Taking Food Preferences to the Next Level at Your Long Term Care Community

A New Year’s Resolution That Benefits You and Your Residents


Does your food preference form adequately meet CMS regulations? Is it in keeping with person-centered care? Does it record a person’s history of eating patterns, allergies and habits and what they prefer to eat at this stage of their lives? If not, taking your food preferences form to the next level in the new year may be the smartest resolution you can make both for your community and your residents.

From Food Preferences to Dining Preferences

Peggy, a new resident at a nursing home was sitting with the dining manager, Max, and dietitian Donna. They had just worked though the newly introduced Dining Preferences form together. This form is one of the first tools you need to jumpstart person-directed dining, giving residents the opportunity to make an informed choice about what they eat. It’s a lot more comprehensive than a typically used food preferences form.

“I wish we would’ve had one of these forms at the last community I stayed in,” Peggy said. “It sure would have saved me a lot of aggravation.”

“How so?” Max asked.

“Let me tell you. Ever since I can remember, I’ve always eaten a late breakfast and not much; just a bagel with cream cheese and a cup of coffee. That’s it. But at the last nursing home I was in they kept waking me up early with everybody else and serving me this humongous breakfast, like bacon and eggs or pancakes and sausage, the whole shebang. Used to really upset me because I never like to eat that much for breakfast and I sure didn’t like waking up that early.”

“Didn’t you tell them that you wanted to eat later and just a bagel and cream cheese?”

“Sure, I did, and sometimes I got what I wanted. But there was a lot of turnover and whatever form they had been using apparently didn’t say when I wanted to eat. So, every new person that came along I’d have to train, so to speak.”

“So, the dining preference form wasn’t very comprehensive?” Donna asked.

“I don’t know what they called it. All I know is that it just listed a bunch of the foods I liked and that was that.”

Max shook his head. “You would think with today’s focus on person-centered care, every community would have a food preference sheet that records a person’s history of eating patterns, allergies and habits and what they prefer to eat at this stage of their lives. After all, asking questions is how we get to know people and begin a relationship with them. “

Donna nodded. “I agree. As a dietitian, I know people’s preferences can change time to time. For instance, I used to eat Caesar salad all the time for lunch. I loved the stuff. And then I burnt out on it and for years never ate Caesar salad. Then one day I got a hankering for it and now I’m enjoying Caesar salad again.”

“That’s a good point. That’s why we should update a resident’s preferences yearly, if not more frequently.”

“That sounds right to me,” Peggy said. “I mean just because I check a box for meatloaf and mashed potatoes on some sheet doesn’t mean that decision is set in stone. I should be able to change what I want whenever I want to change.”

Max agreed. “To me, a dining preference sheet is all about making it easier for the staff to individualize or customize dining for people, which sometimes means liberalizing a restricted diet, if that’s what they want (after learning of the risks and benefits). The fact that it’s a federal regulation to give residents the opportunity to make an informed choice about what they eat is beside the point.”

Donna nodded. “The truth is it’s not all about spinach and fish anymore. There’s a whole new emphasis on such things as diet restrictions, ethnic preferences, allergies and food intolerances. It’s not just about food, it’s about the whole dining experience in the community.”

“Agreed,” said Max. “We need to know what a resident wants to eat, where they want to eat and when they want to eat. We call them The Three Rights of Dining Delight.”

Peggy took a sip of coffee. “I like that. ”

Using the Right Form Has Even More Benefits

At BSN Solutions, we realized another benefit of a comprehensive dining preference form is that it can be used as an investigative tool when a person’s condition changes significantly, especially when a person starts losing weight. It’s ‘best practice’ to obtain a new history of food preferences to determine if the root cause of why the person is not eating or drinking may be related to their dietary choices. We need to have the right documentation tools like a comprehensive dining preferences form to make self-directed care planning easier while covering the risks and benefits of both liberalizing and sticking with diet restrictions. That’s one of the main reasons we created a set of forms and handouts for our newly released manual (click to preview), The Inside Scoop on Informed Choice, that are designed for self-directed care plans that provide an informed choice and help protect the community from citations and potential legal issues.

No one ever said that adapting to self-directed dining was easy, but with all of us working together, including the people for whom we care, we can make change happen for the better. To get you started on your path to self-directed dining, we would like to offer you a free copy of our Dining Preferences form.

Download the form

About Gail Douglas

Gail joined BSN Solutions as a Regional Director in March of 2013. Her role is to promote the adoption of the new dining standards and person-centered dining throughout the communities serviced by BSN Solutions. She also recruits, coordinates placement of, and supports the dietitian consultants who work with BSN Solutions in its client communities. Gail has a vast 30+ year background in long-term care, having worked within skilled nursing and rehab centers in clinical and management capacities. She holds a Master’s degree in Healthcare Administration as well as a Bachelor of Science degree in Human Nutrition.
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