What is an allergy safe adult care facility?
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, facilities should make efforts to create and maintain a safe environment for adults with food allergy. Creating an allergy safe facility involves:
- Following policies and procedures that reduce the risk of accidental exposures to foods that 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 Food Allergy Canada: https://foodallergycanada.ca/wp-content/uploads/Anaphylaxis-Emergency-Plan-Form.pdf (PDF, 749KB)
- 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 treats a protein (an allergen) in a food as harmful. Allergic reactions to foods can be mild or severe. Food allergy needs to be taken seriously. It involves avoiding the food that causes allergic reactions and responding appropriately to an accidental exposure. 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 (anaphylaxis)?
Symptoms of a severe allergic reaction can start within minutes of eating or being exposed to an allergen. In rare cases, the reaction can take up to several hours to start. Symptoms can vary from person to person and can look different each time they have a severe allergic reaction. Symptoms generally include 2 or more of the following:
- Skin: hives, swelling (face, lips, tongue), itching, warmth, redness, rash
- Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose, sneezing and watery or itchy eyes), trouble swallowing
- Gastrointestinal (stomach): nausea, pain or cramps, vomiting, diarrhea
- Cardiovascular (heart): paler than normal skin colour or blue colour, weak pulse, passing out, dizziness or light-headedness, shock
- Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, a metallic taste
Responding to a severe allergic reaction
Anaphylaxis can be life threatening, so it is important to respond quickly and follow these emergency steps:
- Give epinephrine device (for example, EpiPen, neffy) at the first sign of a known or suspected severe allergic reaction. This medication is safe, so if you are unsure, the safest option is to give the epinephrine
- Call 9-1-1 or your local emergency service. Tell them someone is having a severe allergic reaction
- Give a second dose of epinephrine as early as 5 minutes after the first dose if there is no improvement in their symptoms
- Go to the nearest hospital immediately (by an ambulance if possible) even if symptoms are mild or have stopped. The reaction could get worse or come back, even after proper treatment. Stay in the hospital for observation for as long as the doctor suggests (generally about 4 to 6 hours)
- Call emergency contact person
Other important information about epinephrine devices
Epinephrine devices expire on the last day of the month indicated on the product packaging. For example, if the product is marked as expiring in January, it remains valid (not expired) until January 31.
- You are advised to have more than one device in case two doses are needed
- If you are experiencing an anaphylactic reaction and only have an expired device, use the expired product and immediately contact 9-1-1
- Whether the product is expired or not, go to the nearest hospital as soon as possible after using the product, as instructed in the product labelling
What can be done to create an allergy safe facility?
Care plans and epinephrine devices
- 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 epinephrine device in a secure unlocked place that is easy for all staff to access. Ensure their device is available at all times
- Ensure all staff have training in identifying anaphylaxis and administering epinephrine
If it is safe to do so, have the resident carry their device(s) in a fanny pack or other carrier - Replace each device before the expiry date
- 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 and know how to recognize food allergens on product labels. For more information on allergen labelling, visit the Canadian Food Inspection Agency https://inspection.canada.ca/en/food-labels/labelling/consumers/food-allergies
- 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 before 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. Wash 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. Visitors can bring food in unexpectedly
Meal and snack 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
When eating out
- For social gatherings like picnics, pack separate meals for residents with food allergy
- Call restaurants ahead of time 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 devices on all trips
What is pollen food allergy syndrome?
Many people with tree or grass pollen allergies also develop food allergy to certain raw fruits and vegetables. This is called pollen food allergy syndrome (PFAS) or Oral Allergy Syndrome (OAS). PFAS 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 in doubt, include the resident’s health care provider when developing 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:
