Gerinet Listserve Response Summary:
Dining Enhancement in Assisted Living Facilities
This message was posted on behalf of Marla Brodsky, RD, LD, CNSD December 17, 2002 to the Gerinet Listserve.
As part of an aging project, we are trying to find models for dining enhancement to improve nutritional intake amongst independent/assisted living facilities. These may include flavor enhancement techniques, aromatherapy, environmental changes to dining room, or other interventions. Do you know of any models that you might refer to us? MBRODSKY@AMERITECH.NET
You might try looking here:http://www.collington.com/collingtoncommunity/index.html
Nancy Glover, PhD, RD, FADA firstname.lastname@example.org. 228-523-5741.
Nancy Glover conducted research on aromatherapy in an institutional dining environment as a precursor to doctoral work at the University of Southern Mississippi. Work culminated into doctoral study and dissertation: Environmental Conditioning as a Food Service Marketing Strategy: Effects of Pleasant Ambient Scents on Patient Satisfaction. (Dissertation copyright 8/2000).
Becci Fonck, Program Specialist, Adult Services and Aging, 700 Governors Dr., Pierre, SD 57501. 605-773-3656. Becci.Fonck@state.sd.us
Some of the Nursing and Assisted Living facilities in South Dakota are making bread in bread machines in the dining area. The seniors love the aroma, it brings back fond memories. They enjoy eating the bread and they tend to eat more of the meal as well.
Joseph Carlin Administration on Aging Nutritionist Joseph.Carlin@AoA.gov
Becci: Love the idea of baking bread! Makes my mouth water just to imagine the smell. I have a copy of a "white paper" the International Association of Culinary Professionals published a few years ago called "The Quality of Food in Assisted Living Residences for Older Adults: An Expanding Career Opportunity." I can make copies and send it to anyone who is interested. The principles contained in this document can be applied in part to the Title III Nutrition Program. Send me your name and address and I will get it off to you as soon as possible.
Greta Brooks, Executive Director, Western Illinois Area Agency on Aging, 729 34th Avenue, Rock Island, IL 61201. 309-793-6800. Greta@wiaaa.org
Suggestions originating from various actions by providers in our planning and service area:
- The salad bar added at Knox Co. Nursing Home (with dietary aids assisting in fixing salad plates) was reported to be successful because of the element of choice it contributed, and also there was no longer a need for laxatives among the 100+ residents.
- From congregate meal sites - potato bar (again choices), and round tables.
- From Hawthorn Inn (Seminary Village's assisted living in Galesburg) - the building is arranged with apts. In four wings, each being a separate "neighborhood" with its own small dining room (maybe 12 residents) and its own small serving kitchen, which is less institutional.
- Friendship Manor uses cloth napkins and tablecloths. This practice really seems to matter to the residents and is cost efficient and environmentally friendly.
Judy Wisk, RD, Nutritionist, Greater Pittsburgh Community Food Bank, 1 North Linden Street, Duquesne, PA 15110. 412-460-3663, ext. 214. JWisk@pittsburghfoodbank.org
Information from colleagues who consult: A site in WV comes to mind: This site has an extremely low % of residents with weight loss. The majority of individuals who need assistance with meals are transported to their common dining area where they are all given the attention they need during meal times. Only the few who must remain in bed remain in their rooms. This model did not increase the resident/staff ratio. Post note: The intent of my message was that the traditional "feeder" residents did NOT remain in their rooms to be fed: they all went to a common dining area. This had a significant impact on the foods/beverages they consumed.
Kim Fremont email@example.com
I enjoyed hearing about your ideas. I am a VP of a consultant company in the Midwest. We have found that going to buffet dining with as few as 2 choices for meat, vegetable, and starch, and a salad and dessert bar has done wonders for the moral of the residents. The element of choice has really improved intakes. Having the salad bar has allowed us to offer more fresh fruits and vegetables to those who can still chew and swallow them, so instead of taking them off the menu, like we did in the past, we put small amounts of crunchy, semi-crunchy and soft on the salad bar. We have seen a positive increase in the consumption of these items. I think buffet dining has real potential to have a positive influence in the dining room. Also several of our facilities have hired a dining hostess, who goes around and offers assistance like opening condiments, pouring extra beverage, giving verbal encouragement and just that little bit of TLC that our residents seem to need. Our recently retired seem to like this position, its light work, not too many hours etc. Kim Fremont, Health Technologies.
