Everyone knows eating the right foods and having good nutrition is an important part of leading a healthy life. For individuals in senior living or care communities, dining and getting appropriate nutrition can often serve up a host of challenges.
Residents or patients in these communities often become “picky” eaters. Food preferences can vary, depending on changes in their mood or routine, or simply because they might be having difficulty discerning colors and temperatures. Seniors with health challenges might also experience chewing and swallowing difficulties, alongside with problems holding cups or utensils.
To address the critical importance of food and nutrition, industry-leading communities such as StoneGate Senior Living supported communities are “freshening up” their approach by focusing on nutritious meals and elevating the dining experience to create a safe, stress-free, and enjoyable mealtime.
Getting ready for mealtime
“A predictable dining experience helps residents feel in control and stay connected to who they are at the core,” says Antoinette Holford, a registered dietician and StoneGate’s education and training manager. “Supportive dining in memory care is, first, about providing healthy meals and, second, about safeguarding a sense of self.”
“We make every effort to create and maintain a familiar routine. For senior care residents living with dementia – whether in a nursing home, SNF, assisted living, or rehabilitation center – regular mealtimes provide consistency, and that’s important to their dining success. If the routine is altered, confusion can set in, affecting their mood for hours.”
What’s on the menu?
Extra care is taken to make each meal flavorful and visually appealing. Heart-healthy selections use herbs and spices as primary seasonings and for those with chewing or swallowing challenges, nutritious, eye-pleasing pureed foods are freshly prepared.
Providing ample choice is also essential, and StoneGate Senior Living supported communities dining services offer a variety of meal options. Printed menus are available for those who can read, and for those with reading difficulties, plates of food are displayed for their easy selection. Along with regular mealtimes in the dining room, room service is available at any time.
Another key to a successful dining experience is having a person-centered approach. For residents
struggling with dementia, Holford says: “We assess each resident’s stage in the dementia journey and build dining services around their individual needs.”
Food aromas, sights, and sounds evoke memories that are hidden away in the brain. For example, a person with dementia may not be able to verbalize why the aroma of roast beef and gravy is comforting to them. But we can see by their response that it is. Food can be a mood changer, in the best of ways.
Staff and family members also work together to make food decisions. The resident’s or patient’s dining history is explored and preferences are taken into account. Holford tells the story of a resident who enjoyed fast food. Day after day, his family brought him a hamburger and French fries.
When the family took an extended vacation, the nutrition services manager noticed the resident stopped eating. “She asked area fast-food restaurants for some take-out containers with their logo. Each night, the staff prepared his meal and served it to him in a takeout box. His routine was restored, and his interest in eating returned!”
Setting the table
We like to mimic the family table and set the stage for interaction. For example, a bowl of salad and a basket of bread are put on the table to pass around family style. Sometimes it works, and sometimes it doesn’t. Something that happened four or five hours or maybe even a day earlier may affect the resident’s mood and response to meal participation, though they may not be able to define it. We strive to respond to changing behaviors with patience, flexibility, and encouragement.
Every effort is made to create a calm and relaxing experience. Diners are typically seated at tables of four to six. “They can sit wherever they like, but often choose the same seat and table. Sitting in the same place enables residents to have control,” Holford explains. “They’re in their spot, and they entirely own it. We also use square edges as opposed to round, because square lines clearly define space.”
Mealtime is typically a social event. “If the resident can’t verbally participate in a conversation, just being at the table can evoke a feel-good response. The experience of being in the presence of others is stimulating in the best of ways. Our goal is not only to provide nutritious meals but also to create a sense of connection and belonging.”
Lastly, Holford reminds that having a nutritious and enjoyable dining experience in senior care relies on carefully trained frontline staff. “These are the ones who sit with residents while they eat,” Holford says. “They’re the first to observe how needs may change. They see how much a resident is eating, what they are eating, and how they are interacting with their surroundings – and can recommend new approaches to food and environment.
