Ask the nursing expert

I am a director of nursing in a 130-bed facility with three nursing units and we would like to start a restorative dining program. We are privately owned so we do not have a contact person in our company to help us get started. Could you make some suggestions?

First, put together a committee with representatives from the following departments: Nursing (charge nurse and aides), SLP, social worker, Activities and Housekeeping. Someone who is interested in making a change with your current dining process needs to facilitate the committee. 

I suggest you pilot your new program on one of your nursing units for 30 to 60 days and then move it to the other units. Your administrators need to see the need for positive changes, because it will require a significant initial financial investment. 

The spirit of the program is to go to a trayless dining experience and a more homelike environment. Once the changeover is made, all three meals daily, including weekends, will be delivered with this spirit in mind. Areas to be addressed will include the environment in the dining room, menu, resident and family support, and staff support. 

Food, prepared in the kitchen, will come on steam tables. When dining room space is tight, consider leaving as many wheelchairs outside the dining room as possible. Assist residents with ambulation to regular chairs or transfer from wheelchairs to regular chairs. 

Remember, the breakfast meal is included in the program, so nurse aides and licensed staff will have to work together to get residents out of bed to eat in the dining room. Also, consider offering incentive rewards for staff who are the most creative in their approaches. I have seen wonderful restorative dining programs. Change is challenging in the beginning, but in the end is well worth the effort!