Culture Change in Dining

Culture Change in Dining

MEALS AS AN EVENT
The Breakfast Clubs and other similar groups have allowed the reinventing of the dining service program in many facilities.   Now, where these programs have been started 80 percent of Residents choose to eat in thedining room or country style kitchens.

Residents select when they want to eat, what they would like from a larger selection of choices, and with whom they would like to eat. Even more residents eat dinner in the country kitchen: between 85 and 90 percent. They love the hot breakfasts, including eggs made-to-order and breads baked right in the country kitchen.

"The whole area smells delicious. Even having fresh toast makes a difference. The quality and quantity of food has greatly improved in long-term care facilities that embrace culture change. At some communities, dietary aides collaborate with residents to order the type and amount of food for their individual neighborhoods. This has led to greater food enjoyment for the residents and less food waste for providers.

Additionally, the warm and inviting environment encourages residents to hang out in the country kitchens, read a book and drink a beverage, or socialize. Family and friends are spending more time with their loved ones, and many visits are now planned around dining together, in contrast to the tray delivery functioning as a signal to leave.

HEALTHIER RESIDENTS
Nutrition standards tend to improve in resident-centered, homelike environments. Even when residents select the food they want, they tend to eat from all food groups and make healthier choices.More residents finish the meals they've selected, rather than picking at the food that has been served to them. Providers are wasting less food and dining services can use leftovers to make snacks.

Overall, providers note that their residents with dementia present fewer behavior problems because they are more relaxed and comfortable. Dimming capabilities of the lighting and large windows that offer connections to the outside also put the residents at ease.

STAFF SATISFACTION
The new dining room design solutions enable providers to be both more resident and team member focused. Previously, dining staff was removed from the residents, working behind closed doors assembling food trays to be delivered to residents' rooms at a specific time. Now, staff members are in the dining room interacting with residents.

Research indicates that staff members are developing relationships with residents and are more in tune with their needs. When a resident has a special request, the staff members now have the resources to accommodate it. At Hanna HealthCare Center, personal relationships have developed between staff and residents. The staff has a renewed sense of ownership, often saying "my residents" or "my neighborhood." It feels more like a home, a big family working together versus working at an institutional nursing home.

The change in the physical environment does force change in staff positions. At each of the communities evaluated, the staff members faced the greatest adjustment. Most faciloities have to re-write staff positions to allow for greater job flow and flexibility without incurring the need for additional staff or staff hours. Often, it is initially a struggle to integrate the staff.

Dining, nursing, activity, housekeeping and administrative staffs create a team to best serve the residents. Hanna. All staff-including nursing, dining, housekeeping and management-participated in learning circles to discuss vision and values leading to culture change and a person-centered delivery of care. All staff members received sanitation and safe food handling classes. Subsequently, the staff in each neighborhood has become a team working together versus individual departments working in isolation. Staff satisfaction and productivity have both increased dramatically.

REALIZING BENEFITS
Although it may take time for even the residents to become accustomed to having more choices and control, once the new freedoms are realized, they, their families and caregivers, offer nothing but positive comments.

Varied work experiences for staff, increased appetites, less food waste, more socialization and a greater sense of self-worth-all evidence-based design concepts that indicate yes, the homelike environment created in today's retirement communities does indeed work.
  

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