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Best Practices

4 More Reasons to Improve the Dining Experience

The evidence is mounting: what we do in the dining room matters, a lot.

Good nutrition is a key factor in health outcomes and how well people feel day to day. But, lifelong habits and changes related to aging can make it difficult for older people to eat as well as they should. Recently there have been a number of studies showing improvements in the dining experience help overcome some of these issues.
The use of real food residents enjoy improves clinical outcomes. Studies are finding lower weight loss and decreased use of laxatives and appetite stimulants when residents like the food they are offered. One study found a "69% reduction in weight loss in the first three months and no 'unavoidable' loss in six months."[1] Furthermore, when residents eat better, communities save money on supplements and plate waste is reduced.[2]

Enhanced dining environments in nursing homes result in greater caloric intake. “Particular focus on areas such as table dressings (tablecloths, napkins, flowers), family-style meals, and staff presence at the table resulted in significantly increased caloric intake for residents over a six-month period."[3]

These are important findings, particularly in light of research showing 35-85% of nursing home residents are malnourished.[4] Malnutrition is linked to increased infections, electrolyte imbalances, altered skin integrity, anemia, weakness, fatigue and other health issues.
Independence with eating improves quality of life of residents with dementia[5] according to another study, and it’s probably safe to say that is true for every resident, in fact, every person. Eating is a very personal act. Imagine how you might feel if you were not allowed to choose what, when and where you eat. Certainly you would lose some dignity and empowerment. You might also lose your appetite.
What if every meal you ate occurred in a lackluster dining room where conversation was minimal and food was served in a rushed, impersonal manner? Would you feel inclined to savor the experience, or hurry through your meal and get out of there?
Imagine—or better yet, try out—eating in your community’s dining room as if you were a resident. Do you feel the experience would satisfy your emotional and physical needs while you are at the table? Or do you suspect it might be somewhat discouraging and lonely?
New industry quality standards are a call to action.  At every housing level, higher standards of service are being demanded by either surveyors, residents or the families we serve. Although quality assurance and process improvement are not new concepts in the long-term care industry, we are now expected to give residents and staff more input, power and participation than ever before. Delivering high quality of life has also gained new importance. Going forward, we must balance diagnosis-based treatment and safety with resident choice, independence and satisfaction. Mealtimes, because of their centrality to health, well-being and satisfaction within your community, will be critical to improving outcomes.

Dining environments that support better outcomes don’t happen by accident. They are a result of intentional focus on:
  • Honest assessment of strengths and weaknesses
  • Setting high standards based on your mission and goals
  • Honoring residents and their preferences
  • Defining processes that are specific and measurable
  • Training staff using a curriculum-based approach proven to change behaviors
  • Building relationships among all stakeholders
  • Constantly refining and improving

[1] Bump, L. (2010) The Deep Seated Issue of Choice.
[2] Bowman, C. (2008) The Environmental Side of the Culture Change Movement: Identifying Barriers and Potential Solutions to Furthering Innovation in Nursing Homes.
[3] Kristel A.N.D. Nijs et al. (2006) Effect of Family-Style Meals on Energy Intake and Risk of Malnutrition in Dutch Nursing Home Residents.
[4] Furman, E.F. (2006). Undernutrition in Older Adults Across the Continuum of Care. 
[5] Carrier, West & Ouellet (2009), Dining experience, foodservices and staffing are associated with quality of life in elderly nursing home residents.

Spread the Word

Do You Practice Kind Dining®?

Let visitors know your community brings warmth to table

Licensed Communities: The new Kind Dining® window clings are hot off the presses and by now you should have received yours. Web badges are also available for your websites--watch for an e-mail with download links to the badge. Displaying your window and web badges prominently is an excellent way to start a conversation with visitors and prospective residents about your community's commitment to higher standards and genuine hospitality.

If you missed your badge delivery, please e-mail Cindy Heilman, MS, DTR, right away. We want to help you spread the word about the great  work you are doing to build relationships one meal at a time.

Notes from the Field

Keep Learning--and Teaching!

Heading 3

by Vera Bartasavich, BA, DTR

Vera Bartasavich, BA, DTR
Learning is the key to staying young, vital and current with the world around you. As a lifelong learner, I’ve increased my knowledge through seminars, community classes, formal college courses, online classes and reading. I believe knowledge is empowering and should continue on a daily basis.

I spent over 33 years employed full time in the food industry. My job responsibilities incorporated a variety of positions within finance, logistics, sales, information technology, quality management, and regulatory affairs. In my last and most rewarding responsibility, I worked as a nutrition specialist, overseeing the process of nutrition labeling of over 1,000 products and answering consumer nutrition questions. All my job changes required extensive retooling of my skills.

Last August, a new page was turned to start another chapter in my life. I retired. I like to refer to my retirement as “recharging” as I am not ready to slow down yet. Three weeks after I finished working, I started a graduate program at Kent State University Health Education program. Fall semester I took one class and found it intense but very satisfying.

Midway through the semester I was required to meet with my advisor. I inquired about the graduate assistant program I heard about from students during orientation. My advisor exclaimed, “Sweet deal!” So, I asked what I needed to do to apply. My application was submitted the next week and within two months a graduate assistant position was available for the spring semester. I was so excited to receive the opportunity. My assignment was to teach two online courses to junior and senior students. In exchange for my instruction of 20 hours per week I receive a stipend and full tuition reimbursement.

Even though I had taken classes all my life, I never was a full time student. Now I had a full time graduate studies schedule plus teaching two courses that were unfamiliar to me. It was very intimidating but I made it through my coursework maintaining a 4.0 grade point average along with teaching. It was exciting that my contract was renewed to teach during the next year. One of my professors asked if the PhD program is one area I was considering. Who knows?  I can’t control my age but I can control my knowledge.

