Can anything be done to improve meal quality in nursing home?

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Can anything be done to improve meal quality in nursing home?

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My mom lives in a fairly upscale nursing home, at least good for Medicaid accepted ones. But the food is horrible. My mom has been to 4 nursing homes over rehab and long term and this is by far the worst. Some days she gets hamburgers for lunch and dinner several days in a row. Just yesterday I visited and the entire lunch was one piece of white bread, a plate of what looked like tomato soup with noodles thrown in it, it seriously looked half eaten there was barely anything there, and melon. Luckily I brought my mom pizza for lunch that day, but I really wish I took a picture of that meal. There was absolutely no protein and I don't see how that would fill anyone.

I keep my mom supplied with items to make sandwiches and meals as I can, but is there anything that can be done to improve the meal situation there? No protein is a common one and my mom has spoken to the dietitian several times. She is cognitively there and can voice her opinion just fine fortunately, but in this case nothing is working. I know nursing homes are notorious for bad food, but is there anything can I do or someone I can contact to help change the food?

Skilled Nursing Facility

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Is there a family council ? Complaints from more than one resident might be heard

My mom is in private pay memory care but at least three dinners a week have polish sausage as the protein which makes everyone sick

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I would address this immediately with the Administrator of the facility ( not the dietician).

If you see no corrective action in the course of one week, call the Ombudsman andwrite to the Joint Commision on Nursing Home Accreditation.

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A young schoolgirl in Scotland had considerable success taking photos of her school lunches and posting them online, with comments (good or bad).

Never mind the dietitian: where's the cook? Who's in charge of the actual catering service? I like MsMadge's idea of a collective voice, but I'd add - build a relationship with the person who plans and delivers the menu. It's quite possible that when you see what budget s/he is working with you'll have more sympathy with her/him; but also s/he might well respond to someone actually taking a constructive interest in the service. It's hard to take pride in your work if nobody ever says anything about it.

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My mother loves the food her nursing home serves. The menues look pretty healthy to me.

My aunts loved there food, too. Their nursing home was in another state.

Certainly not all care center food is bad. So sorry yours is!

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My mom is also in a nursing home. There are at least two choices for each meal, and my mother's dislikes (rice and cottage cheese) are noted electronically on her "reciept" for each meal. You need to address this situation with the folks at the top.

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Yes my mom is gluten and dairy free, which can cause problems. She has have small amounts but large amounts make her nauseous and sick. That is part of the issue I am sure. But this place doesn't even have a menu for them to pick from. And that meal I just saw shows me that she doesn't exaggerate how bad it is. She has also been in a lot of pain the last two weeks. She blames her mattress but I'm wondering if it's lack of protein. I am going to see her tomorrow, I will talk to the administrator then if I can't call her today. Thanks for that idea!

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The slice of white bread would seem to indicate that they are not even observing the gluten free requirement!

I would definitely address with the administrator.

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Each state has laws that require nursing homes to meet daily dietary nutritional standards. Laws also include trying to meet the dietary needs of each resident. I would visit during different meals times and photograph any meager meals that don't meet the state standards. Then take your complaints and photographic evidence to the nursing home ombudsman for the state.

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My mom is in LTC and they have restaurant style menus,she says food is very good.

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Cost + dietary restrictions is driving force. Sometimes families bring food. Mealtime is typically a social event, so in order for families to stay through mealtime, they often buy take-out food for themselves, then share with family member. Most feel bad eating someone's favorite food while family member is faced with tasteless, unattractive food. Depending upon individual restrictions, residents may or may not be able to special order things like French fries, onion rings, beverages of choice, hamburgers, dessert. Once or twice weekly a piece of cake may be served depending upon restrictions. I occasionally bring restricted/excluded items for spouse as enjoyable, more healthy foods of choice is a measurement of quality-of-life. Residents also bargain/trade with one another to exchange foods they like/dislike. The trading does get reported - I know because I attended a quarterly review and the trade issue was brought up. I just acted surprised and made no comment. The staff understands food issues and is graceful with families who serve preferred meals to their family member. Of course that's recorded in records too. Given dietary restrictions I do minimize the frequency of my contributions as it is a challenge to keep blood sugars and other things at a stable level. Reminds me of the old jail stories about families bringing food to their incarcerated kin.

