Culture Change and Dining Innovations in Long-Term Care

Culture change is making its way throughoutbetween 11:30am and 1:30pm; and dinner will be
nursing homes and other long-term care settingsserved between 4:30pm (for the "early birds")
across the nation and one of the most excitinguntil 6:30pm for those who prefer it later. Flexible
innovations in culture change is in the dietarymeal times offers choice and freedom to
department. Some people believe that the kitchenresidents and simply makes the meal experience
has been one of the most forgotten andbetter, because they can choose when they
underrated place within long-term care. But, notprefer to eat.
any more! Many facilities that implementAnother goal of change in dietary services is to
person-centered care as a part of their culturebe innovative and creative in how food is served.
change start in the kitchen because it can lead toSome of the more common dinning styles utilized
significant improvements in the quality of dietaryin long-term care facilities include buffet-style
services. Everyone looks forward to great fooddinning, restaurant-style dinning, 24-hour room
and how food is served, and these changes areservice, and open access to food. These styles
highly visible to residents, their families, and staff.offer more choice to residents and can make
Also, there are endless possibilities andmeal times more enjoyable. Buffet-style dinning
opportunities for change in dietary.involves a hot steam table in a central area
Hippocrates made the connection between food(dinning room) or placed in multiple sites within the
and health over 2000 years ago. He said "Letfacility (i.e. on each unit or wing). Many facilities
food be your medicine". Food is a very importanthave indicated that the buffet works very well
part of health and in addition to its nourishingfor breakfast. Restaurant-style dinning can be
aspects, food has the power to heal and comfortused in the main dinning room and those
people. Food is also a powerful symbol ofemployees working in the dinning room can wear
nurturing, love and celebration. But, food has to bechef coats and black pants, to create a
attractive and desired. It has to be served inrestaurant atmosphere. A restaurant-style menu
ways that appeal to people. Uneaten food has nois placed on each table and residents order
nutritional value and does nothing but go to waste.whatever they wish from it. The menu can be
Remember, meals many times are often thechanged once a month, quarterly or seasonally.
highlight of our resident's day.Many facilities have always offered room service,
One goal of making dietary changes is to bring inbut perhaps never called it "room service" and
the concept of "home" as much as possible to theindicated that it was available 24-hours a day. This
dinning experience. Think of your own homes. Youis a nice feature for residents who are up at night
can find and have a snack anytime you want. Youand prefer to sleep throughout the day. It is also
can make a meal for yourself or for your entirea nice option for family visitors who work odd
family. You can drink what you want when youshifts and visit their loved one during late evening
want. You can put on a fresh pot of coffee,hours. And finally, all residents, family and staff
make tea, have a glass of ice water or whatevermay have access to snacks 24-hours a day by
else you wish. You can eat with your family, increating or building small, kitchenette areas in the
front of the television, while reading, or chattingfacility. And, don't stock it with just healthy
on the phone with friends. You make a grocerysnacks. Stock it with what residents and families
list, hang it on the refrigerator, anyone can add towant.
it, and then you go shopping. Just as we chooseOther innovations in dinning include a private
foods to eat, resident councils choose their owndinning room for special occasions, dinning areas
menus. Ethnic food choices are also important tothat have a warm and comfortable appearance,
consider.bread- and cookie-baking throughout the day to
Another goal when making changes in dietary iscreate a more homelike atmosphere and to
to offer flexible meal times. In person-centeredstimulate the diet, replacing 4-top tables with
care, the point is to de-institutionalize meal timeslarger dinning room tables that seat 8 or more
and the dining experience. To facilitate residentspeople, natural lighting or attractive lighting, salt
sleeping in later in the morning, we must developand pepper shakers, hot sauce, and sugar bowls
systems to serve meals to our residents at theplaced on each table, and kitchenettes complete
times they choose to eat. We will have towith microwaves, small refrigerators, coffee pots,
become more flexible in how we think about foodand storage space for snacks.
service. And as residents come and go we mayDietary services are important in long-term care
have to further tweak our dining services. Manyand culture change is providing great ideas
long-term care facilities have decided toconcerning how to become more innovative and
implement flexible meal schedules such as thecreative with food and how it is served. Food is
following: breakfast will be offered betweenvital to life and the kinds of food and how it is
7:30am to 9:30am weekdays and maybe slightlyserved should enhance the quality of life for
later on the weekends; lunch will be servedresidents in long-term care.