Choice. Dignity. Self-determination. Relationships. Respect.
These are key principles in culture change conversations and represent values that we all know are important in daily living. But when it comes to the dining room, these virtues are often missing.
For decades, meal service has typically been done by tray service, pass-through window, or a stationary kitchen set-up. Staff take many steps to deliver meals. Items are often pre-poured or pre-plated by staff using preference lists because they just “know the resident.” Staff then simply set meals down in front of residents without really talking to them. This method is often referred to as restaurant-style serving, but if I went into a restaurant, and staff assumed they knew what I wanted, without asking, I wouldn’t leave a tip or return. Residents unfortunately don’t have this luxury, as this is now their home. Too many assumptions are made on behalf of the resident, and this is a fundamental problem in our industry.
Here are some easy and practical ideas on how to honor choice, increase variety, and set up self-directed dining, all which meet CMS regulations.
- Start an Enhanced Dining Committee or Learning Circle with family, residents, and staff to evaluate and recommend ways to improve the dining experience. The goal is to evaluate the dining experience for self-determination, décor, flow, and make suggestions as a team.
- Put management on a coffee serving rotation so they have a regular weekly presence in the dining room, not just passing through, but actually being present for the meal hour.
- Have serving staff circulate through the dining room and offer second helpings. Meal service should be at least one hour from start to finish.
- Make continental breakfast available from 6:30 am – 10 am, along with a hot breakfast option. A relaxed breakfast is becoming the industry standard.
- Send out an anonymous survey to get feedback about the dining experience from family, residents, and staff. You might be surprised what you learn!
- Show residents the menu choices on sample plates before food is plated, and then let them decide if and how much they would like to be served.
- Offer breakfast on demand where waffles, French toast, or omelets are made to order in the dining room with an action station.
- Have the cook wear a chef jacket, and equip the serving staff with crisp, clean serving aprons and name tags. It gives a professional appearance, and the residents love knowing and interacting with the people who are responsible for making their meals.
- Make salad plates in front of the resident directly from a mobile food cart. Offer a variety of choices of salad toppings.
- Stimulate their senses by plugging in a bread maker machine and filling the air with the aroma of fresh-baked bread.
- Allow for open seating so that residents have the flexibility to sit wherever they wish with the company they choose.
- Encourage staff to eat their meals in the dining room with the residents. To encourage socialization, some communities give discounted meals to employees who participate in this way.
- Turn off the TV and play music that's from the era of the residents (1920’s-1950’s); don't play "Top 40" simply because the staff enjoys it.
- Have a “Question of the Day” on the dining room table to help facilitate conversation (e.g., What was your first job? What was your favorite vacation and why?). Encourage staff to ask residents and each other this question.
- Use caution on how quickly employees clear the dining room to prevent residents from feeling rushed out of their space. Allow the residents to linger, and staff to find other tasks to do. Leave the dirty dish cart out of the dining room until all residents have left.
- Institutional gloves and hairnets look terrible. Instead, wash hands and use serving utensils, unless staff members are directly touching the food with their hands. Always follow food safety principles.
Summing It Up
On a daily basis, residents should have the flexibility to choose what, if, and how much they would like to eat and drink in their own home. It is our job as CDMs to provide nourishing and timely meals, but not to choose for residents.
How would you rate your community’s dining experience? Is your meal service system honoring a person-centered philosophy? What way are you currently doing your meal service and why?
Learn more and continue the conversation.
Take the dining experience quiz which only takes a few minutes to fill out. Afterwards, you'll learn tips and tricks on where you can improve and you'll also have the opportunity to coordinate a call with Suzanne to discuss your results.
If you missed us at ANFP '19, check out the products that we displayed in our booth by clicking here!
About Suzanne Quiring: Suzanne Quiring, RD, CDM, CFPP has worked in residential care for over 25 years and has her Continuing Care Administrator designation. She has assisted over 800 healthcare centers and improved their meal programs with tableside service. She is the inventor of the “SuzyQ Cart System” by Lakeside. She has spoken at conferences throughout North America and is passionate about self-directed dining.