Monday, March 11, 2013

Eating or Dining?

By Cynthia K. Klinowski, RN, MSN

In a follow up to my previous post, “What’s on the Menu?” , guest blogger Cynthia K Klinowski offers us the following thoughts:

Good nutrition is eating a well-balanced diet every day.  A basic well-balanced diet is the same for everyone, including the elderly.  Although older people need the same nutrients as younger people, in most cases they do not require as many calories.  The challenge is to choose foods that are nutrient dense, that is, high in nutrients in relation to calories.  For example, skim milk is considered more nutrient dense than whole milk because it has the same nutrient content but contains less fat and fewer calories.

040 The Dining Hall
040 The Dining Hall
 (Photo credit: Wikipedia)
Elements of a well balanced diet include water and five vital nutrients:  proteins, fats, carbohydrates, vitamins and minerals.  A nutritious, well-balanced diet for ALF residents is composed of foods from the basic four food groups:  Fruits and Vegetables, Bread and Cereals, Milk and Milk Products, and Meat and Meat Substitutes.  These food groups supply key nutrients.

Menu planning for an ALF include many components.  In addition to being nutritious and well-balanced, there are time constraints.  No more than 14 hours may elapse between the end of the evening meal and the beginning of the morning meal.  All other meals should be spaced so that not less than 2 hours, nor more than 6 hours elapses between the end of one meal and the beginning of the next.  Planned snacks must also be incorporated into the meal plan.
English: Balanced Diet
English: Balanced Diet
(Photo credit: Wikipedia)

Menus must be planned at least one week (preferably a month) in advance.  All menus, both regular and therapeutic, must be reviewed annually by a registered dietician.  Portion sizes must also be indicated on the menu.  Meals served in an ALF are required to meet the Tenth Edition of the Recommended Dietary Allowances (RDAs) established by the Food and Nutrition board, adjusted for age, sex and activity.
While following all of the rules and regs the ALF menu must also provide foods which are familiar and maintain a connection to the resident’s past life experiences, especially those that recall pleasant times.  Many older people prefer familiar items and will not eat new foods.  This provides an additional challenge for the dietary department.

chef (Photo credit: StuRap)
So how does the Dietary Department prepare interesting, tantalizing, delicious meals?  By hiring well trained credentialed chefs all of the pieces are brought together by incorporating the food pyramid concept.  Substituting within the same food group and varying the foods that are served.  Trying new foods as each food group has many items from which to choose.  Use fresh food whenever possible, especially when seasonal foods are available from specific regions.  Prepare foods in different ways using new and revised menus.

One visit to an ALF will illustrate how important mealtimes are to the residents.  They sometime begin lining up 30 minutes or more before serving time in anticipation of the meal.  This being said, the last thing anyone wants is to disappoint the residents with a meal experience that is not a positive one.  The meal time provides socialization and interaction with other residents, dietary staff and the visitors.  The meal table is one of the last bastions of social grace.  Providing a gracious elegant dining area adhering to the rules for proper table etiquette enhance the dining experience.  Remember that the ALF setting is very much a part of the Hospitality Industry and service must show it.

If you find you need an Assisted Living Facility, Nursing Home or any other type of Senior Facility, I hope you will consider       

If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Cynthia K. Klinowski, RN, MSN, is a co-owner and senior medical officer of several Assisted Living Facilities in Florida and a guest blogger for

Bob Gregory is an advocate for Seniors and is one of the founders of At, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider

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