Nutrition and the Dining Experience in Long-Term Care: Critical Indicators of Nursing Home Quality of Care

Abstract

nursing care in particular, are at a crossroads. With the predicted growth of the older adult population, and the population of older adults who will require dementia-specific care, long-term care facilities face a probable and rapid increase in the need and demand for skilled nursing services. In fact, the number of adults over the age of 65 in nursing facilities* is predicted to double by 2020. Currently, there are 16,032 nursing facilities in the United States with more than 1.4 million residents. In North Carolina, there are 424 nursing facilities with capacity for 42,897 residents. In the face of the changing demographics in our society, nursing facilities are re-engineering to embrace the future and successfully meet these challenges. Part of the re-engineering will involve modifications of the physical plant, new construction and innovations in technology and services to match the evolving needs of residents. This issue of the North Carolina Medical Journal focuses on one of the most salient aspects of long-term care quality—food and the dining experience (as well as hydration and fluid intake). Nutrition is one of the major determinants of successful aging and, for most, eating is one of life’s most pleasant daily experiences. In the long-term care setting, the medical-nutritional needs of nursing facility residents are often competing with the provision of “consumer-defined” quality of care. To begin with, nursing facility residents often have complex healthcare conditions that limit their function, depress their senses of taste and smell, require multiple medications, and necessitate therapeutic or mechanically altered diets. These treatments can limit independence, choice, and pleasure and, thus, have a negative effect on quality of life. In the interest of preserving both the health and happiness of their residents, long-term care facilities are trying to find a balance between the residents’ required medical treatments and personal preferences. North Carolina’s nursing facilities are finding ways to achieve this balance as they also juggle the logistic challenges of feeding large numbers people in a highly regulated industry. Many of these specific efforts are described in the commentary by Nadine Pfeiffer, BSN, RN, and her colleagues in this issue of the Journal.