Running head: INCREASED APPETITE WITH CHOICE

Increased Appetite with Choice at Nursing Homes

Travis Pettit

Pennsylvania State University

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Increased Appetite with Choice at Nursing Homes

Imagine losing your spouse of 60 years a couple months ago, your children live hours

away in another state, and you are 87 years old and now live alone. As your family tries to

figure a solution from far away, the best solution they can come up with is placing you in a

nursing home, of which 1 in 4 people end up in during some point of their life (Demko), you are

now the “1” in that statistic. Aging seniors are faced with a change in tastes, restrictions from

medications, loss of spouses, and general loss of appetite. All of this leads to malnutrition in our

elder population. Malnutrition causes decreased mental and physical quality of life

(Drewnowski, Herold, and Varner). Nursing homes are a great way to ensure residents are given

proper nutrition. The appetite of patients’ can be increased by efforts of employees at senior care

facilities, like nursing homes. However, it can still be hard for these facilities to find a happy

medium between resident preferences and healthy nutrition. Many say a survey, completed upon

admission to the facility, will allow residents to provide input as to what is served for their meals

to increase their appetite and quality of life.

Malnutrition and Quality of Life as an Issue for Aging Seniors

Malnutrition is a broad issue among several senior citizens across the country in care

facilities and in their own home. Causes of malnutrition may include, loss of appetite,

forgetfulness, poor oral health, poor eating habits, loss of a spouse, even restrictions from

medications (Varner). As seniors age, their senses of taste and smell can drastically change,

affecting their appetite and what appeals to them; leading to a reduced intake of food and

eventually, malnutrition and poor quality of life (Drewnowski).

The Institute of Medicine (US) Committee on Nutrition Services for Medicare

Beneficiaries states in a report (2000) that nursing homes provide wide areas of intervention to
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improve the food intake of their residents, with methods such as, modified diets, assisted feeding,

liquid supplements, and tube feedings. Their report goes on to state, “Menus and dining

experiences should accommodate food preferences, preserve residents' dignity, and emphasize

their joy in eating” (Institute of Medicine, 2000). However, it also says that the current state of

nutrition services in nursing homes must be improved beyond current practice. Quality of life

depends on the “environment, personal attention, personal engagement, food enjoyment,

negative mood, and positive mood” (Herold, 2014). Herold, a contributor for the University of

Minnesota, specifically states that the enjoyment of food affects a patient’s quality of life in a

nursing home.

A Plain Solution to a Major Problem

A survey gives residents the ability to input their wants and needs into the menus that the

facility’s dietician designs. By choosing what appeals to their taste buds, food intake will

increase, leading to better nutrition and ultimately a higher quality of life. If a resident does not

like chicken, they are highly unlikely to eat the entirety of their meal when chicken is served. By

implementing the survey, the facility’s dietary department can plan on having two options on the

days that have meals that conflict with a resident’s fancy. Some residents may even face

restrictions on foods due to their medications. When admitting a patient with dietary restrictions

due to medications, the staff could find alternatives to meals that were previously inaccessible to

patients. This will give hope to the resident that there are still meals they can enjoy, even if it’s

not what they’re used to. Although this may make more work for the staff at the facility, it will

greatly improve the resident’s quality of life, and even their outlook on living in the nursing

home, which boosts morale.

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The survey will consist of questions answered by the patient, or spokesperson for the

patient, the dietician at the facility, and a medical professional. Questions will pertain to

preferences, dislikes, restrictions, goals for nutrition, and modifications needed, such as pureed

or mechanical requirements. The survey should be completed as close to the time of admission

as possible, to minimize, or even maximize, the effects the change in atmosphere on the resident.

The survey will be kept as part of the resident’s medical records and made accessible to make

changes as medical or nutritional needs change.

Does this Concept Already Exist?

Sunny Vista, a nursing home in Colorado Springs, is participating in a national trend

occurring in the United States’ 15,600 nursing homes, an individualized menu approach. In an

article by Alejandro Cancino, “Nursing homes starting to offer more individualized menus”,

describes how the foodservice director at Sunny Vista, Chris Willard, is preparing a Thai-style

soup for “a woman of Asian descent who didn’t like any of the option on the menu” (2018).

Cancino continues to describe the attitude of the federal government on menu choice in nursing

homes, “the federal government is proposing regulations that would require facilities to create

menus that reflect religious, cultural and ethnic needs and preferences” (2018). According to the

website of another nursing home, The Cedars, in Cranston, Rhode Island, the facility provides

“delicious, high quality meals and personalized dining service” (Dining Menu, n.d.). The page

continues to state that their nationally recognized services received a 200% improvement in

resident satisfaction.

Malnutrition is an issue that has the possibility of affecting nearly all Americans,

especially those in nursing homes. Nursing homes can combat this by improving the appetite of

their residents. A survey is one way they will be able to find what is appealing to the residents,
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as well as meeting dietary and cultural needs. Although there are many causes of malnutrition,

nursing homes can use the survey to get past these obstacles and get the resident back on the

right track upon admission.

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References

Cancino, A. (2018, January 30). Nursing homes starting to offer more individualized menus.

Retrieved from https://www.longtermcarepoll.org/nursing-homes-starting-to-offer-more-

individualized-menus/

Demko, D. J. (2000, May 24). Can Aging Boomers Avoid Nursing Home Care? Retrieved

October 26, 2018, from http://www.demko.com/m000522c.htm

Dining Menu. (n.d.). Retrieved from http://cedarsliving.com/library/dining-menu/

Drewnowski, A. (1997, July 1). Taste preferences and food intake. Retrieved October 26, 2018,

from https://www.annualreviews.org/doi/citedby/10.1146/annurev.nutr.17.1.237

Herold, L. (2014, January 08). Improving quality of life in nursing homes. Retrieved October 26,

2018, from https://www.healthtalk.umn.edu/2014/01/03/improving-quality-life-nursing-

homes/

Institute of Medicine (US) Committee on Nutrition Services for Medicare Beneficiaries.

Nutrition Services in Post-Acute, Long-Term Care and in Community-Based Programs.

(2000). Retrieved October 26, 2018, from

https://www.ncbi.nlm.nih.gov/books/NBK225311/

Varner, J. M. (2007). Elders and malnutrition. Alabama Nurse, 34(2), 22-3; quiz 24-5. Retrieved

from http://ezaccess.libraries.psu.edu/login?url=https://search-proquest-

com.ezaccess.libraries.psu.edu/docview/204323962?accountid=13158