Tina Kies

With two eggs over easy, bacon, and a side of fresh fruit on her mind, she makes her way down to the main dining hall. Breakfast is her favorite time of day, so the wheels on her chair move a little faster in the morning hours. And while she could probably find her way down to the café blindfolded, on this day, the savory scents of ham and buttery hash browns guide her way.

She is a creature of habit, and while breakfast is served well beyond the hours she deems necessary, she arrives at her normal table as the clock chimes 7:30. A warm smile from this morning’s server welcomes her almost immediately, as a hot cup of coffee is placed in front of her.

“Would you like to hear this morning’s special or see a menu – or would you prefer your usual, Mrs. Anderson?”

Many things have changed since Arlington Health and Rehabilitation became her home a year ago, but on this day, her usual would do just fine.

Her usual reminds her of home; of her younger years, when she prepared breakfast for her late husband and children. Her usual offers a sense of belonging, knowing that her daily breakfast choice, as straightforward as it was, was unique to her.

She liked having the option to change her mind on a whim and order hot cereal and toast, if that were her preference. She liked that the kitchen knew her by name and how she liked her eggs prepared. But, mostly, she liked the freedom of choice; a freedom she feared lost when going home after rehab wasn’t an option.

Today, her usual would do just fine – but, she thought, maybe she’d try the special tomorrow.

“Food is the most primitive form of comfort.” -Sheilah Graham, 1904-1988

What is it about food that connects us, brings us heightened levels of satisfaction, and provides a greater sense of community?

Food is such a basic necessity, it would seem, but it dictates so much more than sustenance.  

In a nursing home setting, there’s a freedom that comes with having the ability to choose when and what you eat, how it’s prepared and where you consume it. There’s a freedom in having preferences in life and, further, having those preferences be heard no matter how small they may seem. For many seniors, the moment they arrive at a nursing home, whether it’s for short-term rehabilitation or for a more permanent stay, these freedoms disappear.

Not all nursing homes are set up to accommodate resident dining choices. The reasons differ from facility to facility but, most often, the big picture is overshadowed by the short-term financial and logistical burden of implementation.

Providing residents with a diversified choice at meal time implies that they’ll not only have increased menu options, but also an enhanced flexibility with meal schedules. This type of implementation can stretch a dietary team thin, decentralizing their dining service and usually requiring additional infrastructure, personnel training, and equipment.

“We can not change what we are not aware of, and once we are aware, we cannot help but change.” -Sheryl Sandberg

For the last decade or so, senior living communities have been noticing a change. As the nursing home demographic shifts alongside our country’s aging population, also have resident preferences. Today’s resident demands ambiance, better dining services, and, quite frankly, more choices.

It makes sense.

Today’s residents want choices. With more frequency, nursing homes across the country are beginning to embrace this shift, recognizing that a hospitality approach, one that is less institutional and recreates the comforts of home, will provide the most person-centered experience for their residents and align with government regulatory guidelines.

While once it was commonplace for meals to occur at set times and include pre-portioned options, more and more nursing home operators are letting residents’ voices be heard on what and when they eat.

Moreover, the trend toward restaurant-style dining – one that is by no means a new one for other senior care communities, such as assisted living and independent living facilities – is becoming noticed by more skilled nursing (SNF) operators.

“Food, like a loving touch or a glimpse of divine power, has that ability to comfort.” – Norman Kolpas

Tucked away in the small community of Arlington, WA, one progressive, family-owned SNF has doubled its bacon and fresh fruit order since transitioning to restaurant-style dining back in September 2016 – and for great reason.

“The residents are happier,” said Rodger Bowman, Food & Nutrition Services Director at Arlington Health and Rehabilitation. “It feels more like home to them.”

Now, with two years of restaurant-style dining under its belt, this SNF’s dining program operates as a well-oiled machine – but it hadn’t always been that way. It took just over a year for Bowman and his team to get to a point where all three meals would be served in this manner.

Bringing to the table, so to speak, more than 30 years of dietary service in healthcare settings and restaurant experience, Bowman had a vision – make the dining program the hub for social activity and resident engagement.

Success of this facility’s dining program took time.

“Our staff needed proper training,” continued Bowman. “Many of them had ‘institutional’ kitchen training, but not restaurant-style, short-order training. We handed out a lot of pans and flipped a lot of eggs in preparation for the breakfast roll-out.” The memory brought a smile to his demure face.

The team eased into menu service taking approximately three months to conclude the initial breakfast implementation, all while studying up on proper food etiquette and customer service training. It’s the dietary team that crosses over and acts as the food service team as well.

Bowman uses a 4-week cycle menu whereby, every month, residents provide feedback and suggestions for the next month’s menu offerings.

“The food we prepare here is for the residents,” added Bowman. “So, receiving regular feedback is imperative to our program’s success. As a result, we just don’t get food complaints which is really rare in this setting.”

This month, for example, the residents have spoken – and they want steak! Budgetary restraints don’t allow for filet mignon, so a suitable alternative must be found. Further, the goal is zero-waste, so proper food ordering and daily prep is vital to the program’s overall success and financial viability for the facility.

Today, nearly 70% of all breakfast meals at Arlington Health and Rehabilitation are short-ordered with approximately 50% of lunches and 30% of dinners being ordered off the menus.

The program’s success has proven worthy of a kitchen redesign and upgrade this coming winter to better suit short-order food prep. The kitchen will receive new counters, steam tables, prep space, refrigeration, sinks, and all new flooring – an expense, one can only assume, that deters other SNFs from implementing such a program at their facilities.

“My goal is to serve breakfast all day after the New Year,” concluded Bowman. “I love breakfast for dinner and I’m sure a lot of our residents will too.”

“Food is our common ground, a universal experience.” -James Bear

An enhanced overall sense of health, happiness, and satisfaction – all can be contributed to a pleasurable dining experience. Kind of a fun fact, isn’t it?

The reality is, food is the way to most of our hearts.

Restaurant-style dining appears to be a positive alternative to the traditional food service programs offered in SNF settings. By operating under the premise that high quality food and dining programs that encourage engagement and community are critical to meeting residents’ personal needs, nursing homes will benefit from higher resident and family member satisfaction. All this leads to the golden fruit – higher facility occupancy levels in a competitive marketplace.

As I wrap up this article, half-eaten cheese stick in-hand, one thing has been made clear. There’s a reason we gather around a table at Thanksgiving; a reason behind meal preparation being so important, if not the most stressed about focus of the upcoming holiday season.

This holiday season many of us will gather together over food. Enjoying a meal with others in a welcoming environment provides a sense of comfort and community that not much else can rival. Fulfillment of the senses, an ease of the mind, and peace in the heart – we all deserve this luxury regardless of where we call home, temporarily or otherwise.

Tina L. Kies is the founder of Chikara PR, a comprehensive public relations and content marketing agency. A nationally recognized and award-winning communicator, she has 20 years of professional industry experience, including five in the healthcare sector. For more information, visit chikarapr.com.