Resident Centered Dining Dianne Buckley, Dietary Director Holy Trinity Eastern Orthodox Nursing & Rehabilitation Center, Worcester, MA Long Term Care Medicine – 2011  March 24-27, 2011  Tampa, Florida

Faculty Disclosures: Dianne Buckley has disclosed that she has no relevant financial relationships which would present a possible conflict of interest.

Learning Objectives: By the end of the session, participants will be able to: Identify the positive clinical and social outcomes that can be achieved with resident centered care. Identify if their facility is ready to embrace resident centered care philosophy. Create a plan to involve all disciplines in the process of achieving a resident centered dining program. Implement steps towards achieving this using a detailed work plan.

Culture Change = Resident Centered Care Residents are given the opportunity to make basic choices such as what they want to eat and when they want to eat it. We do not “wake” them to eat, they eat when they awaken, just like home. Sometimes those choices can be “AMA”… When they are…education, informed consent discussions, and documentation are the keys to maintaining regulatory compliance.

Sample Menu Ticket

Survey Says….. Greater resident satisfaction based on survey results… improved to 4.50 out of 5.00! ”Choices” increased by 9%...residents order off of menu, course by course. “Quality of Food” rating increased by 8%...toast and grilled cheese are a few of the items that are made to order and served immediately. Improved clinical outcomes… use of nutritional supplements decreased by 31% without further weight loss!

…Improved Satisfaction

Buffet Dining Cart Dietary Aide & C.N.A.

Return to “Normalcy” More meaningful social interaction between staff and residents… conversations occur. Meals became less “task-oriented” & more resident focused. Food is served to order with some items “prepared to order”, which contributes to maintaining temperatures. The dining rooms smell like bacon and toast at breakfast!! Diets were liberalized…contributing to increased intake. Family interactions changed positively, with families choosing for their loved ones, if they are not able to. Salt & pepper shakers were added to the Main Dining Room…unimaginable in an institutional setting.

“Change always comes bearing gifts.” ~ Price Pritchett Document identified areas needing change using Resident & Family Councils, Satisfaction Surveys, observations, trends, and anecdotal feedback. To change the paradigm and the “culture” of the organization…build a new box if necessary. Create a plan including all disciplines; don’t forget to include the residents. Ours was written in February 2006, updated as needed & still ongoing! Prepare for implementation by continually meeting, brainstorming, answering questions & training. Embrace the resistors…use their concerns to identify opportunities for improvement.

Things to consider……. Physical layout limitations and solutions, i.e. electrical, space, storage, work flow, etc… Disaster planning…what if the elevator is out of service, will equipment run on generator? What is the financial impact? Both initial capital expenses and long-term. Reallocation of resources and assignments will need to be reestablished and rewritten. Identify ongoing training, provide as needed. Dietary software compatibility and support? Regulatory compliance and food safety must remain as most important filter for elements.