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Meals should be about more than just shoveling in the calories. How sad. It's a problem in schools with our young people, and it's a problem in nursing homes with our old people.

I agree that you need to get more families involved in this problem to get any meaningful changes made to the menu. If you can, get other families to also document each meal a few times with both photographs as well as description of its components.

Food is expensive. Yet food waste is a huge problem in this country. Big grocery stores are trying to figure out how to save good food - produce and proteins especially - from the garbage. Perhaps the nursing home can make use of some of this food.

I believe this problem isn't for lack of resources but rather for lack of imagination and creativity. Good food doesn't have to be expensive. It's about caring enough to put in the time and energy to put together nutritious and appetizing meals.

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I'm going to take a somewhat contrary position and propose that management of nursing homes can extend beyond elder and diet specific issues and fall into the realm of good management, period. Restaurants don't survive by serving unappetizing and unhealthy food, nor are they able to tolerate ignoring customer's desires.

They're competitive; nursing homes if run more like a competitive business would be able to see the value of high standards across the board.

The facility I've taken Dad to 3 times for rehab falls in that category. When issues have arisen, I've gone to the DON or the Administrator, if staff isn't able to resolve the problem. I follow the chain of command and with the exception of a few problems last time (which I was unaware of as I wasn't able to visit as often), issues have been resolved satisfactorily.

This favorite rehab facility (also now expanding to long term care) hired a chef from one of the top upscale restaurants in the area. Menus were planned as if they were in fact operating a restaurant, but not at the level of lobster and prime rib offerings. There was a standard alternate menu with a good choice of items.

This facility also offered one free meal to one family member, a nice way to begin a relationship with the family as well as the elder.

Our first experience with rehab was when we were still novices. Food was generally good, always served hot in a manner hospitals use (warmth held into the food by covers, delivered on carts). If Mom didn't like the food, sometimes we supplemented with food from home, but if my recollection is correction the food staff could make accommodations for special diets.

I would first try to discuss the issue with management and find solutions at the facility level. If you go beyond and bring in an Ombudsman, it puts unwanted pressure and embarrassment on the management, which might in fact be willing to work with you and address the problem.

I like the "speak softly and carry a big stick" philosophy.

And remember, staff in these facilities are subject to criticism at perhaps a level seen only in hospitals. If attorneys, repair shops, restaurants and more found themselves explaining to oversight authorities, they might just tell the complaining person on the next visit that they're no longer handling his/her work, or the repair shop is booked for the next several weeks and can't accommodate them, or that the restaurant is already booked to capacity and it's suggested the complainer find another restaurant.

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GA is absolutely correct, address this with the facility before going outside to the Ombudsman.

But also remember that, simply knowing that there is an Ombudsman and Joint Commision out there is very empowering. At a point when my mom's care was substandard and there didn't seem to be anything anyone could do, asking the administrator why my next call shouldn't be the the Ombudsman and Joint Commision lit a fire like I'd never seen. Just keep it in your pocket.

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Take some photos, date them and show them to the administration. Politely point out that food does nor meet nutritional standards as well as not being appealing. Ask if you can speak to the person in charge of food services. See what results get first. Be polite of course.

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The State requires balanced meals for residents. My daughter says its really too much for some of her residents. But the facility must provide it even if resident hasn't eaten it. In most places, lunch is the largest meal. I would cpmplain to the state.

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Wouldn't it be better to complain to the NH first? Document the complaints and if there is no satisfactory response, then go to state authorities?

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We were just talking about this yesterday. My friend wanted to celebrate the Rams first game in LA, so we had a “football” party and brought everyone’s family member from their care facility. The biggest complaint is they dislike the food. I recently obtained my Dental Hygiene Alternative Practice license and will have an opportunity to go into the facilities and see for myself. I have been a cook and know the joy and pleasure a good meal brings. What else to they have? I plan to provide oral hygiene and promote all healthy living. I intend to intervene on the behalf of any patient who needs help. Wish me luck. By the way, I would be kind but approach the administration. I grew up very poor, and cooking on a tight budget is nothing new to me, I have done it.

