women.

A severe reaction can take place without hives.

If a person with a food allergy is concerned they are having a reaction treat this as a priority. Do not ignore early symptoms.

How is a severe allergic reaction treated?

When a reaction begins, it is important to respond right away. Do not wait. Give the prescribed medication called epinephrine (eh-puh-NEH-fren). Epinephrine will not cause harm to the resident if it is given unnecessarily.

Epinephrine comes in a pre-loaded syringe called an auto-injector. Epinephrine helps reverse the symptoms of an allergic reaction and can save the person’s life.

Steps for treating a severe allergic reaction:
  1. Use the auto-injector right away. Give the shot of epinephrine into the muscle of the outer-mid thigh, through clothing if necessary.
  2. Call 9-1-1 or the local emergency number.
  3. Lie the resident down with their legs raised slightly. If they are nauseated or vomiting, they should lie on their side. Keep them lying down. Do not make them sit or stand up. If they are having difficulty breathing, let them sit up.
  4. Do not leave the resident alone.
  5. If the resident’s symptoms do not get better or come back, give a second dose of epinephrine within 5 to 15 minutes after the first injection.
  6. Ensure the resident gets to a hospital.

The above section has been adapted from: Anaphylaxis in Schools and Other Settings, Copyright 2005-2015 Canadian Society of Allergy and Clinical Immunology..

What can be done to create an allergy safe facility?

Care plans and auto-injectors

  • Create a care plan for every resident with food allergy. Include a copy of the resident’s Anaphylaxis Emergency Plan. Ensure their meal plan is free of their food allergens.
  • Store each resident’s auto-injectors in a secure unlocked place that is easy for all staff to access.
  • If it is safe to do so, have the resident carry the auto-injector(s) in a fanny pack or other carrier.
  • Replace each auto-injector before the expiry date. Ensure that the auto-injector of a resident with a severe food allergy is available before they are served foods.
  • Consider having residents with food allergy wear MedicAlert® identification.

Buying, preparing and serving food

  • Tell food suppliers about the food allergies at your facility.
  • Make sure staff who buy, store, prepare and serve food:
    • Have a complete list of foods that cause allergic reactions among residents. Know how to recognize food allergens on product labels. For more information on allergen labelling, visit Canadian Food Inspection Agency
    • Read the ingredients list each time they buy a food or receive a food delivery. Ingredients in packaged foods can change without notice. Do not assume that a food served previously is safe.
    • Ensure all foods prepared and stored on site are clearly labelled with a list of ingredients. This includes leftovers, foods made from scratch, and any foods brought in by families or staff.
    • Prevent cross-contamination by washing hands, utensils, and food preparation surfaces well between preparing different foods.
  • Do not take risks. If you are not certain a food is safe for a resident with a food allergy, offer something else.
  • Be aware of the needs of residents with food allergy whenever food is offered, not just at regular meal and snack times. Celebrations, demonstrations, and craft activities can involve food. Food can be brought in unexpectedly by visitors.

Meal times

  • Make sure all residents and staff wash their hands with soap and water before and after eating. This helps prevent food from getting on objects, clothing, or other surfaces. Hand sanitizers or just water are not as effective.
  • Supervise meals and snacks if residents need help to follow instructions.
  • Clean all tables and other eating surfaces well before and after eating.

During outings and when eating out

  • During social gatherings such as picnics, if needed, pack separate meals for residents with food allergy.
  • Call the restaurant to see if meals can be prepared without the resident’s allergens. Restaurant staff may not have the training to deal with food allergy. If in doubt, choose another restaurant.
  • Take Anaphylaxis Emergency Plans and epinephrine auto-injectors on all trips.

What is oral allergy syndrome?

Many people with tree or grass pollen allergies also develop food allergy to certain raw fruits and vegetables. This is called Oral Allergy Syndrome (OAS). OAS can lead to itching and mild swelling of the lips, and in the mouth and throat. It is uncommon for OAS related reactions to become severe. Adults with OAS can often eat the fruits or vegetables if they are cooked. If there is doubt, make sure that the resident’s health care provider is included in the development of the resident’s care plan.

For More Information

If you have questions about food allergies, call 8-1-1 to speak with a registered dietitian.

For more information about understanding and managing anaphylaxis, visit:

Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.

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