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Culture Change and Dining Innovations in Long-Term Care
Culture change is making its way throughout nursing homes and other long-term care settings across the nation and one of the most exciting innovations in culture change is in the dietary department. Some people believe that the kitchen has been one of the most forgotten and underrated place within long-term care. But, not any more! Many facilities that implement person-centered care as a part of their culture change start in the kitchen because it can lead to significant improvements in the quality of dietary services. Everyone looks forward to great food and how food is served, and these changes are highly visible to residents, their families, and staff. Also, there are endless possibilities and opportunities for change in dietary.
Hippocrates made the connection between food and health over 2000 years ago. He said “Let food be your medicine”. Food is a very important part of health and in addition to its nourishing aspects, food has the power to heal and comfort people. Food is also a powerful symbol of nurturing, love and celebration. But, food has to be attractive and desired. It has to be served in ways that appeal to people. Uneaten food has no nutritional value and does nothing but go to waste. Remember, meals many times are often the highlight of our resident’s day.
One goal of making dietary changes is to bring in the concept of “home” as much as possible to the dinning experience. Think of your own homes. You can find and have a snack anytime you want. You can make a meal for yourself or for your entire family. You can drink what you want when you want. You can put on a fresh pot of coffee, make tea, have a glass of ice water or whatever else you wish. You can eat with your family, in front of the television, while reading, or chatting on the phone with friends. You make a grocery list, hang it on the refrigerator, anyone can add to it, and then you go shopping. Just as we choose foods to eat, resident councils choose their own menus. Ethnic food choices are also important to consider.
Another goal when making changes in dietary is to offer flexible meal times. In person-centered care, the point is to de-institutionalize meal times and the dining experience. To facilitate residents sleeping in later in the morning, we must develop systems to serve meals to our residents at the times they choose to eat. We will have to become more flexible in how we think about food service. And as residents come and go we may have to further tweak our dining services. Many long-term care facilities have decided to implement flexible meal schedules such as the following: breakfast will be offered between 7:30am to 9:30am weekdays and maybe slightly later on the weekends; lunch will be served between 11:30am and 1:30pm; and dinner will be served between 4:30pm (for the “early birds”) until 6:30pm for those who prefer it later. Flexible meal times offers choice and freedom to residents and simply makes the meal experience better, because they can choose when they prefer to eat.
Another goal of change in dietary services is to be innovative and creative in how food is served. Some of the more common dinning styles utilized in long-term care facilities include buffet-style dinning, restaurant-style dinning, 24-hour room service, and open access to food. These styles offer more choice to residents and can make meal times more enjoyable. Buffet-style dinning involves a hot steam table in a central area (dinning room) or placed in multiple sites within the facility (i.e. on each unit or wing). Many facilities have indicated that the buffet works very well for breakfast. Restaurant-style dinning can be used in the main dinning room and those employees working in the dinning room can wear chef coats and black pants, to create a restaurant atmosphere. A restaurant-style menu is placed on each table and residents order whatever they wish from it. The menu can be changed once a month, quarterly or seasonally. Many facilities have always offered room service, but perhaps never called it “room service” and indicated that it was available 24-hours a day. This is a nice feature for residents who are up at night and prefer to sleep throughout the day. It is also a nice option for family visitors who work odd shifts and visit their loved one during late evening hours. And finally, all residents, family and staff may have access to snacks 24-hours a day by creating or building small, kitchenette areas in the facility. And, don’t stock it with just healthy snacks. Stock it with what residents and families want.
Other innovations in dinning include a private dinning room for special occasions, dinning areas that have a warm and comfortable appearance, bread- and cookie-baking throughout the day to create a more homelike atmosphere and to stimulate the diet, replacing 4-top tables with larger dinning room tables that seat 8 or more people, natural lighting or attractive lighting, salt and pepper shakers, hot sauce, and sugar bowls placed on each table, and kitchenettes complete with microwaves, small refrigerators, coffee pots, and storage space for snacks.
Dietary services are important in long-term care and culture change is providing great ideas concerning how to become more innovative and creative with food and how it is served. Food is vital to life and the kinds of food and how it is served should enhance the quality of life for residents in long-term care.
James H. Collins, Ph.D.
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Person Centered Care – From An Institution To A Home
Recently, person-centered care in nursing homes has been receiving a great amount of attention. Organizations have developed with the sole purpose of advancing the philosophy and approaches of this model of care. More nursing homes have undergone culture change by using a person-centered approach. And, there is an increasing amount of publications written about person-centered care, person-first care, patient-centered care and resident-centered care in nursing homes. Although the philosophy behind this care model is not new, some of the specific approaches and methods used in nursing homes today are rather new and very exciting. It takes a total commitment, from the administration to floor staff, to make person-centered care work. If there has been some hesitancy in implementing this type of care in your facility, its time to get excited about the best way of delivering the most highly individualized care there is. And, yes, you can do it!
First of all, leadership must believe in the person-centered model of care. This is no easy task for some administrators and directors of nursing, who have been used to more traditional forms of care. It involves more than prettying up the facility with more home-like creature comforts. It is a philosophy of care that truly puts the resident in the center of the care process. Routines, schedules and tasks become secondary to the needs, desires and pace of the resident.
Second, leadership must get all employees on board with this type of thinking. Nursing, social services, activities, dietary, housekeeping and laundry, and therapies must be educated and shown the benefits of this kind of care in order to believe that it can and will work in their facility. Skilled nursing homes have traditionally provided institutionalized care under the old medical model that places medication passes, treatments, dinning schedules, and pre-scheduled activities before the needs of the resident. Leadership must emphasize that person-centered care essentially turns this old model of care upside down.
