Dining Practice Standards 101: Part 1 Contributed by Rose Hoenig, RD, CSG. LD, and Carol S. Casey, RD, CDN, LDN, SFPM, FSM Review Date 12/11 G-1752

Where did they come from? Why were they developed? What do they tell us? New Dining Practice Standards

On September 7, 2011, Pioneer Network announced a Food and Dining Clinical Standards Task Force; the Rothschild Regulatory Task Force finalized new Dining Practice Standards agreed to by 12 national clinical standard- setting associations. Pioneer Network Announces New Dining Practice Standards

What is Pioneer Network?

Formed in 1997, the Pioneer Network was formed by a small group of professionals in long- term care (LTC) to advocate for person- directed care. It called for a radical change in the culture of aging in LTC and elsewhere.

Pioneer Network’s Vision A focus on the Culture of Aging Remember this acronym: LASHM Making the culture Life Affirming Ensuring this culture is Satisfying Assuring this cultural environment is Humane Making certain that this culture is Meaningful L A S H M

Pioneer Network’s Commitment to Values and Principles These values and principles are the same principles we all MUST adopt and embrace, if we have not done so already Like Pioneer Network’s commitment to these values and principles, we MUST buy into these same values and principles…WHY? It is the HUMANE thing to do What are these values and principles?

Pioneer Network’s Values and Principles These values and principles are found at: A commitment to know each person Always remember each person can and does make a difference A guiding premise is that relationship is the fundamental building block of a transformed culture (Cont’d)

Pioneer Network’s Values and Principles Look at the person as a whole— respond to the individual’s spirit, as well as mind and body Even in the culture of aging, risk taking is a normal part of life Just as in good customer service, put the person before the task (Cont’d)

Pioneer Network’s Values and Principles We must realize that ALL are entitled to self-determination wherever they live It is important to realize we do not work in an institution, we work in a community— c ommunity is the antidote to institutionalization Always remember the Golden Rule: Do unto others as you would have them do unto you (Cont’d)

Pioneer Network’s Values and Principles It is imperative to promote growth and development for all We must shape and use the potential of the environment in all of its aspects:  Physical  Organizational  Psycho/social/spiritual (Cont’d)

Pioneer Network’s Values and Principles All stakeholders (employees, volunteers, and elders) need to practice self-examination, searching for new creativity and opportunities for doing better Recognizing that culture change and transformation are NOT destinations, but a journey, and always a work in progress, which creates a partnership aimed for L A S H M Life Affirmation, Satisfying, Humane, and Meaningful Culture in Any Environment

The Pioneer Network advocates and facilitates deep system change and transformation in our culture of aging Pioneer Network’s Mission

Which is achieved through... Creating communication bridges, networking, and learning opportunities Building and supporting relationships and community Identifying and promoting transformations in practice, services, public policy, and research Developing and providing access to resources and leadership Pioneer Network in Culture Change 35 E Wacker Drive, Suite 850, Chicago, IL

 Primary financial supporter: the Hulda B. and Maurice Rothschild Foundation  Founded by Hulda Rothschild, who had great interest in elderly life—Chicago based  She died in 1980 at age 102 years  Her will directed the money left—to advance the quality of life for the elderly population

  that supports the care of elders in settings where individual voices are heard Working Toward a Culture of an Aging Population  as well as ensuring that individual choices are respected The Pioneer Network is very effective with influencing policy makers and caregivers

Pioneer Network works with stakeholders to modify regulations to support new models of aging in LTC

National Life Safety Task Force Consumer Education Kits Training materials for nursing homes National benchmarking and outcomes analysis of culture change implementation Development of core competencies in culture change for nurses Pioneer Network’s Additional Initiatives

Recent Accomplishments Pioneer Network announced approval from the National Fire Protection Association (NFPA) of all of its submitted proposals from the National Long-term Care Life Safety Task Force: A Rothschild Regulatory Task Force— incorporated in the 2012 edition of NFPA 101® Life Safety Code®

Increase percent of wall/door areas for display of art and photos Remove barriers in nursing homes that prevent a homelike atmosphere Allow use of residential cooking equipment in homes of 24 residents or less Allow more movable functional furniture

Why are the dining standards important?

CMS reports that the most frequent questions and concerns that it receives focus on the physical environment and dining, as well as food-related issues

Pioneer Network, CMS, AHCA 2010 cosponsored National Symposium

Brought Together Diverse Stakeholders Nursing home industry staff Regulators Providers Researchers Registered dietitians Various health care professional organizations Vendors Advocates for culture change

Symposium Results Set of research papers commissioned Series of webinars to solicit input Food and Dining Clinical Standards Task Force formed to obtain evidence and consensus Developed Practice Standards and Current Thinking/Recommendations for more research

Twelve National Clinical Standard Setting Associations American Association for Long Term Care Nursing (AALTCN) American Association of Nurse Assessment Coordination (AANAC) Academy of Nutrition and Dietetics (AND) American Medical Directors Association (AMDA) American Occupational Therapy Association (AOTA) American Society of Consultant Pharmacists (ASCP) American Speech-Language-Hearing Association (ASHA) Dietary Managers Association (DMA) Gerontological Advanced Practice Nurses Association (GAPNA) Hartford Institute for Geriatric Nursing (HIGN) National Association of Directors of Nursing Administration in Long Term Care (NADONA/LTC) National Gerontological Nursing Association (NGNA)