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Dining With Dignity In Long-Term Care

09/08/2017 14:17 EDT | Updated 09/08/2017 14:17 EDT

When you think about an evening with friends and family do you think about the "dine and dash" type of dining or the "sit, relax, chat and enjoy" type of dining experience?

When you eat with family at home, which do you prefer? Do you like to "grab and go" or do you expect the family to sit and eat the meal that someone so lovingly prepared?

How do you define a "good" dining experience? If you were living in long-term care, what would you want and expect? What would make a "great" day for you?

And what do you think older adults expect? Many older adults in our society expected families to sit and eat together. The "dine and dash" or "grab and go" was not really considered to be the pleasurable or routine norm for daily dinners or special dining. In long-term care people eat together three times a day. Don't you think the "sit, relax, chat and enjoy" is the experience they deserve each day? There are many different types of experiences in dining. Let's explore.

Compare the dining experience of someone living in a memory care area of a retirement home to the experience in your local nursing home. Is it the same — or different? How? And WHY? Is there any reason that dining in nursing homes couldn't be as lovely as the experience in a retirement home?

The DementiAbility Methods focus on achieving the "look," "feel and "smell" of home in all aspects of daily life. The dining experience is an important part of the total experience. In long-term care people will dine together three times a day. What should that experience "look," "feel" and "smell" like? Should one have the option of contributing to that experience? Let's consider each experience separately.

The Smells of Home - and daily living - with meaning and purpose:

Let's begin with the "smell" of home. When LTC homes prepare meals away from the area where people eat (e.g. - in the kitchen on the first floor or basement of a multi-level home) there are often no smells to stimulate the appetite before the meal is served. The meal simply arrives. The anticipation of eating is as important to some people as the actual experience of eating. Since we may not be able to move the kitchen in a nursing home to the location where people eat, we need to think about how to create opportunities that will provide the smells of home in the areas where meals are served. A basic and simple solution includes using a crock pot or toasting a couple of pieces of cinnamon flavoured bread. If you use a crock pot, the residents can contribute to mealtime preparations and help with peeling the vegetables or fruits that will be cooked each day. This also adds meaning and purpose to daily living. If the crock pot is used in a home area, don't forget to lift the lid throughout the day, as you want to send the smells out into the spaces for all to enjoy. Some LTC homes make apple sauce, soups and barbeque sauces in their crock pots, and many staff note how they too have benefited from the smells of home.

The Look and "Feel" of Home:

The "look" of home should be "familiar". Long-term care homes need to consider who lives in their homes. Should we not consider décor that was familiar to them in their younger years? Although they may have liked modern design and décor, they may not remember their more recent preferences. To add to the "look" of home, consider using curtains on windows and table cloths with dishes in contrasting colours, as contrast works well for those with aging eyes. Since many people in LTC require memory supports, we should put name plates on the tables (about the size of a small 5" x 7" double sided picture frame) with a person's name facing their chair (so they can see where they sit) and their name on the other side to help the others at the table remember the names of those they are joining for dinner. This not only helps with memory loss; it adds to a feeling of belonging. Who wants to sit with strangers who don't know your name? Knowing someone's name creates an important feeling of human connection, because there is nothing more important than hearing someone use our name.

Polished meal attire:

Another important feature of the "look" of home in the dining experience is the look of the clothing protector, which in long-term care often looks like a "bib". I have been trying to implement dignified clothing covers since the 1970's. Why can't we design clothing protectors to look like clothing? I believe we do not need to sacrifice fashion for function. The Leacock Home in Orillia has created clothing protectors for men using the front of old dress shirts (with arms removed and flannel on the back), and secured by Velcro at the neck. The women wear a large scarf-like cover that looks like a fancy dress. This is truly an example of dining with dignity.

When you think about dining with dignity, be sure to create a home-like environment that includes meal preparations, the anticipation of eating that comes from the smells of food, a sense of belonging through use of names, the dignity of dining with a familiar "look" (thus eliminating the "bib" look that is so commonly seen in LTC) and a room that provides the look one would enjoy in a fine dining room environment. Bon appetite!

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