Best Practices for Food Services in Senior Care Facilities

If there is one thing that contributes more to the quality of life for those living in senior living, it's the food. Food services in long-term care have come a long way. Resident-centered food service is an essential part of the culture change movement.

Let's look at some best practices.

Resident-centered meal service is no longer about serving the food on trays or adding tablecloths. The Centers for Medicare & Medicaid Services (CMS) has developed protocols and interpretive guidelines that state the "the facility must provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs, taking into consideration the preferences of each resident."

Keep in mind CMS regulates nursing homes and has little oversight of assisted living or independent living communities so you need to be the judge for a loved one.

The Importance of Person-Centered Care

First, let’s cover some of the basics of person-centered care (PCC). While implementing varies, there is foundation of patient respect regarding their needs and wants that includes the following elements collaborative care, comfortable settings, full transparency and family input.

You get the idea. Now apply that to food services. First, think about how you eat and some of the common things you are used to and expect. Perhaps harken back to high school. Then progress through adulthood and the fine dining experiences that you remember. Then apply them to your organization’s dining approach.

• You can sit wherever you want and with your friends if you prefer.
• The kitchen is never closed.
• You can choose from a variety of foods, not one set menu take it or leave it.
• Presentation goes a long way.

Offer a fine-dining atmosphere by using flowers, playing music. People eat with their eyes so how the food looks influences how it is perceived to taste and how much it is enjoyed. Food should be fresh, colorful, and appetizing. It should be presented beautifully on the plate with colorful garnishes.

Kitchen employees can wear formal kitchen outfits, such as chef’s hats, black pants, and chef’s double-breasted jackets. Residents order from menus placed at every table as employees take their orders.

Alternatively, offer a breakfast, lunch, or dinner buffet.

Standards of Food Service

Three set meals a day, while still standard, are being supplemented by several small meals throughout the day depending on residents’ taste and eating habits.

Not everyone can make it to the dining room and some may prefer to eat in their rooms. If so, consider a room-service mentality. Instead of breakfast at 7 a.m., breakfast is made available between 7 a.m. and 10 a.m. Snack carts can roam the halls to satisfy in-between urges. In other words, just like you might eat at home.

Making food available 24 hours a day is a huge step in assuring person-centered care. Some homes build small kitchenettes on each unit and have it stocked with food that residents would want to eat any time of the day, such as fresh fruit, vegetables, yogurt, ice cream, cookies, soups, deli meats, and bread, and other items can be kept in a small refrigerator that staff, family, and residents have access to throughout the day and night.

Have a coffee pot, microwave oven, and cupboards stocked with snacks such as microwave popcorn, chips, and pretzels, hot and cold cereals, pudding and gelatin.

Menu Preparation

Marketing 101 says go to the source when you want to know what someone wants. Start by creating a survey or questionnaire and spend a day or two researching the types of food that the residents want to eat. They may be in the mood for foods that they haven’t told anyone about, or their tastes may change. Then going forward, create a resident food and dining committee.

Of course, note on intake all food preferences, food restrictions, food allergies. But intake isn’t the end. A registered dietitian needs to be consulted to assure the menu is nutritionally balanced. Input from the cook can help couch expectations of what is reasonable to offer and that it is within the operating budget of the home.

Present the menu to residents at their resident council or food committee meeting and gather feedback. Family council can weigh in as well. In short, residents’ preferences, food acquisition, preparation, and the method of production are the factors that influence menu planning.

But It Starts at the Top

The best dietary ideas may never materialize unless leadership and management buy in and endorse resident-centered food services. Leaders create the context and empower employees to do the right thing.

Supplement with a positive attitude and lots of training and education, and you will have exceeded employee, resident, and family expectations.