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 that “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 implementation varies, there is a foundation of patient respect regarding their needs and wants that includes collaborative care, comfortable settings, full transparency, and family input.

Apply that foundation to food services. Consider how you eat: What are you used to and what do you 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, alone or with friends as you prefer.
• The kitchen is never closed.
• You can choose from a variety of foods, rather than one set menu, take it or leave it.
• The presentation enhances the experience.

Offer a pleasant atmosphere by using flowers and playing music. How the food looks influences how it is perceived to taste and how much it is enjoyed, so food should look 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. Perhaps residents can order from menus placed at every table as employees take their orders.

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

Standards of Food Service

While having three set meals a day has long been standard, these meals may be supplemented by several small meals throughout the day depending on residents’ tastes and eating habits.

Some residents may have difficulty getting to the dining room and some may simply prefer to eat in their rooms. If so, consider a room-service mentality. Instead of breakfast at 7 a.m., breakfast might made available between 7 a.m. and 10 a.m. Snack carts could roam the halls to satisfy between-meal urges.

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

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

Menu Preparation

Marketing 101 says to 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 create a resident food and dining committee.

At resident intake, note all food preferences, food restrictions, and food allergies. But intake isn’t the end. A registered dietitian needs to be consulted to ensure the menu is nutritionally balanced. Input from the cooks can help shape expectations of what is reasonable to offer and determine what is within the operating budget of the facility.

Present the menu to residents at their resident council or food committee meeting and gather feedback. The 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.