Activity Directors Rock!: dietary regulations

I was recently passed an interesting article from our instructor Kathy Hughes, ADC that I think we can all relate to. Nursing home food is often compared with hospital food and is rarely accused of being appetizing. However, the nationwide push to make care homes more person-centered has extended well beyond care and is now attempting changes in the dietary department. It may be hard for some to believe but prior to November 2016 family members weren’t allowed to bring outside food in. The value of sharing recognizable comfort food with a loved one in the throes of dementia could easily be recognized by the family, but couldn’t be executed until this all important CMS update in 2016 that was over 20 years in the making. According to the article:

The new and modified regulations explicitly state that menus at facilities participating in the Medicare and Medicaid programs must now reflect the religious, cultural, and ethnic needs of residents, be updated periodically, and undergo review by a dietician or nutrition professional (who, according to the new regulations, have higher certification requirements than in the previous iteration). Also, for the first time, nursing homes can officially grow their own food or buy it directly from local producers, and allow residents to eat food brought in by friends and family. Finally, meals and snacks can now be served whenever works best for the residents, not just at designated feeding times.

The changes these updates are making can be felt already in many homes, perhaps even yours. Rather than regular American staples day in and day out residents are now enjoying more ethnic foods being served right in their dining rooms. The ability to participate in CSA (community supported agriculture) programs opens a whole new way to plan activities for your community as well, providing pathways for field trips, vegetable, fruit and herb education, harvesting and preparation, increased health education and the lists goes on and on. Better food isn’t just about better taste and nostalgia either. Nutrition is critical in determining how one’s life will unfold particularly at this leg of life. Fresh and accessible food, from a variety of trustworthy sources increase intake in general and nutritional levels greatly. The article discusses many advantages to these CMS updates, but its central point remains that the boost in mental well-being received by these residents is really what counts. The ability to feel autonomous and to be reminded of the good times in life go a long way in contributing to joy. A care home should not feel like a jail and access to a variety of food and lifestyle experiences is a basic freedom.

The updates are a huge step in the right direction however there is a stark difference between policy change and implementation. Positive effects are being felt as are the negative effects that variety can have on an ever decreasing dietary budget. The article references some worst cases scenario numbers that come in at less than $1 per meal. Think about that. Staffing issues also remain a concern that block many attempts above and beyond the norm of how things have always been. Even still, these changes are good changes and they were a long time coming. It allows residents to remain in contact with food, which is such a cornerstone of all of our lives and interactions therein. It is true progress and I for one was fascinated to read the article. I grew up in an Activity Department because my Mom was an Activity Director and I can remember the food vividly. I really hadn’t realized that food could be or was regulated in that way and that dietary had such restrictive guidelines and budgets (even though I should have because my Mom’s best friend Debbie was the Dietary Manager and she complained about it constantly!). I am glad to see these changes going into place and it gives me great hope about the type of facilities we are all pushing for together. The future is certainly brighter….and tastier.

Article Referenced:
Nursing home food is getting better. But the journey is far from over.
by Jillian D' Onfro
Nov. 27, 2017

Read the Article

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Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. Activity Directors are the key to creating environments that we ourselves would be excited to live in. We envision facilities that feel like homes, not institutions. Facilities that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe providing the best education available, with the most talented teachers we can find, is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network.