Exercise is essential to keeping seniors healthy, active, and motivated. But getting them on board with a well-rounded exercise program can be a tall task. According to the Centers for Disease Control and Prevention, 28–34% of seniors ages 65–74, and 35–44% of seniors 75 years or older, are physically inactive. Senior living providers are looking for fresh approaches to engaging residents in fitness – with simple-to-implement group programs that meet individual needs.
Short-term rehabilitation, or “rehab,” centers provide critical medical follow-up for patients in their first days after a hospital stay. These facilities are key to ensuring a continued high level of care that helps patients regain health, strength, and mobility. They can mean the difference between a frustrating rebound to the hospital and a seamless return to home.
Recovery requires more than just top-tier clinical care. It also involves providing opportunities for purposeful activity and engagement. One best-practice innovation is “Wellness on Wheels,” a mobile concierge program offering a range of portable activities for residents and their families.
Many senior living communities are looking for ways to decrease the use of antipsychotic medications through nonpharma approaches. The Centers for Medicare and Medicaid Services (CMS) has set a national goal of reducing the use of antipsychotic medication in long-term care facilities by 15 percent by the end of 2019.
A viable alternative? Aromatherapy. CMS supports the use of aromatherapy as an “individualized, nonpharmacological intervention to help meet behavioral health needs.” Clinical studies point to promising results: aromatherapy programs have helped in reducing medications for pain, anxiety, and depression, as well as improving sleep and lowering fall rates.
Lillian, formerly an opera singer and today a resident living with dementia, likes to sing loudly. It’s her way of communicating. But it can be disruptive. To help her focus on other activities that feel familiar, staff in the community where she lives put together a “life engagement kit.”
An employee exodus continues to batter the senior living industry, with an average staff churn rate of 42 percent. Unhealthy, unhappy, and “unhinged” employees can lead to widespread fallout, from poor health outcomes and lower satisfaction for patients to higher costs and a tarnished reputation for senior care providers.
In a highly competitive senior care labor market, delivering a consistently positive experience for employees is a key differentiator. A viable way to attract and hold on to dedicated staff is through an employee wellness program– designed to enhance the physical, mental, and emotional wellbeing of those who care for residents.
Part 2: Celebrating Every Beat
As noted in our previous blog, February is American Heart Health Month, a 28-day celebration of heart health. To help seniors understand and avoid the risk factors for cardiac disease, Lifetime Wellness – a leading provider of wellness services to senior living facilities – is supporting its partner communities in conducting a February wellness campaign. The theme is “Celebrate Every Beat…Live a Heart-Healthy Life.”
Part 1: Meeting the Need
“Many believe that heart disease is a fact of life in our senior years. Yet we have plenty of ways to keep our hearts in great shape, at every age,” says Callie Whitwell, chief operating officer and founding partner at Lifetime Wellness. “Understanding how to best approach daily health is essential, and being in the know about a heart condition can alleviate anxiety.”
Yet surprisingly, just 3 percent of seniors have the foundational knowledge to monitor their personal health, follow care plans, and pursue healthy behaviors. “We work with senior living communities to help residents understand how they can put less stress on the heart,” says Whitwell.
Once upon a time, activity and recreation programs in senior communities were typically low priority. Yet as the senior population surges, and seniors seek to stay active as a way of life, today’s senior living providers are rethinking their offerings to include wellness and life enrichment programs. In expanding their focus, many are finding they can’t go it alone. They’re looking for trusted partners to extend in-house resources and design an engaging, person-centered experience.
The holidays are a time of joy and celebration. But for the 5.7 million Americans living with Alzheimer’s disease and related dementias (ADRD) – and their families – it can be a season of angst and isolation.
A groundbreaking program called Music & Memory™ has brought life-changing hope to people who suffer from ADRD, helping to trigger memories, build bridges, and improve quality of life. Launched in 2006 by Dan Cohen, the program took the spotlight with the 2014 documentary, “Alive Inside: A Story of Music & Memory,” and was recently endorsed by legendary singer-songwriter Carole King. With the therapeutic effects of personalized music, many people living with ADRD become more aware, animated, and “alive inside.”