Page 13 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
WHAT IS POSSIBLE
compliance with regulations. Choice for Norman meant meeting his whims and desires on a daily basis, and when they were accommodated, he ate. Having a stocked 'pantry' in the dining area with items normally found in kitchen cupboards – cereals, soups, snacks, a variety of drinks and more – allowed him to choose and eat as he had at home. When Norman wanted to 'come to the kitchen', he came, sat by his window and had a 'meal.' His meals might be at anytime between 8am and 7pm...whenever he was hungry, not just when meal time was scheduled. This returned Norman to a sense of normalcy – alone, smaller meals, snacking and at times socializing when his mood was consistent with eating socially. Accommodating his needs rather than the desires of the nursing home by simply making food and choices available for Norman when he was naturally hungry led to success. Norman’s food intake is acceptable even with what are sometimes smaller than normal meals. His outcomes for weight, laboratory values and skin health are always monitored. Self-determination even with the disease that affects memory can be life altering with something that meets a basic human need – food. A Metro Denver home
In the article Providers Urge Flexibility & Sensitivity to Better Serve Residents’ Nutritional Needs, Gretchen Robinson is quoted: “We need to look at the simple things – what is the resident’s quality of life, and how can we provide a positive (meal-time) experience?” When planning residents’ meals and dining experiences, she adheres to a basic rule inspired by Emma Luten, former CMS Central Office lead dietitian: “Food has to look good, taste good, and
be offered courteously.” (Henkel, 2004) Madalone sums it up well:
Just seeing elders order from a menu in so many of our homes and allowing SO much choice daily has impacted so many lives with meal consumption and health maintenance as something we 'measure,' and to me good consumptions means satisfied elders. Regulations that give us guidance on menu development are just that – guidelines to be in our profession a template but not an absolute. In the aged, six servings of... five servings of....four servings of....the RDIs mean nothing to an elder who wants to enjoy her last daily pleasure. Cheeseburgers and pie are GOOD! If you want those daily, I say give’m PIE!!!! (Madalone, 2009)
Community is Possible
Steve Lindsey, CEO of Garden Spot Village, sees the kitchen/dining room of a household as what Ray Oldenburg calls a “social condenser” in his book The Great Good Place (1989). Lindsey says this view can help us “to begin to draw out the integral role that this space has in the development of true community within a household. ‘Social condensers,’ the places where citizens of a community or neighborhood meet to develop friendships, discuss issues and interact with others, have always been an important way in which the community developed and retained cohesion and a sense of identity...according to Oldenburg. They are distinctive informal gathering places, they make the person feel at home, they nourish relationships and a diversity of human contact, they help create a sense of place and community, they invoke a sense of civic pride, they provide numerous opportunities for serendipity, they promote companionship, they allow people to relax and unwind after a long day at work, they are socially binding, they encourage sociability instead of isolation, they make life more colorful, and they enrich public
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