Consumer Directed Care in Menus and Mealtimes

September 2019

Imagine you have gone from cooking what you like and eating at a time you want to eat, to having meals presented where there may be little or no choice, the mealtimes regimented and the consideration to your likes or dislikes non-existent. This is the harsh reality for many residents in our aged care homes.

Mealtimes should remain as a pleasure, an event to look forward to. Perhaps the food tastes nice, but you really have a yearning for something else. It may be about the lack of choice or a lack of flexibility that causes dissatisfaction.

What we are aiming for is to make the meals as tasty as possible, to have a choice of foods and flexibility in mealtimes. This is what Person-Centred Care is all about. The question is how we can do this within the current aged care model, with considerations of budget, equipment and staffing.

The Menu

The menu is the plan for what needs to be ordered, cooked and served. But even within the menu structure and meal selection there are ways more choice and flexibility can be incorporated. Providing two or more hot main meal choices at lunch and dinner, offering alternatives such as salads and sandwiches and access to other alternatives such as eggs and toasted sandwiches are already great initiatives that can be seen at many homes. However, it would be great to go beyond this with the following examples:

  • Breakfast buffets
  • Broader range of short order items beyond eggs and salad sandwiches
  • Adjustments made onsite if the meals on offer just don’t seem to suit the resident group
  • Access to greater range of condiments, use seasonings and even fresh herbs (from the garden).

Can this menu have more input from the residents or their representatives? Consider:

  • Having a food focus group or a menu selection committee.
  • Obtaining more meal suggestions via survey, meetings or ideas box
  • Increasing variety by including Theme Days, Take away nights? Restaurant nights? Cultural nights such as Italian, Spanish, Chinese nights
  • Welcoming recipes from residents, families and the staff.
  • Getting feedback about a meal straight after the meal
  • Asking some residents to be guest dish reviewers.

Access to food

Imagine the kitchen at home was locked at 5.30pm, you could make a cup of tea at 7pm, and then there is no easy access to food and hot drinks until 8am in the morning. It’s important that we can make food and drinks more accessible by ensuring:

• There are different mealtimes for different dining rooms. Residents can then choose when and where to attend.
• Having access to a range of food and drinks 24 hours a day
• Consider a clear policy around allowing residents ordering takeaway or using Uber eats.

Food preferences

Imagine, you don’t like tomato, and every day in your sandwiches you have to pick out the tomato. Perhaps your eyes are not so good, or your fine motor skills diminished and getting that tomato out is too hard. Not eating that sandwich may become the easiest option.

Consider the systems in place and how you tailor for likes and dislikes. When a resident has expressed a dislike for a certain item, has this been implemented. It is also important to be clear about what is offered instead rather than just be taken away.

Where to start?

Changing food service is a really big deal, for staff, management and residents. There is lots of things homes can do, and lots of ways to improve. Perhaps finding out from residents what is most important to them. Sometimes little things make a big difference and picking the right little things to do first can make for a quick win. Remember to communicate what you are doing and what you are trying to achieve. Then, evaluate the change and adjust as needed to continue to strive for improvements.

If you would like more information or would like assistance in implementing a menu that considers consumer direct care, please contact Leading Nutrition dietitians on 1300 712 722.