Individualized or “person-centered” care is a strong trend in senior living. Nutrition is a cornerstone of that individualized care. In a person-based setup, nurses and dietitians look at such things as a resident’s nutritional needs, oral function, food preferences, ailments and any sensory or physical impairments. Chefs develop the types of finger foods and/or purées that will work for that resident. This type of individual attention can especially make a difference for a senior who is struggling with dementia.
Morrison has developed a comprehensive program, Dignified Dining, which touches on everything from the environment where meals are served to utensils that can reduce confusion to the type of food that can best nourish those seniors living with dementia and other issues.
“When we approach senior dining, we try to be a thought leader by taking a holistic approach,” says Joe Gorman, division president for Morrison Community Living.
Here are five ways Morrison managers, dietitians, chefs and culinary associates are making dining a dignified, nourishing experience:
-Be more innovative with purées: While fresh produce, whole grains and lean proteins are the go-to for Morrison’s healthy menu engineering for regular menu items, the team wanted to make sure the purée menu received just as much thought. The plates coming out of Morrison’s purée program more closely resemble those of a trendy restaurant, at least in philosophy.
“We put an emphasis on a beautiful presentation. We think of traditional cooking methods that produce food that’s the desired texture, like poaching, steaming and braising,” says John Rifkin, senior corporate executive chef with Morrison Community Living.
Those cooking methods also add tons of flavor and allow the kitchen to use less processed foods, focusing more on herbs and vegetables, Rifkin points out, adding that presentation is just as important as flavor.
“We approach plating as deconstructing a dish for a lot of items,” Rifkin says. “For example, ravioli. How would I serve this in a restaurant if I wanted to present it in a really different way? Maybe puréed pasta is arranged on the plate artfully alongside a tomato purée and blended basil and olive oil on the side.”
-Pay attention to how seniors respond to the food:
“Dementia care is a hot button issue overall in healthcare,” says Jessica Shyu, MS, RD, senior director of nutrition and wellness for Morrison Community Living. “We care for them, but sometimes they can’t communicate to us with words. So we learn from their behavior and body languages. One-on-one care could eliminate some of the need for placing people on antipsychotic drugs.”
“You want to notice a resident’s behavioral changes: Are they agitated? Are they more engaged? Are they losing weight? Are they gaining weight?” Gorman says. “And sleep patterns are linked to nutrition.”
This is where communication comes in. Making sure the night staff knows what went on during the day is a simple step that can go a long way.
-Improve communication within the team: Maureen Janowski, director of clinical support for Morrison, recently served on the advisory board for a research paper on nutrition and dementia commissioned by Morrison’s parent company, Compass, and Alzheimer’s Disease International.
She was pleased to see a lot of the recommendations in the report were already standard practice for the Morrison Community Living’s clinical team, reaffirming that they’re on the right track. Some of the other key takeaways from the research paper were incorporated into the Dignified Dining Program. The bottom line: those who are successfully providing dignified dining for seniors are always learning.
To that end, live-streaming cooking demos are available for regional chefs, and training kitchen staff is a continuing process.
Reconnecting food and memory
-Pay attention to the dining environment: Factors such as noise level, décor, lighting, furniture and silverware all make a difference in the dining experience, and there is research on what works and what doesn’t. Here are several items to be aware of, from Morrison’s dining environment checklist. Lighting: natural light, contrasting colors, mesh window screens, reducing glare for sun and overhead lights. Noise: no high-traffic pathways near resident seating areas, reducing equipment noise and kitchen noise, noise-absorbing materials like carpet, wall coverings, pads on tables, upholstered chairs. Tables: Solid-color linens, large handles on mugs, tables contrast at edges, cups not too heavy, color contrast between seats and floor.
-Take advantage of the connection between food and memory:
Connecting with others at mealtime can be tougher than just serving a senior in his bed (helping that person get up and dressed and down to a dining room). But the impact cannot be underestimated, Shyu says.
“Dining is a social occasion,” she says. “We want to use our dining program to reconnect residents with their food memory and enhance their quality of life.”