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EBeach: The answer is yes. At my mother's NH, she was given a menu to pick from for the weeks' meals. She didn't realize it, though. She didn't like one meal, that was a Mexican dish. I had already been living there for 6 months. I went out to do a quick errand. My brother had arrived for his 7 DAY stint and he said when I got back in the room of the NH "this is cold." I said "it's supposed to be cold; it's salsa!"

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First, the meals have to meet the health department rules that say low fat and low salt. That alone can make meals seem a bit flat.
Second, special diets have to have written orders from an MD. You can't just ask for a diabetic meal. It has to be ordered by your doctor. Same with gluten free; it has to have a doctor's order. The health department makes the rules, facilities just follow them.

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At one time I was placed on a gluten and dairy free diet. The only bread I could have was rice bread as none of the gluten-free bread of today was even on the shelves, same with lactose free milk.

The diet was extremely tricky as it was amazing how many food items contain gluten and dairy. Just curious what type of items are you bringing your Mom to make sandwiches or is she making lettuce sandwiches with the lettuce wrapped around the meat or chicken?

My Dad is on a dairy free diet, so I supply his Assisted Living kitchen with his LACTAID® Milk and LACTAID® ice cream. Dad gets his fair share of protein with fish, chicken, eggs, nuts, green peas and beans. Sometimes lactose free yogurt. Dad has a menu style meal, thus sometimes he only orders soup and salad for lunch so he can have his heavier meal at supper.

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Cost and dietary restrictions are no excuse for producing bad food. Simple food is easy to cook and does not have to be complicated. Do kitchen staff ever taste the food they serve? If it does not taste good to them it will not taste good to the clients. Perhaps the kitchen needs better supervision. Please don't tell me that I don't know what I am talking about. I have cooked in University kitchens serving at least 200 students at a time. The food is always simple and attractive and taste good. If the clients refuse to eat the food, the food is wasted. Add a little love to your cooking, and take pride in what you do. If meals are included in the monthly fee, why should family pay extra to have to food brought in?

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The highlight of the day for nursing home patients can and should be the food!
My step father was recently in a nursing home inside a hospital. It is called a Skilled Nursing Facility...It is a great place. Medicaid was paying for his stay.

He was there for 2 years until his recent passing 3 weeks ago. He enjoyed the food until recently and wanted a change. I talked to the dietitian and found out that he could design his own menu, from the choices she provided, for the next 21 days in a row...all 3 meals. Then it would repeat. And if he didn't see what he wanted on the menu, he could write in what he wanted! The dietitian was helpful to the extreme to try to get him what he wanted. So the key is ... get to the dietitian, find out what is possible, and if that doesn't work, escalate to the next level! Don't just accept the status quo without investigating!

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Thanks for this advice. One of the nurses, a very nice one, said that the meals come in mostly frozen and that there is not much they can do. I don't know. Most residents don't seem to complain or at least they just accept it. I don't see why they can't do better. I will talk to whoever is in charge of food service.

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Plus a lot of the meals are taken out to "Meals on Wheels" customers.

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My mom's memory care has bizarre food especially considering many folks have trouble swallowing plus there's no choice - everyone gets the same thing - they gave polish sausage at least twice a week - yuck

I try to get her takeout from a family diner at least a couple if times a week - I have no idea was they served tonight as menu said chef's choice but mom had tummy trouble and her poor bedridden roommate was vomiting - I had to f fetch a nurse at midnight to help her

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MsMadge, It seems you have a serious problem with your nh. Have you spoken to the food service people?

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NH gets a good deal buying food in bulk.

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zythr, Nursing homes get about $5 a day from Medicaid, for all 3 meals. Plus they are required to serve low fat, low salt, low sugar items. Blah!! Yes, the food is tasteless. You would eat better tasting stuff in the county jail.

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Wow only $5 a day! And they charge over $300 a day!

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Trevor, the posted rates are not what Medicaid pays. My MIL paid $400 a day, but if she went on Medicaid, the facility got $200 a day. That's why nursing homes love to take private pay residents.

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Can anything be done to improve meal quality in nursing home?

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