Survey protocols examine elements that enhance the quality of dining experience such as attractiveness of food, sound levels, and seating comfort.
There are many influences on appetite and comfort, and the Director of Nursing and the entire nursing home staff can contribute to developing a therapeutic dining environment. These efforts are best focused on decreasing the institutional influences on nutrition and increasing more homelike attributes and increasing quality of care.
On the matter of diets, The American Dietetic Association now recommends against restrictive diets for the elderly in long term care facilities.
They state that therapeutic diets or overly restrictive diets do not make sense for residents with poor intake. They recommend having a Dietician assess the risks versus benefits of therapeutic diets, and evaluate the need for therapeutic diets according to each resident’s individual medical condition, and needs and rights.
Offering as many choices as possible will increase the intake of residents.
Studies have shown residents especially prefer buffet style dining because of the presentation, freedom of choice, and the variety of choices. The studies found that looking at the food stimulated appetites, and residents ate more and gained more weight. Comprehensive admission assessments with interviews of the residents and family members will give information on food preferences and histories. Resident council meetings are an opportunity to hear requests, ideas, and complaints concerning meals.
A lot can be done to improve the nursing home dining room environment.
The temperature of the dining room should be adjusted to the comfort level of the residents. Noise should be at a minimum, and soft, pleasant music can be played in the background. Ideally the smells of the food being cooked will reach the dining room. Tables with nice tablecloths and pretty centerpieces will make the meal more pleasant.
The attitude of the staff at mealtimes has a big impact on the residents’ appetites.
Bad feelings and negativity are contagious. Negative comments from the staff about the food, such as “same old thing again” or “mystery meat” will certainly reduce a resident’s intake, whereas remarks like “that looks so good” or “this is making me really hungry” can only have a positive impact. Having enough staff to assist with meals is vital.
Feeding assistants can help to provide more staff at mealtimes. The meal should never seem rushed.
Promoting a therapeutic dining experience will increase the resident’s intake and happiness with meals. The impact of the environment on nutrition can not be overestimated.
Read more about topics of interest to the DON in long term care in the book Director of Nursing Book and in the book Nursing Policy for Long Term Care.