I want to thank Cindy Heilman of Higher Standards, LLC. I view Cindy as a mentor, providing support and encouragement while I pursue higher learning, just as she did years ago. During her studies she discovered the need for better customer service in senior living communities and skillfully Kind Dining® curriculum. I met Cindy during our volunteer terms in the House of Delegates for the Academy of Nutrition and Dietetics. Over the years I’ve followed her success while she researched, implemented and expanded her business. I appreciate her sharing her knowledge and wisdom of dietetics along with her business savvy.

Remember, you are never too old to learn or share your learning with others!

The 1 Time You Should Gossip

Ever been the victim of a rumor? It's no fun, is it? Most gossip is destructive. It tears down team spirit and ruins reputations. Wise people generally don't pass along anything they hear on the community grapevine, but there's one time when it's absolutely alright to spread the word: when someone has said something nice to you about someone else.

Did Mrs. Brown mention she appreciated Tina's hard work yesterday? Has the social worker commented about the dining staff doing a good job of starting on time lately? Don't keep the compliments to yourself; let Tina and the dining staff know their efforts are making a good impression.

Better yet, encourage people to share their sentiments directly. You might say, "What a nice compliment! Have you told Tina you feel that way? I'm sure it would make her day to hear your positive feedback."

Compliments tend to be contagious. The more we sincerely acknowledge and praise others, the more acknowledgement and praise goes around. Over time, these encouraging messages strengthen relationships and create a more encouraging work atmosphere, so, spread good news every chance you get!

Table Tents

Here's an easy way to inspire conversation in the dining room: 
Create and print table tents on light card stock to add to your dining tables—you can find pre-cut templates or plastic frames and layout ideas on the web. Feature interesting news and tidbits, using your table tents to:

~ Tell your residents more about the "server of the month"
~ Introduce new residents
~ Announce birthdays or special anniversaries
~ Create trivia games
~ Spark memories with pictures of memorabilia from their younger years
~ Announce the next reading club book selection, include reviews
~ Give details of an upcoming party or special event
~ List "this day in history" facts
~ Feature a "resident of the month"
~ Have residents vote on "cutest pet" or who will win an upcoming sports championship

There are endless ways to use table tents, just apply your imagination and invite the community crafters club to help out.

Let's Get Together at Convention

Are you attending Food & Nutrition Conference & Expo (FNCE) in Houston this October? Or our local Oregon Healthcare Association (OHCA) Annual Convention & Trade Show in September? If so, look me up. I'll be in attendance and speaking at both shows about meeting Boomer expectations in the dining room. At FNCE, find me on Sunday at the Members Marketplace booth #33. Come to my booth for a chat and receive a conference discount on my book, Hospitality for Boomers: How to attract residents, retain staff, and maximize profitability.


September 16-17
Oregon Convention Center
Portland, Oregon
How to Meet the Demanding Dining Needs of Boomers, by Cindy Heilman, MS, DTR, September 16, 9:30 am - 10:30 am

October 19-22
George R. Brown Convention Center
Houston, Texas
Preparing for Boomers: Long-Term Care Organizations Incorporate Quality and Sustainability, by Cindy Heilman, MS, DTR and Bonnie Gerald, PhD, DTR, October 22

Hope to see you there. In the meantime, if I can be of service, please call me or e-mail any time.

Kind Regards,

Cindy Heilman, MS, DTR

Higher Standards, LLC

Why Kind Dining®?

Warmth Pin

"Kind Dining® training truly transformed our operation and resulted in a significant improvement in our guest meal revenue and resident satisfaction"
Sarah McEvoy: Administrator of Villa Crest, Manchester, NH

“Cindy definitely brought 'warmth to the table' at Bethesda Healthgroup. with her Kind Dining® training. Within days of the training the employees had connected with Cindy’s ideas, and these brought positive results not only for the residents, but for the employees too. Cindy’s “passion for hospitality” continues to flourish within Bethesda Healthgroup. Thank you Cindy.”
Shelley Carley, RD, Director of Food and Nutrition: New York Presbyterian Hospital

"We have received positive feedback from EVERY person who attends the Kind Dining® training. There are always a few staff members who stop and thank us for teaching the class and express how much they learned. We will continue promoting positive customer service through implementation of Kind Dining®."
Amy Van Oordt, RD, LD, Directory of Dining Services: Bethesda Meadow

"Our industry has been asked to accomplish culture change, but the words alone are hollow. Kind Dining® caused those words to make more sense. It helped us understand, whatever our department, it is time to change our approach and focus on the residents. If you're looking for 'how to do culture change,' Kind Dining® is a great opportunity to learn and work from the top down to create culture change residents want."
Kathryn Kindopp, Administrator: Maplewood Nursing Home of Cheshire County

Learn more about Kind Dining® at

Did you read?

6 Ways Nutrition Pros Need to Be Leading Now

All the recent emphasis on resident-centered care, liberalizing diets, and implementing QAPI, has many food and nutrition professionals wondering, “What is my role in all this?”

In some ways, we will be doing what we’ve always done: working to help people understand the connection between nutritious food and good health. In other ways, we’re being challenged like never before to support positive clinical and emotional outcomes for residents, and provide community leadership.

Read more about how to help lead your community to greater success in 6 Ways Nutrition Pros Need to Be Leading Now at

Did you read?
ANFP Culinary Buyer's Guide

6 Ways to Grow a Healthy Community

Gardens, a natural environment for community building and empowerment, are starting to pop up in forward-thinking senior communities. Learn about the benefits of community gardening in 6 Ways to Grow a Healthy Community in the ANFP Culinary Buyer's Guide.
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