QUALITY IMPROVEMENT
the severity of the disease. “In cases of kidney disease, we tend to restrict protein, but many [older adults] are protein-depleted to begin with,” Patel said. “So, we tend to work with them based on their disease progression and their lab work. If they’re on dialysis, they have no restrictions as far as food is concerned.” However, it is important to monitor intake of sodium and potas- sium, which could build up in the body of a renal patient.
• Medication interactions. Grapefruit juice can cause interactions and changes in absorption rates with a wide range of medications, including statins, antihista- mines, and blood pressure medications. Natural black licorice can cause sodium retention, deplete potassium, and inter- fere with the effectiveness of the blood thinner Coumadin. Even leafy green vegetables can interfere with blood thin- ners when eaten in large amounts. Cer- tain medications and medical treatments can also cause changes in the sense of taste or appetite that may interfere with healthy eating.
• Modified texture/pureed. For residents who require pureed or mechanical soft foods, standard menu items can be altered to a suitable texture or thick- ness within the community kitchen or ordered in prepared versions. Me- chanically altered foods are available in forms that closely mimic the shape and appearance of the original food, which helps make them more appetizing.
• Food allergies/intolerances. Culinary staff should be made aware of residents’ food allergies or intolerances such as dairy or gluten. Since allergies can be immedi- ately life-threatening, it’s imperative that residents with food allergies receive the proper diet always.
• Other special needs. Numerous other factors can impact the ability of a res- ident to eat normally. These include issues such as reduced vision or hearing, problems with teeth or dentures, hand tremors, cognitive decline, depression, or even difficulty sitting up or reaching.
44 SENIOR LIVING EXECUTIVE MAY/JUNE 2018
SHOULD YOU HAVE A DIETITIAN ON STAFF?
Dietitians and certified nutrition specialists are indispensable members of corporate menu planning teams. They also provide valuable services at the community level, either as staff members or consultants. Whether an individual community needs one of these professionals on staff depends largely on the makeup of the resident population.
Registered dietitians are uniquely qualified to plan meals for residents with medical conditions. They are most often employed in skilled nursing and memory care environments. In those settings, the ongoing need for specialized dietary knowledge makes their presence imperative.
Vi employs dietitians and nutritionists on staff in its communities. “The advantage mostly is in our care center environment, where the residents may have more challenges and they may have more restrictions,” said Sandblom. “That’s where the registered dietitian or registered nutrition services manager would be involved to verify that the resident has the amount of calories they need and the food they’re supposed to be eating.”
In independent living and assisted living communities, dietitians can serve as consultants. The frequency of their visits would depend on the demand for their services.
Some residents will try to hide these issues rather than admit they’re having trouble. Residents should be thoroughly assessed when they move to a commu- nity and, if necessary, observed during mealtimes to determine the source of any difficulties. It can also be helpful to ask family members about any eating challenges they’ve noticed.
What’s trending? “The population is changing,” said Bouch- ard. “We’re getting a more sophisticated group that’s focused on health and well- ness.” He added that residents are request- ing more healthful options, including veg- etarian entrees such as Unidine’s popular homemade veggie burger and a chocolate cake made with beets. Technology is also enhancing senior living dining. The software application eMenuCHOICE presents diners with pho- tographs of more than 600 menu items along with written and audio descriptions, which
can be recorded in any language. “What we like to say is that if you have a lot of options but the residents really don’t know what they are, then it’s not really true choice,” said Matt Stenerson, eMenuCHOICE cofounder and CTO. The program also stores individual
dietary guidelines, allergy, and health in- formation for each resident, and integrates with electronic health records for real-time updating. It further identifies each diner by billing category and generates an appropri- ate monthly bill. The customizable program runs on any platform and can use a commu- nity’s existing tablets, PCs, and Macs. Senior nutrition is a complex process
that requires the involvement of everyone in the community, from culinary staff and dietitians to aides, nurses, residents, and family members. “Food service isn’t an island by itself,”
Bouchard said. “We have to work with everybody within the [community] to meet the needs of the residents.”
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
