Monday, July 27, 2009

Culture Change: Nursing Home Dining (Video 2:13 mins.)

Broadwater Health Center (above) in Montana has cooked-to-order breakfasts and multiple-entree noon and evening meals.

The Centers for Medicare and Medicaid Services (CMS) guidelines for state surveyors give detailed information on accessing nursing home compliance with regulations. Recently, the CMS added that nursing homes must support residents' preferences and other efforts to transform nursing homes into homelike environments. Changes mentioned are both environmental and resident-centered. They include activities such as dining, scheduling, bathing, sleeping, and many more beneficial changes that will advance reform in nursing homes.

A hospice volunteer in Detroit nursing homes, I am aware of the great need for reform. Across America, best practices in many nursing homes are far ahead of those in too many others. But improving nursing homes requires much more than environmental enhancements and enrichment activities. Changing the culture of nursing homes successfully requires major shifts in thinking with input from all levels of staff, residents, and community. Incentives encouraging achievement of new and shared goals are also effective. A helpful resource is the National Consumer Voice for Quality Long-Term Care. This organization was formerly the National Citizens' Coalition for Nursing Home Reform (NCCNHR).

In this video titled "Culture Change Dining - Restaurant Style,” we see how residents and staff of Ballard Healthcare have implemented improvements in the dining program.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
“Hospice and Nursing Homes Blog”


  1. Thanks for this video, Frances. Problems with the food and meal environment are some of the issues most frequently mentioned to me by residents during their psychotherapy sessions. I agree that many enhancements in nursing homes can occur even in facilities that haven't officially embraced culture change. One small, easily implementable, and free improvement in the dining experience would be to add a week to the food rotation schedule. When it's my turn to be in a nursing home, I'm only going to look at places with a four-week or more food rotation schedule.

    Eleanor Feldman Barbera, PhD

  2. Thanks for sharing your thoughts on the dining "drill" in many nursing homes, Eleanor. You sound like a good cook. lol