Dining Culture Change: Meal Selection Options

Menu selection in long-term care has an interesting history. The progression follows.

• No select. You got what was served! (Sounds like prison, doesn’t it?)
  
• Pre-select. Your likes and dislikes were obtained in advance. If a dislike was on the menu, a substitution was automatically served. (Let’s hope it was something you did like!)
  
• Select menus. You got to circle what you wanted to eat. The problem was, it may have been for a week or more in the future! This is fine if the choice is liver and chicken and you hate liver. But what if it is roast beef and chicken, you really like both, but you don’t know what you will feel like eating in a week?
  
• Selection at the time of service. Just like a restaurant! You are told the selections for the meal and you get to choose what you feel like eating at the moment!

Which type of selection would you prefer? Which type do you think your residents would prefer?

The closer to meal service the selection is made, the better for the residents. In part, this is because many of our residents forget what they have chosen or change their minds. This type of selection requires accurate production and serving records so that forecasting can be as accurate as possible the next time, but it is possible.

If selection at the time of service is not possible, the next best thing is the meal before. Selecting at breakfast for the rest of the day is another option. This is easier for forecasting and production, but it is not as good of a service for the residents.

There are various ways to offer selection. One is restaurant-style. The residents are seated. The menu selections are offered verbally or a menu is placed on the table. The wait person takes the order. This may be verbally or the residents may have selected on the menus at the tables. The wait person goes to the server and communicates the request. The server portions the items and the wait person takes it the resident.

Another good method for meal selection is buffets. Residents can see and smell the food and decide what they want to eat. Generally with buffets, nursing staff assist the residents through the buffet line and carry the plate to the table for them. Dining services staff portion the plate. With this method, residents can also choose the amount they want, which can decrease waste while increasing consumption.

Other methods to offer choice include beverage carts, salad and/or soup carts, and dessert carts. And there are many variations possible on the basic ideas presented.