Are you wondering why "Apples and Oranges"? Apples and
oranges are alike. They are fruits, edible and nutritious. They
are different. They differ in color, shape and taste. In discussions
we often compare Apples with Apples, and in arguments we try to
compare Apples with Oranges-and all this led to the creation of
the Title of the Net Program and to our net names, "Apples"
and "Oranges". We are by profession, Registered Dietitians.
Our experience as dietitians extends from Consultants in long-term
Care Facilities to Hospital Dietitians and anything in between.
"Apples and Oranges" is a new adventure for us. Our
mission, is to inform you of nutritional issues and information
to help you make intelligent decisions to enjoy eating and remain
Food is important to all of us. After all, we have been eating
all our lives. Food and fluids are essential for life. They provide
needed calories, protein, vitamins and minerals. Nutrition is
1. The process
of nourishing or being nourished, especially the process by which
a living organism assimilates food and uses it for growth and
for replacement of tissues.
2. The science
or study that deals with food and nourishment, especially in human
3. A source of nourishment; food.
A daily diet of foods that contain the nutrients we need will
give us a good start toward feeling good and being healthy. The
nutrients in the foods we eat affect every cell in our body. It
affects our skin, bones, teeth, brain, heart, eyes, kidneys, liver
and other organs, blood, and a lot more. This is a great reason
to eat right. After all, we want to have our entire body as healthy
Today's topic: You, Your Family, and the Dietary Department
in a long-term Care Facility
Are you thinking of becoming a nursing home resident? Or are you
looking to place a family member or friend in a nursing home?
We think you should know, or at least be aware of :
- Who to talk to from the dietary department
- Questions to ask the dietary staff
- What to look for, and What You Should Expect from the Dietary
Remember-Eating and Enjoying Meals and Snacks are foremost to
our Quality of Life.
Who to talk to from the Dietary Department
There are two key people in the dietary department we recommend
you talk to: the Food Service Supervisor (some facilities
name the position as Food Service Director) and the Registered
Dietitian. Of course, anyone else would also be a good choice,
like the cook.
Generally, the Food Service Supervisor is responsible for the
purchasing of food, supplies and equipment; food preparation (cooking
and preparing foods); the meal service (the delivery of food to
the resident); and the sanitary conditions in the dietary areas
(kitchen, refrigerators, food storage area).
The Dietitian provides the Nutritional Services for the residents.
He/she approves the menus for nutritional adequacy, which means
the menus must meet the standard as set by the Regulations for
Licensure. He/she is responsible for the nutritional care of the
resident. One of the Registered Dietitian's responsibilities,
is evaluating each resident for his/her nutritional status, make
appropriate recommendations to maintain the nutritional status
if normal, or improve the resident's nutritional status when needed.
In case we've lost you, please, be patient, I'll try to explain.
Remember we stated that nutrients are essential. Each nutrient
has a role to play in keeping us healthy. Well, if we have low
stores of a nutrient or nutrients in our bodies, our nutritional
status is abnormal The signs and symptoms related to nutrient
deficiencies, depending on the nutrient(s), may be physical such
as being weak and tired, underweight, and showing evidence of
slow wound healing, or observed in laboratory tests such as blood
tests. The Registered Dietitian evaluates the physical symptoms
and laboratory tests results. He/she then provides recommendations
to the MD and facility staff, and then develops a plan for the
nutritional care of the resident. Another responsibility of the
Registered Dietitian, is to approve the therapeutic diet menus
for nutritional adequacy as well as insure that the therapeutic
diet menus are in accordance with the Diet Manual and accepted
Questions to ask the dietary staff
Ask the Food Service Supervisor to see the menus, you may want
to ask for a copy. Take a good look at the foods listed. There
should be a second or alternate item on the menu for each noon
and night meal. Do you or your family member like the foods on
the menus? That's very important. Three meals a day, seven days
a week you better like the foods offerred. Ask the Food Service
Supervisor if the resident is visited on admission and periodically
for food preferences, and are the foods served to the resident.
The Food Service Supervisor should be able to tell you if the
menus are followed, and how the resident gets the alternate food
item if he/she wants it. Ask what is served if the resident does
not like either item on the menu. Check the menus. Each day should
include a minimum of six ounces of meat, fish, poultry, eggs,
cheese or other high protein food, sixteen ounces of milk, four
servings of fruits or vegetables, and four servings of bread,
or bread substitute such as spaghetti, or cereal. If you have
questions about the food groups, ask the Registered Dietitian
to explain them and show you that the menus include the foods
and adequate size servings to meet the minimum standard. If he/she
likes big meals, inquire as to the availability of large portions.
Inquire as to the times the meals are served. Ask questions. If
the night meal is too early, is it possible to eat at a later
time? The Food Service Supervisor can provide answers.
Ask the Food Service Supervisor how the food is prepared. Try
to find out if most of the entrees are prepared or cooked by staff
at the facility or are most of them convenience foods straight
from the freezer! We do recognize that there are some good convenience
foods, but others don't belong in the nursing home.
Check what foods and beverages are offered between meals. You
can take a look in the nourishment kitchens on the units to see
what's there. Chances are, the foods there, are the foods served
Sanitation? Ask to tour the kitchen areas, or at least peek through
the door. Ask yourself is the kitchen clean, neat and tidy; does
the dietary staff appear clean and neat. Now, be a little reasonable,
we're not expecting total cleanliness, they are working, but you
shouldn't see yesterdays food on the floor. You get the drift.
If your family member has a disease, or condition that requires
a therapeutic diet, we strongly recommend that you discuss the
information with the Registered Dietitian. He/she should inform
you of the therapeutic diets available in the facility. Recent
trends have included liberalizing therapeutic diets for residents
in nursing homes, and "Apples" and "Oranges"
agrees with the trend. We have, and continue to recommend, based
on the resident's nutritional status, the most liberal diet the
resident can tolerate without compromising his/her health. In
most cases, the doctor will agree and change the diet to the one
recommended. It is important to us that the residents eat their
meals, and if a more liberal diet makes the difference, why not?
What to look for and What You Should Expect from the Dietary
May we suggest you observe a meal or two and take notes-was the
tray attractive, the food prepared properly, the menu followed,
and most importantly would you eat the meal?
You should expect the Dietary Department to serve meals and snacks
which are nutritious, palatable, adequate in portion sizes, and
include foods you enjoy.
Our Best to You in Your Search for a long-term Care Facility.
Bye for now. See you next time on the Net.
'Til then---HAPPY EATING!
The American Heritage® Dictionary of
the English Language, Third Edition
copyright © 1992 by Houghton Mifflin Company. Electronic
version licensed from InfoSoft International, Inc. All rights