Meal Plans

With states in the process of reopening, some businesses and restaurants are gradually welcoming guests. However, to protect the vulnerable elderly population in the long-term care sector, facilities are still deciding on how best to serve and protect them. There are many questions to be answered in the coming months. For example, what will the future of the resident dining experience look like once the green light is given to reopen? And how can we continue to provide nourishing meals and pleasant dining experiences for our residents?

Resident care facilities will likely need to continue multiple seating options at meal periods to accommodate more residents in dining areas. This also allows for proper social distancing and sanitation practices for infection control. While most dining rooms cannot return to normal seating arrangements at this time, facilities are able to utilize their own resources to make the most of the dining experience. They can continue to use the main dining area but should also look at utilizing other areas around the building for use as smaller dining areas. Create a small space for residents to enjoy a meal outside of their rooms, while continuing to adhere to social distancing guidelines.

Facility menus may need continuous review along with dietitians continuing to provide oversight and direction with menus. Changes may arise due to implementing emergency menus, product shortages, and staffing shortages. Additional changes can also include utilization of simplified recipes and removing more time-consuming items from the menu by using more ready-to-eat foods. Facilities can also add their own individualized touch by starting:

  • ‘Chef’s choice’ meal weekly
  • Mobile dessert or salad cart for delivering special items room by room, or from one dining area to another
  • Hydration and snack carts coordinated with activity department (puzzles, games, bingo)
  • Additional theme meals or specialty desserts
  • Utilize outdoor space for a barbeque or meal grilled out which allows residents to have a meal outside.

To maximize resident meal satisfaction, one should liberalize therapeutic diets whenever possible to ease stress on kitchen staff and optimize menu choices for resident enjoyment. This is also a great time to touch base with residents individually to review food preferences. Meal trays can also be used in a creative fashion by using special place mats (colored or those that have games or coloring options), adding daily/weekly menus on eye-catching paper or leaving notes from staff on trays.

The future of resident salad bars and buffets is uncertain. At this time, to eliminate the chance of potential contact contamination, spread of the virus, and potential for food waste, it is best to remove salad bars and buffet options. Staff can instead provide a more individualized experience on a condensed scale by offering a smaller selection of items daily. Reducing meal options allows for staff to pre-plate items before meals. This also allows items to be rotated daily/weekly to provide options and room for variance in ordering availability. Foods can be individually chosen by and provided to residents which then can be added to meal service trays no matter their current dining location. These options could be printed on colorful paper or on a disposable menu. Other technology such as a television, computer or tablet can be utilized for visual representation with staff assistance.

In order to ensure and prioritize the safety of residents and staff, food service staff should continue thorough cleaning and sanitizing practices. Food service staff should wear personal protective equipment (PPE) such as masks and gloves when serving residents. Proper glove usage and handwashing for both residents and staff will continue to be extremely important for infection control. Staff members providing feeding assistance to more than one resident at a time should comply with proper hand hygiene requirements.
More frequent cleaning and sanitizing will need to be performed on high touch areas. This may mean new cleaning schedules for all contact surfaces in the kitchen and dining room to ensure specific areas are addressed. Additional training for staff on proper procedures, product usage, and food safety may be required.

Each facility must follow their infection control policies regarding using disposables versus china for those with and without strict isolation precautions. Proper handling and washing of regular trays and dishware is extremely important to ensure complete sanitization.
Long term care facilities will need to continue to review their current policies and procedures to formulate the best action plan for their building and residents. They will also need to continue to adhere to Centers for Disease Control and Prevention (CDC) and state guidelines. Every facility can continue to provide individualized care and attention to maximize their resident’s enjoyment and interaction among others while striving to maintain safety for everyone.

References:
1. (2020). CMS Communal Dining Possibilities [Webinar]. Pandemic Micro Webinar Series. Retrieved from https://videos.anfponline.org/pandemic-micro-webinar-series-cms-communal-dining-possibilities
2. Cooley, Mary; Cooley, Tom; Hancock, Dexter; Shockey, Georgie; Shin, Mina. “COVID-19 Impact on the Healthcare Foodservice Industry – Predictions on what the Future Looks Like for Healthcare & Senior Dining Facilities.” Published May 13, 2020. Association for Healthcare Foodservice.
3. Fearnow, R., White, J., & Mazyck, S. (2020, March 17). Restrictions on Communal Dining for Long-Term Care Providers During COVID-19. Retrieved from https://www.quarles.com/publications/restrictions-on-communal-dining-for-long-term-care-providers-during-covid-19/
4. Linja, Sue. (2020, April 14). Menu Adaptations: Quick and creative menus and meal ideas during a pandemic [Webinar]. Retrieved from https://www.beckydorner.com/tips-resources/covid-19-webinar-series/
5. Long Term Care Facilities Guidance. (n.d.). Retrieved June 1, 2020, from https://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/coronavirus/long-term-care-guidance
6. Quiring, Suzanne. (2020, April 9). Going mobile with your meal service: Providing safe and appealing meals in post-acute care [Webinar]. Retrieved from https://www.beckydorner.com/tips-resources/covid-19-webinar-series/
7. Reily, Leah. (2020, May 27). Past, present & future state of kitchens in healthcare and senior dining [Webinar]. Retrieved from https://connect.healthcarefoodservice.org/resources/webinars