Grind Dining: Beyond Finger Food

In nursing homes and senior assisted living facilities all over the country, meals for memory care residents - primarily those with neurological conditions like Alzheimer's and other related dementia - are often, for the sake of convenience, served easy-to-handle food like French fries, chicken nuggets, and pizza rolls.  Worse, if they are served the same meal the other residents in the facility eat, mealtime often becomes awkward, frustrating, and downright embarrassing for the resident, with food falling off of forks and spoons, rolling down the resident's clothes, and falling on the floor.

Chefs Sarah Gorham and Stone Morris aim to change that.

Read what Grind Dining is and what's next...    http://asccaresblog.com/2015/10/grind-dining-beyond-finger-food/

Original article published by A Superior Choice, LLC

Written by Angela Downs

The Best Ever Adaptive Dementia Eating Utensils

It seems as if almost every time I go to a pitch event there are one or two bright young entrepreneurs pitching the next great adaptive device and a good number of them have to do with eating.  It's a reasonable thing to tackle and these devices can help people.

The Wrong Approach... Often

See Grind Dining's approach in this article and how fingers are the new forks in Grind Dining:

http://seniorhousingforum.net/blog/2015/10/11/best-ever-adaptive-dementia-eating-utensils

Original article published by Senior Housing Forum

Written by Steve Moran

Appetite Stimulants for the Elderly: Insight into Reasons Behind Appetite Loss

Older adults sometimes experience a loss of appetite that may adversely affect their health.  Even foods they once loved no longer seem appealing.  Caregivers of seniors with this problem will certainly want to explore ways to stimulate their loved ones' appetites and get them eating now. Here's some great tips on how to stimulant the appetites of seniors. Warning: this post will make you hungry!  https://www.ourparents.com/care-topics/2015/04/10/appetite-stimulant-for-the-elderly-insight-into-reasons-behind-appetite-loss/

 

A Nurses Perspective of IDA

Since becoming a nurse, I have worked in a long term care facility as well as a skilled nursing and rehabilitation facility.  As a home health nurse I was in many skilled nursing, memory care, long term care and rehabilitation facilities to provide various skilled nursing functions.  One common thread among them all was the ongoing issue of how to manage meal time. 

Meal time in these facilities presents two immediate issues.  First, many of the residents designated as unable to feed themselves due to cognitive or physical limitations required a caregiver to feed each resident one at a time.  My observation has been for one caregiver to hand feed residents at one or two tables as quickly as possible.  So while the caregiver fed generally two residents at a time, the other residents sat and watched.  Sometimes an effort was made to keep the food warm, but most times it was not hot.  The second issue was the residents inability to chew or swallow food.  These residents were placed on a soft diet and given a plate of pureed pools and blobs, sat at the table wearing a bib, waiting to be spoon fed or struggled to feed themselves.

When families came at meal time it was generally a problem.  Many times the families would be angry that their loved one wasn't fed first; that the food was cold; disgusted by the pools and blobs of pureed foods; or their loved one was wearing a bib covered with the puree food.  It's hard to watch a person you love relegated to this kind of existence and I suppose many felt guiltier for putting their family member in this place when this reality hits them.  So the family member gets angry and they vent to the "person in charge", usually a nurse who is already overwhelmed.  This nurse has half of her/his staff in the dining room and the other half in patient rooms feeding those residents who cannot go to the dining room.  This means no one is available to answer the call bells or no one left to watch for that patient who is wandering and at risk for falling.  In a facility with hundreds of residents this is very scary.  Meal time is an unsafe time of day in skilled nursing and assisted living facilities.

How remarkable these two chefs saw this situation and developed a solution that is so simple.  The very first time I read about the Grind Dining concept, I laughed and cried at the same time!   If even half of the patients that are currently relegated to being spoon fed or placed on a pureed diet could utilize Grind Dining, it would tremendously impact the caregiver staffing problem at meal time and make everyone safer.  Beyond that, Grind Dining provides great tasting food that the residents will actually want to eat, so nutritional status is improved which directly contributes to better resident outcomes in this fragile population.  Most importantly, with the Grind Dining solution, residents will be able to feed themselves again, returning them to some sense of autonomy and independence.

Peter Thiel, creator of the Founders Fund, a San Francisco based venture capital fund, cautions readers in his book, "Zero to One" that innovation will not come from trying to reinvent a better Google or Microsoft, rather innovation and the next great start up will come from new ideas, fresh ideas on how to do things better.  Grind Dining meets that criterion.  I am excited for this company and for the many residents whose lives will be so vastly improved by their creative innovation.

