1. The art of Interviewing
Emily Hogue, RDN, LD
May 2015

2. Plan what you will do before you go Ask pertinent questions but be ready for questions you did not plan to be asked Follow up on the information you re given

3. Before you go Check to see what diet the resident is on
If the resident has been in the facility, Check to see what you are Currently sending (diet, likes/dislikes/supplements)
If the resident is on supplements or “extras” try to determine if he/she is taking the items
Ask nurse or CNA if it is ok to visit the resident, can the resident answer questions?
Take the diet list for all residents (the roommate of the resident you are visiting may have questions about their diet as well)
Is the resident on isolation?

4. The visit Knock on the door. This is their home/their space
Ask permission to come in
Identify yourself
Try to sit at eye level with the resident
Ask, “How are you doing with the food your get here?” This is an open ended question aimed at having the resident open up
Tell them what kind of diet they are on and what the diet means
Do they accept the diet? What if they say they are not going to eat without salt? What if they say they cannot drink thickened milk or eat “mushed up food”?

5. Complications to gaining information:
What if the resident does not speak English?
What if the resident is hard of hearing?
What if the resident is very confused?

6. The visit (continued)
Ask, “Do you have any problem chewing or swallowing?
If the resident has no teeth and claims to have no problem chewing, ask, “Would you be able to chew a piece of fried chicken breast, a piece of ham, or a pork chop?”
“Do you have your own teeth or dentures?” Do they have dentures, no teeth, many missing teeth, obvious dental problems, etc. If they say they have dentures but are not wearing the, ask if they wear the dentures to eat and if there are problems with the dentures. Many times we see residents whose dentures were left at home (some “wise” relative feared they would be lost) and the resident could eat much better if someone would bring the dentures from home

7. The visit (continued) Do family or friends bring in food
The visit (continued) Do family or friends bring in food? Does the resident go out to eat? Where do they go and what does the resident eat? Check around the room Are there snacks (are the snacks permitted on the resident’s diet?) Are there supplements still unopened/partly consumed? Is there a refrigerator?

8. The interview (continued)
“How is your appetite?”
“Do you have any food allergies” If they say they have a milk allergy, try to determine if this is a milk allergy or a lactose intolerance. Persons with lactose intolerance an frequently consume anything except milk to drink and ice cream. Using “acidophilus” with each meal that contains milk products opens many doors. If it is a true milk allergy, find out if they avoid anything with milk (pudding, gravy cheese, cornbread— the list can be very long). Ask if they use a milk substitute such as soy milk or SILK

9. The interview (continued)
If the person says they are gluten intolerant, this will entail many questions. Do not go out and buy a large quantity of gluten free products ( bread, cookies, cake, pancakes, etc.) until you determine which items the resident will actually eat. You may want to make some of the products in your kitchen but special equipment/and supplies will be needed A dedicated toaster is only a starting point for persons who are truly gluten intolerant. Get with your consultant dietitian ASAP!
If they say they don’t eat pork, be sure to ask about bacon, sausage, hot dogs, etc. For some reason, some people who avoid pork choose not to give up bacon or sausage “Go Figure!”

10. When to quit asking questions
By the time you ask all of the questions above, the resident may not want to go through a lengthy list of foods you serve. This may need to be reserved for another day. Use your professional judgement.
Before you leave, always ask, “Is there anything that you want me to mark on your tray card or tell the people in the kitchen?” This could be beverage preferences, need for someone to assist with setting up the tray, etc.
Always address anyone else in the room such as a roommate, sitter, etc. If there is another resident in the room, ask “Is everything ok with your food?” This is just a common courtesy and hopefully will not take a lot of time.
Tell the resident about alternative foods available, meal times, dining room service vs room service, etc.

11. Exit
Go over any facts that you have learned, “Ok lets see: you want coffee with all meals, don’t like cabbage or casseroles. Did I miss anything?”
Tell their resident when you will be back to review the longer list of food preferences. Be sure the resident and/or family knows what to do if there is a problem with their food
Discourage the resident from writing notes on the tray card (We all know what happens to tray cards)
Follow up on your visit. Enter information for the tray card
Be sure to check back within the time frame you promised
Follow up with nursing on any issues that may have come up (ie. Resident states they will not eat without salt or they state they will not drink fluids if the fluids are thickened)

12. The exit (continued) At least yearly, update food preferences
Quarterly, visit with residents on when their care plan is updated
Be sure to document your visit If the resident or family had complaints, how did you follow up?
If you updated food preferences document this
If the resident had unfounded complaints, document what you did.

13. Note: The above is not intended to be a script for resident visitation, but just a starting point for making the most of your time with residents. Urge residents and families to tell you anything that will help them with their food intake. Something like “Helping you eat better will help you get stronger or maintain your strength." It is our job to serve them and make them as happy as possible.

14. The end