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Culture Change Best Practices:

Transforming the Dining Experience

Dining, food service, the way we offer meals—all of these aspects of food have been radically changed by the fact that nursing homes are traditionally modeled on a mini-hospital style of care delivery. In a hospital, the important aspect of food is nourishment—not enjoyment. Nursing homes inherited that focus on food. Culture Change asks us to bring enjoyment of food back into the dining experience.

homelike dining roomAgain, we must ask ourselves, as we look down at a tray of bland, tasteless, colorless, hospital-style food served on a tray—“Is this the way I would eat a meal in my own home?” Of course, the answer is no. We look forward to meals because they not only satisfy our bodies’ needs for nourishment they also appeal to our sense of taste, smell, sight and touch. Eating is a pleasurable experience. Dining services in culturally-transformed homes seek to bring all elements of pleasure and choice back to the residents.

Many homes early in their progress on the Culture Change journey have started their initial change with the type of foods they offer and the way they serve meals. Some of the initiatives that have been explored and adopted include:

  • Family-style dining (serving dishes with each course placed directly on the table; residents serve themselves)
  • All-hands dining (all levels of staff participate as wait staff in the dining rooms during the meals)
  • Buffet tables in the dining rooms (so that residents can order exactly what they want)
  • Steam tables taken room-to-room (eliminating tray service; residents are served on china directly in their rooms)
  • Crockpots, bread machines and blenders on the neighborhoods
  • Resident and staff family recipes multiplied to serve the entire house
  • Elimination of supplement shakes in favor of full-fat ice cream and fruit smoothies

Ultimately, the idea behind radically changing the way we offer meals in the nursing home comes from a desire to not only nourish, but to delight the senses as well. Outcomes from these initiatives have included decreases in weight loss, a reduction in supplement use, increased socialization, a reduction in food costs, elimination of complaints to the kitchen, and increased resident satisfaction.