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Our learning collaborative recently dived into the topic of dining and how to make it a more natural and homelike experience, akin to sitting around one’s own kitchen table with family or friends. The topic of dining is impossible to separate from a discussion of the power of food and the emotional impact that food rituals have on our own lives.

Think for a moment of your go-to comfort foods and how they make you feel. What comes to mind as you recall Nana’s homemade dessert or Mom’s comforting mac and cheese? (OK, sorry if I made you hungry!)

There’s no doubt that good food is good medicine. Yet, comforting, appealing, aromatic, appetizing, artful and colorful are not the words that institutional meals usually bring to mind. Likewise, there’s no positive, emotional association,  either. In fact, these meals may have little in common with the foods and experiences residents have enjoyed over a lifetime.

How can we change that? This was the challenge posed to our learning collaborative participants. Look at plate waste and supplement use, for example. We prepare food that goes into the trash can because it’s not eaten, and then we must offer expensive supplements in its place. Often, it’s a combination of factors that contributes to these undesirable outcomes. Dietary restrictions, texture alterations, holding times, and limited staff to help with mealtimes are all likely suspects in the problem of uneaten and wasted food.

However, it is possible to make dining a more homelike and positive experience for our residents. The video , “Dining With Friends”, effectively illustrates these possibilities (you can view this video for yourself at https://www.arc-ct.org/dining_with_friends_overview.php ).

Elements that set this dining experience apart from the ordinary include joint preparation of the meal by both staff and residents, encouraging staff to sit, eat and converse with residents at the table while using conversation prompter cards as necessary, the gathering of residents’ life stories so that mealtime conversation and the overall dining experience can be customized to lifelong preferences, the use of colorful and attractive dishware and “real” utensils, the serving of pureed foods that are artfully prepared to resemble the original source, providing lots of verbal or visual cueing throughout the meal to encourage independence, and providing hand-over-hand assistance, if needed. There are no babyish bibs in this dining room! Instead residents select from an array of colorful dining scarves, which discreetly protect clothing while preserving their dignity.

Our own group of change advocates brainstormed and discussed ways to improve the dining experience for their residents. One concept that particularly struck a chord was the idea of “all hands on deck” during mealtimes. This expression means that all staff members plan to participate in the meal service, not just the nursing assistants.

Other ideas included “decentralizing” food storage and preparation, so that snacks can be more readily available and microwaves, more accessible, and the expansion meal times so there is less need for residents or staff to rush and so that residents have more control over the time that they eat.

All agreed that meal time has a direct impact on the satisfaction level of residents, as well as on their health and well-being. It is imperative to nourish their souls, as well their bodies, through a pleasurable and positive dining experience.