Third, leadership must get residents and families involved in designing, customizing and implementing person-centered care through active participation in one-on-one discussions, resident council meetings, and family focus groups. Administration and staff cannot make all the decisions that go into care without critical input from those they care for. Residents provide important information concerning care issues such as when they like to wake up in the morning and when they like to go to bed, what they like to eat and when they would like to eat, preference of a bath, shower, or some other bathing experience, preference of caregiver, and where they would like to live in the facility. Families offer details on their loved ones history, likes and dislikes, religious and spiritual preferences, past occupations and careers, and hobbies. All of this input helps staff to create a more unique and individualized resident-centered care environment and experience.
Fourth, leadership gathers all of the ideas and information they have collected from residents, families, and staff and rolls out their special version of person-centered care in their building. Their model of care may include breaking down long hospital-like hallways and corridors (which are very common in many nursing homes) into smaller neighborhoods or communities of 6 to 8 residents. They may wish to have caregivers assign themselves to each neighborhood and provide consistent assignments. They may want to provide cross-training for nursing assistants in activities and housekeeping and create a new position: the person-centered specialist. They may endorse natural waking and retiring, liberalized diets, easy access to outdoors, and spontaneous activities 24 hours a day. These are just a few ideas that facilities can include in their journey through person-centered care.
Last, all employees must feel person-centered care in their hearts. This is where real care from anyway. It can also be where true culture change comes from, turning their once traditional and institutional facility into a person-centered home where residents want to live, families want to visit and staff want to work. Employees must also understand something else very important about person-centered care: it is not an end unto itself. Instead, it is a process, a ongoing journey, and one in which mistakes will be made and processes changed in order to constantly improve not only the quality of care in nursing homes, but the quality of life itself.
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Berufsbegleitendes Studium an der Steinbeis Business Academy (SBA)
Mit rund 1.800 Studierenden ist die Steinbeis Business Academy (SBA) die größte Business School der privaten Steinbeis-Hochschule Berlin. Die SBA bietet berufsbegleitende Bachelor- und Masterstudiengänge mit dem Schwerpunkt Business Management an. Fach- und Führungskräfte aus dem Gesundheits- und Sozialwesen, der Industrie, dem Dienstleistungssektor, Handel, Handwerk, Sicherheitswesen, Tourismus, und Product Engineering bilden sich an den über 30 Seminarorten bundesweit fort. Ist ihr Interesse geweckt? Dann besuchen sie uns doch unter: www.steinbeis-academy.de
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City of Munich, Germany – International Business School – Graduate/MBA – European University
euruni.edu – http The dynamic cultural and business environment in Munich offers an excellent backdrop for international students pursuing business studies. Munich is consistently voted the most attractive city in Germany and one of the top 5 worldwide. European University Munich; English-speaking business school in Germany that offers flexible business study programs at undergraduate/BBA/Bachelor and graduate/MBA/Master degree levels.
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Pune University
Pune University is one of India’s leading universities, located in the north-western part of Pune. It was established under Poona University Act, passed by the Bombay legislature on 10th February 1948 and later founded in 1949. Mr. M.R. Jayakar was the first vice-chancellor of the Pune University.
The University of Pune is spread over 400 acres of campus and involving around 46 academic departments. The location of the university has the historical significance. Some events of Battle of Khadki took place in the university area. The present day Main Building was built-in 1864 and known as the Governor’s House.
Pune is the main educational center in Maharashtra. Numerous students from every corner of India come to Pune for their further education. It is quite safe and peaceful city in comparison to other educational centres in India. The Pune city houses many renowned institutes and colleges. Pune University is one of the supreme and popular educational centres in the city. It offers the courses in variety of areas including Science, Commerce, Arts, Languages and Management Studies.
About University:
University of Pune is popularly known as ‘Oxford of the East’. It has near about 118 documented research institutes and 269 affiliated colleges offering graduate and under-graduate courses.
Different Courses:
University offers various graduate and post-graduate courses like Bachelor’s, Master’s and Doctoral programs in Science, Arts, Commerce, Languages and Management Studies. Students desiring admissions for various courses have to clear the corresponding entrance tests in the particular subjects.
Management Science Department:
Department of Management Sciences (PUMBA) is one of the best and foremost business schools in India. The business programs are available in marketing, finance, IT, biotechnology, systems, human resource, etc. There are well equipped foreign language departments for languages like German, French, Spanish and Japanese.
Other Departments:
There are in all 46 departments in the university conducting professional and non-professional courses. The list of some major departments is provided below:
* Department of Geography (DOG)
* Department of Chemistry (DOC)
* Department of Microbiology (DOM)
* Department of Biotechnology
* Environmental Science Department
* Computer Science Department (PUCSD)
* Department of Physics (DoP) – 1952
* Department of Electronic Science
* Department of Communication and Journalism
* Department of Zoology
* Department of StatisticsAccommodation:
The Pune University provides good accommodation facilities to the students. There is a provision of hostel for students in the University. Well stocked library with plenty of book regarding various subjects are made available for students. University also offers different scholarships to the bright students. Seminars and conferences regarding different topics and career guidance are regularly being conducted in the university.
Accreditation or Recognition:
1. University Grants Commission, India (UGC) – 2005
2. National Assessment and Accreditation Council (NAAC)
3. Bar Council of India (BCI)
4. Council Of Architecture (COA)Affiliations and Memberships:
1. Association of Indian Universities (AIU)
2. Medical Council of India (MCI)Address and Location:
University of Pune, Ganeshkhind,
Pune – 411 007, Maharashtra, India
Ph: +91 20 569 3868
+91 20 569 7388University of Pune is one of the most famous and recognized university in the world. Hope this article provides you sufficient information about this out-standing education centre.
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