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