Page 9 - Life Happens in the Kitchen

INTRODUCTION
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Food in the History of Long Term Care
OBRA ’87
We often think of the impact of OBRA ’87 and the federal regulations as limiting to our creativity and to our ability to meet our elders’ preferences and their expectations. Yet, when given the opportunity to speak with the leaders of the legislative process which created OBRA ’87, or with the committed leaders in CMS today who enforce OBRA ’87, they often share that, in fact, OBRA ’87 mandates the resident choices and the environments of home we are creating today when we implement culture change in our long term care facilities.
Rights
OBRA ’87 mandates at Tag 246 that “a resident has a right to receive services in the facility with reasonable accommodations of individual needs and preferences.” Change agents speak of “refrigerator rights” as one of the desirable outcomes of culture change in long term care: the right to have foods of the elder’s preference accessible all day, every day.
Autonomy
One of the foundations of OBRA ’87, simply stated, is that autonomy is choice. It’s all about asking what our elders want, how they would do it at home, and how we can do it in their home in long term care.
Dignity
The dignity in dining goes beyond the obvious decisions to change our language and eliminate “feeders” and “bibs” from our language and culture.
Tag 242 “Self-Determination” states that the resident has the right to make choices about aspects of his/her life that are significant to the resident.
Tag 241, “Dignity” promotes care in a manner and environ- ment which maintains or en- hances each resident’s dignity and respect in full recognition of his or her individuality.
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