With a growing number of people reaching older age, the need for care provided in long-term care institutions is increasing. Although the goal is to deliver person-centred care that includes choice and flexibility opportunities, pre-scheduled mealtimes and set menus are still used. The aim was to explore how food choice and flexibility practices were perceived and performed by residents and staff at three care homes in Denmark. Three food journey interviews with eight residents (aged 83–96) and three focus groups with 12 people from the care and kitchen staff were conducted. Food choice and flexibility practices were mainly performed informally and selectively by the staff, and through personal practices by the residents, implying that many residents were excluded from food choice and flexibility opportunities. However, food choice and flexibility practices were also inhibited by the staff's time pressure and unfamiliarity with choice possibilities, and by the politeness of the residents. Our findings suggest that food choice and flexibility practices must be understood and performed broadly, and include various ways of listening and responding to the residents’ needs and preferences. The study highlighted the importance of incorporating the essential embodied knowledge and emotional know-how, inherent in food choice and flexibility practices, into formal and inclusive strategies concerning how to think and act in relation to the food and meal situation.