Lee Wolf, RD, LD, Non Commercial Segment Leader: EBU. 800-968-7500 x7171. lwolf@GFS.COM
The Consultant Dietitians in Health Care Facilities Practice Group of the American Dietetic Association has a great resource called "Dining Skills." You probably heard of it, but I think it is great.
Chris Reid chriscr@OPTONLINE.NET
There is a cookbook that people may find interesting called "Well Aged." It is a cookbook that was put together by Ginny Gordon Walters, after visiting her elderly grandmother in a nursing home and finding her covered with spaghetti and feeling very distressed. She could not eat the food she was given, a problem I saw over and over again with my parents when they were in nursing homes. My mother's teeth condition did not allow her to eat anything but the very softest of foods, and she was routinely given food that might be "soft" to some people, but she couldn't eat it. My father's food was frequently inedible (food quality so poor). Very basic stuff, very basic interventions implied -- just paying attention to the food quality served and appropriateness to the person eating it. Also, often there is not enough time for staff to help people eat who really need help. But I digress. This book by Ginny is a labor of love, inspired by her visit to her grandmother and containing recipes that are easy to make and easy to eat. I used the ideas in it to create recipes for my mom, increasing the amount of protein and calories she would get per bite by adding ingredients like powdered milk and protein powder. Ginny also has a website, and the book is available for sale there. Ginny also has links to sources for specialized cutlery and cookware that could be of value in assisted living situations.
Judy Inglis, B.Sc., M.L.S. Director, J.W. Crane Memorial Library of Gerontology and Geriatrics, Coordinator, Collaborative Research Unit, Deer Lodge Centre, 2109 Portage Avenue, Winnipeg, Manitoba R3J 0L3. 204-831-2107. Judy JInglis@DEERLODGE.MB.CA
A few resources that may be of interest:
- Zgola, Jitka M.; Bordillon, Gilbert. Bon Appetit: how to create meaningful mealtimes in long-term care facility Woodstock, ON: Canadian Learning, 2001.
- Nutrition management and restorative dining for older adults: practical interventions for caregivers. Chicago, IL: American Dietetic Association, 2001.
- Wood, Paulette. Dining skills: restoring pleasure to mealtime...techniques for helping the older adult Pensacola, FL: Consultant Dietitians in Health Care Facilities, 1993.
- Consultant Dietitians in Health Care Facilities Dining skills supplement: practical interventions for the caregivers of the eating-disabled older adult. Pensacola FL: American Dietetic Association, 1998.
- Kobriger, Annette M. Care planning interventions for the cognitively impaired resident in the dining room Chilton, WI: Kobriger Presents Inc., 1997.
- Chester, Rosie; Davies, Stephanie; Counsel and Care Appetite for life: a study of good practice around food and mealtimes in homes for older people London, England: Counsel and Care, 1997.
- Eating well for older people with dementia: a good practice guide for residential and nursing homes and others involved in caring for older people with dementia: report of an expert working group. Manchester: Voices, 1998.
- Counsel and Care Appetite for life: the place of food and mealtimes in homes for older people. London, England: Counsel and Care, 1997.
- Klinger, Judith Lannefeld; Howard A. Rusk. Institute of Rehabilitation Medicine Mealtime manual for people with disabilities and the aging. Thorofare, NJ: Slack Inc., 1997.
- Baycrest Centre for Geriatric Care Eating assistance: encouraging participation. Toronto, ON: Baycrest Centre for Geriatric Care, 1996.
- Malone, Lesley; University of Stirling. Dementia Services Development Centre Mealtimes and dementia. Stirling, Scotland: University of Stirling, 1996.
- Nursing and Midwifery Practice Development Unit. Best Practice Statement: Nutrition for Physically Frail Older People. NMPDU: Edinburgh, Scotland.
Prepared by Lester Rosenzweig, MS, RD, Associate Director
National Policy and Resource Center on Nutrition and Aging