Written by Nancy Page Forbes, MSN, RN, CCM - Grind Dining Advisory Board Member

 

Baby Boomers' Eating Habits Will Affect Your Business

As a Baby Boomer, I can appreciate companies scrambling to capture our aging and shifting demographic.  Innovation is going to rule to satisfy the "Boomers" eating habits and preferences.  Gone are the days of eating heavily processed foods (remember TV dinners?), Jello, and grilled ham and cheese sandwiches.  Let's meet the challenge and be a part of this culture change - Grind On for the "Boomers"!  Here's some food for thought on "Understanding Today's Aging Consumers for Tomorrow's Food Products"  http://hartbeat.hartman-group.com/article/508/A-Day-in-Food-Life-Understanding-Today-s-Aging-Consumers-for-Tomorrow-s-Food-Products

"How food evokes the feelings of childhood"

This is a very interesting read looking at food and the "Madeleine Effect". How when the author tastes the cake (Madeleine), soaked in a spoonful of tea, he experiences not a surge of memory but "an exquisite pleasure" and "all-powerful joy", taking him back to very comforting and fond childhood memories of spending time with his Aunt on Sunday mornings.

Wow! That's the power of food!!! I know when I smell bread baking it cues or prompts me to thinking and remembering me sitting at my Grandma Ida's kitchen table when I was just 3 or 4 years old. I can see her vividly dressed in her white-laced old fashioned apron making bread in her kitchen. I feel the anticipation of the bread baking in the oven and cooling on a rack until my Grandma can cut a piece for me to eat. A very loving and comforting memory evoked by just the smell of bread baking.

As foodservice providers in senior assisted living, we have the opportunity to evoke a resident's memory 3 times a day with meal service. Food is nourishment but it is also so much more. Food can prompt memories, just like photos, and contributes to the emotional and mental well-being of a resident. Check out this article, and take a journey to your childhood memories...  http://aeon.co/magazine/being-human/why-is-food-so-potent-in-evoking-the-memories-of-childhood/

What are you serving your memory care residents or patients on a "Finger Food" diet?

Senior Assisted Living caregivers know how challenging and frustrating meal service can be for memory care residents. Many of these residents have difficulty in eating, chewing, and using utensils. For those residents who must use their fingers to eat and are on "finger food" diets, my observations have been that often time they get meals that are limited in variety and nutritional value, such as fried chicken nuggets, fish sticks, and peanut butter and jelly sandwiches. A meal not much different you would serve your 3 year old son or daughter.

Worse yet, the memory care residents who are not eating will be put on a puree diet because they are not able to chew, swallow, or use utensils. Many of these residents must be spoon fed purees, similar to feeding a baby. It is a difficult dining experience for the resident, caregivers, and family members to watch and the resident looses all sense of independence and dignity.

Grind Dining has changed this sad type of dining experience for memory care residents. We have developed a creative and innovative solution for "finger foods." Grind Dining uses the process of grinding the cooked foods on that day's menu in a way that retains the texture, taste, and nutritional value of the meal that is easily accessible. More importantly, Grind Dining creates a sense of inclusion for mentally and physically challenged residents, as well as the families who come to visit them, by allowing these important residents to enjoy the same delicious foods as the rest of the community.

Grind Dining can also be an alternative bridge for some residents on pureed diets since the food is easy to chew, swallow, and may be eaten with fingers.

We would like to hear from you and get your feedback. What are you serving your memory care residents or patients on a "finger food" diet? Do these residents enjoy these meals? Are family members happy with the foods being served to their loved ones? Are you satisfied with the meal service provided to these residents with unique and complex dining needs?

Don't be shy - we would love to hear from you!

 

 

Some notes from the front line kitchens...

If it was just about grinding up food and putting it on a plate so people could eat it with their fingers, all you need is a commercial grinder and some plastic trays. But changing the kitchen culture in senior assisted living means more than just providing the minimal food service needs of your residents. You want them to enjoy their dining experience and you want their families to know they are getting great meals and great service.

Most importantly, you want your residents to be happy, to have their spirits lifted by a dining experience that allows them menu choices and the chance to eat without assistance.

That's our goal. And here's some of what we've learned so far in working with the facilities we serve:

  • Food service staff and caregivers are great at cooperating with us to refine our menu items and tailor them to the specific needs of their residents. We perform community taste panels for the entire staff before implementing the Grind Dining program, allowing everyone to taste the new menu items. The staff is happy to try something new and different and they respond to the positive feedback they get from the residents.
  • We've created customized Grind Dining menu extensions so memory care residents can enjoy the same delicious foods as everyone else in the community. Our Dining Director Finger Food Toolkit provides the management resources needed so the staff can easily carry out the program once we have finished training.
  • Memory care residents register over a 90 percent approval rating that the food was more accessible and intake increased by 30 percent for those eating Grind Dining meals. The additional nutrition improves the overall health and well being of some of the community's most vulnerable residents.
  • The "service standards" we employ make a huge difference in how our meals are enjoyed. Tablecloths, napkins, even aromatherapy, can enhance the dining experience. Try it. They'll like it.

