Culture turn and Dining Innovations in Long-Term Care

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Culture turn is development its way throughout nursing homes and other long-term care settings over the nation and one of the most absorbing innovations in culture turn is in the dietary department. Some people believe that the kitchen has been one of the most forgotten and underrated place within long-term care. But, not any more! Many facilities that implement person-centered care as a part of their culture turn start in the kitchen because it can lead to essential improvements in the potential of dietary services. Everyone looks forward to great food and how food is served, and these changes are extremely visible to residents, their families, and staff. Also, there are endless possibilities and opportunities for turn in dietary.

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Hippocrates made the connection between food and condition over 2000 years ago. He said "Let food be your medicine". Food is a very foremost part of condition and in expanding to its nourishing aspects, food has the power to heal and relax people. Food is also a fine seal of nurturing, love and celebration. But, food has to be absorbing and desired. It has to be served in ways that petition to people. Uneaten food has no nutritional value and does nothing but go to waste. Remember, meals many times are often the feature of our resident's day.

One goal of development dietary changes is to bring in the notion of "home" as much as possible to the dinning experience. Think of your own homes. You can find and have a snack anytime you want. You can make a meal for yourself or for your whole family. You can drink what you want when you want. You can put on a fresh pot of coffee, make tea, have a glass of ice water or anyone else you wish. You can eat with your family, in front of the television, while reading, or chatting on the phone with friends. You make a grocery list, hang it on the refrigerator, anyone can add to it, and then you go shopping. Just as we select foods to eat, resident councils select their own menus. Ethnic food choices are also foremost to consider.

Another goal when development changes in dietary is to offer flexible meal times. In person-centered care, the point is to de-institutionalize meal times and the dining experience. To facilitate residents sleeping in later in the morning, we must form systems to serve meals to our residents at the times they select to eat. We will have to become more flexible in how we think about food service. And as residents come and go we may have to further tweak our dining services. Many long-term care facilities have decided to implement flexible meal schedules such as the following: breakfast will be offered between 7:30am to 9:30am weekdays and maybe slightly later on the weekends; lunch will be served between 11:30am and 1:30pm; and dinner will be served between 4:30pm (for the "early birds") until 6:30pm for those who prefer it later. Flexible meal times offers selection and leisure to residents and plainly makes the meal feel better, because they can select when they prefer to eat.

Another goal of turn in dietary services is to be innovative and creative in how food is served. Some of the more common dinning styles utilized in long-term care facilities include buffet-style dinning, restaurant-style dinning, 24-hour room service, and open entrance to food. These styles offer more selection to residents and can make meal times more enjoyable. Buffet-style dinning involves a hot steam table in a central area (dinning room) or placed in multiple sites within the factory (i.e. On each unit or wing). Many facilities have indicated that the buffet works very well for breakfast. Restaurant-style dinning can be used in the main dinning room and those employees working in the dinning room can wear chef coats and black pants, to generate a restaurant atmosphere. A restaurant-style menu is placed on each table and residents order anyone they wish from it. The menu can be changed once a month, quarterly or seasonally. Many facilities have all the time offered room service, but perhaps never called it "room service" and indicated that it was available 24-hours a day. This is a nice feature for residents who are up at night and prefer to sleep throughout the day. It is also a nice selection for house visitors who work odd shifts and visit their loved one during late evening hours. And finally, all residents, house and staff may have entrance to snacks 24-hours a day by creating or construction small, kitchenette areas in the facility. And, don't stock it with just salutary snacks. Stock it with what residents and families want.

Other innovations in dinning include a secret dinning room for extra occasions, dinning areas that have a warm and comfortable appearance, bread- and cookie-baking throughout the day to generate a more homelike climate and to stimulate the diet, replacing 4-top tables with larger dinning room tables that seat 8 or more people, natural lighting or absorbing lighting, salt and pepper shakers, hot sauce, and sugar bowls placed on each table, and kitchenettes complete with microwaves, small refrigerators, coffee pots, and storage space for snacks.

Dietary services are foremost in long-term care and culture turn is providing great ideas concerning how to become more innovative and creative with food and how it is served. Food is vital to life and the kinds of food and how it is served should improve the potential of life for residents in long-term care.

James H. Collins, Ph.D.

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