Household Models In Long Term Care

Posted by on 04/16/2019

Blog_nprtheone As the old saying goes… “There Is No Place Like Home.” Many long term care facilities have taken this saying to heart and are implementing a new wave approach to serving their residents. It is called the “household model” and it aims to create a home like environment for its residents, especially when it comes to their food. Institutional hallways and tray carts have been replaced with full service eat in kitchens and dining areas with staff prepared to serve residents what sounds best. This model was created to boost resident moral, provide a more comfortable setting to live in and decrease incidences of weight loss. And results are in—these facilities are succeeding! 

One LTC facility that has implemented this model is Asbury Place of Kingsport in Kingsport, Tennessee. They follow a liberalized diet philosophy, that means just what you think it would mean; residents are placed on the most liberalized diet they can be on, taking into consideration ST recommendations, acute/chronic illnesses, etc. Because of the smaller scale of residents being served at this facility, resident’s specific food preferences can better be attended to than at other facilities. Meal times mirror those at your own home, with all of the residents gathered around the table, family and staff as well, cultivating conversations and encouraging adequate PO intake. It truly does seem that the happier the residents are, the better they eat at meal and snack times. 

But the truth of the matter is that not all LTC facilities have the ability to implement this household model as it usually entails a complete building remodel, staff training/cross training and monetary funds that just aren’t accessible at the moment. So how can we as consultant dietitians bring the experience of these household models to our other more institutional facilities? 

Here are a few tips! 
Focus on the food preferences: Make it a point to carve out an appropriate amount of time to spend with the incoming residents to assess their food preferences. Furthermore, follow up to ensure these preferences are honored and served to the residents by the kitchen staff. If the CDM is responsible for taking food preferences, spend some time training or teaching him/her do this effectively (if needed). 

Call the resident by name: One thing is for sure, whenever you are at home, everyone knows your name.Do your best to get to know the resident’s names and make it a point to say hello to them (using their name) whenever you pass them in the hallway or see them in the dining room. The CDM can be very helpful with this as they typically spend more time at the facility than the dietitian does. 

Utilize food first: Whenever you are at home, you typically don’t eat or drink a lot of supplement drinks (Ensure, mighty shakes, magic cup). Although these items cannot be completely avoided and are completely necessary in some instances, do your best to utilize food items first (fortify if needed!) when trying to increase a resident’s calorie and protein intake. 

Let’s do our best to make these residents feel more at home in our facilities!