Years ago, while eating a quick, free lunch of mushy spaghetti and tepid tomato sauce with coworkers in the dismal staff dining room, I decided I was DONE with facility food. I now pack a lunch box filled with delights from home. It’s not quick and it’s not free, but it nourishes me in a way that the other meals never did.

I spend a lot of time thinking about food every day, but with Thanksgiving feasts on our minds this week it’s a particularly good occasion to consider what and how we serve meals to residents and staff.

Almost all the residents in every place I’ve ever worked have complained to me about various aspects of the food: the taste, the texture, the temperature, the lack of variety, the provision of disliked items or those to which the resident was allergic, the callous way in which it was being served, the chaos in the dining room.

My co-workers and I have eaten on unsteady tables in windowless, overheated, undecorated staff cafeterias that smelled vaguely like the laundry room.  

In search of better, I visited the Culinary Coach booth in the LeadingAge Expo Hall last month where I spoke with Chef Shawn Boling. Clad in a chef’s hat and an orange uniform, he and dietitian nutritionist Courtney Christy enthused about their consulting program, which addresses all the problems mentioned above. Culinary Coach works with facilities to turn ordinary long-term care meal provision into gourmet menus and service — all while meeting dietary budgets.

Over the years I’ve come across other offerings designed to improve the dining experience of elders. These include pureed foods that are shaped to look like the items prior to pureeing, and weighted silverware to reduce difficulties caused by hand tremors. There are dishware sets crafted with high sides and color contrasts to make it easier for elders to eat independently, and creative menus of finger foods provided with the same goal in mind.

The Pioneer Network’s Dining with Dignity program has a resource library that includes guides for implementing improvements in this aspect of care. Many of them are free.

CMS has collaborated with the Pioneer Network and other organizations on an evidenced-based program that complies with regulations. This article details the New Dining Practice Standards and this video offers a 25-minute overview of the recommendations.  

The benefits

There are many reasons why it’s worthwhile to invest in improving residents’ dining experience.

From a customer experience perspective, a good meal, served with care, is the event residents enjoy most each day. Unpleasant food and service leads residents to feel dissatisfied and uncared for, even if other aspects of care are of high quality. Fully consumed meals aid healing and reduce food waste.

Revamping the staff dining room not only offers the chance to model the appropriate way to serve food, it sends the message that workers are valued and important. Many employees would prefer to purchase a tasty meal at work than to have a free but unpalatable one, thereby subsidizing the cost of changes.

“If it’s such a no-brainer,” my husband wanted to know when I told him the topic of the column, “why don’t they improve the food?”

“I have my theories,” I responded, outlining the ideas below.

Theory #1: Since the usual meal service has passed inspection, providers are loath to change something that “works.”

Theory #2: Facilities trying to cut costs are concerned that revamping the dietary service will be expensive. The reality is that there are start-up expenditures and then, once in place, the benefits outweigh the expenses.

Theory #3: Those in charge of decision-making aren’t eating the meals being offered.

The proposition

With that last in mind, I suggest that decision-makers wondering whether their meal service is “working” take the time to dine in the staff cafeteria.

Watch the manner in which the food is being served, take note of the décor, taste the items and consider their texture, presentation and temperature. Listen to the sounds in the cafeteria. Evaluate what message the environment is sending to the staff members.

Now, go up to the units and observe the experience of the residents. If you’re brave, have a seat and ask for a sample of puree.  

If you’ve enjoyed your dining, then congratulations, your food program is working! If not, perhaps one of the facility’s New Year’s Resolutions has just become clear.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is the Gold Medalist in the Blog-How To/Tips/Service category of the American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with over 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at