Dementiavillage

Dementiavillage, a fascinating concept in Weesp, Holland that has designed a community for just those suffering from dementia. Its success has been built on the premise of "treating residents as normal people" and tailoring the village to the unique needs of these residents. Primarily designing an environment that supports the use of remaining skills of the resident rather than over-emphasizing what is lost. Cannot the same principles apply to dining? Grind Dining - Eating with Independence, Dignity, and Accessibility.

http://gizmodo.com/inside-an-amazing-village-designed-just-for-people-with-1526062373

"Everything the world could offer"

We got this mega-cool letter from one of the senior assisted living facilities we work with. It comes from the husband of a memory-impaired resident who noticed something special in his wife's attitude at the table, which had been lovingly set up by the staff to meet the service standards we suggested for the Grind Dining meal she and others were getting that day for lunch.

"As I stood at her side she looked up at me with this faint smile on her face and a look in her eyes of anticipation that only I would have know," he wrote. "She was saying, 'Look at me. Something good is going to happen.' I was taken aback as I didn't know anything special was about to happen. I opened my eyes to see what was really there and I saw it. She was sitting in front of a table covered in a neat, white-linen tablecloth with a crisp blue napkin folded in a pyramid. She was a very little girl again and she might have been with her dad at a tea party at the Waldorf in New York, or with her friends...she was happy and life was good."

He went on: "Who in their right mind would put a tablecloth and real napkins on the table in a place where they would never be appreciated? On this day, at this time, to this little girl, it was everything that the world could offer."

Wow! That's why we do this. That's Eating with IDA.

Stone and Sarah

How we got started…

“When you passionately believe in an idea that does not yet exist, then you CREATE it!”

Sarah and I had this idea that memory impaired and cognitively challenged residents in long-term care facilities deserve better choices when it comes to what they eat. Both of us had seen too many dining rooms where residents who had trouble eating were relegated to being served fried nuggets, spoon-fed pureed food, PB&J sandwiches that were torn apart by caregivers and other forms of finger food. All this while the residents at other tables had a choice of delicious-looking meals that they could eat on their own.

It just isn’t fair, we thought. And it doesn’t have to be that way.

The task of finding real dining alternatives for these residents was more daunting than we anticipated. The challenge, we discovered, wasn’t just in finding finger food – pigs-in-a-blanket, peanut butter-stuffed celery sticks, meatballs, those choices were always available. But creating something that was both nutritious, visually appealing and similar to what residents were getting on the traditional menu meant we had to rewrite the finger-food cookbook.

That’s when I remembered my Grandmother Bubbie’s tradition of using a food grinder to make gefilte fish, grinding and poaching fish into balls. If it worked on this time-honored Jewish culinary tradition, might it work on other, everyday meals?

So we employed Sarah’s grandmother’s old food grinder in our kitchen, added some attachments, and were off to the races. While experimenting with different meals, we heavily researched how cooked and ground meat was not only nutritious, but for many – especially the elderly – it was easier to chew and digest.

Plus, this was personal. Sarah’s mother had been living with dementia for four years. She passed away last summer at the age of 91, just as we completed our second pilot project at a Cobb County assisted living facility. 

Having worked in restaurants, hotels, and institutional settings, we knew the finished product would need to taste great AND but be served with a sense of flair. Memory care and cognitively impaired residents deserve the same presentation as other residents. We transformed selections from the main menu and created a palette for these meals that looked every bit as good – if not better – than what everybody else gets.

So began the Grind Dining experience. Much has been learned since we created those first few meals. We’ve put our technique to work in several locations and have put together a training program, toolkit and other professional services that can be used just about anywhere with any patient population.

We’ll be updating this blog as frequently as we can to let you know how that’s going and to present some interesting stories, research and other news that you might find useful. We invite you to share your experiences too. If you have a family member, friend or loved one who lives in a residential facility that might need our help, please let us know. And drop us a line on how you think all of us can do better at ensuring these folks can joyfully anticipate eating again.

One last note: We’re calling this eating with Ida because we both had close relatives with that name. So we borrowed it from them to stress Grind Dining’s strong belief that everyone should be able to dine with Independence, Dignity and Accessibility. 

Stone

Comment

Sarah E. Gorham

Chef Gorham holds a M.S. in Hospitality Management and Tourism and B.S. in Hotel and Restaurant Management from the University of Wisconsin-Stout She has 23 years of experience in hotels, restaurants, catering, and hospital foodservice with 15 years of management experience in this field. Positions held include executive chef, sous chef, food production manager, co-founder/chef, and culinary consultant. Former employers include Marriott Hotels and Resorts and Two Chefs, Inc. She opened 4 hotels for Marriott including the Marriott Marquis, Atlanta, Georgia. She also has 19 years in higher education as Associate Dean of Academic Affairs, Culinary Arts Department Chair and Chef Instructor.