Since January, mealtimes at Lutheran Social Services' Lutheran Home and Rehabilitation Center have been much more pleasurable for its residents.
Gone is the tray line of the past, which had numerous dietary employees in the kitchen loading up plate after plate in assembly-line fashion before carting them upstairs and delivering them to residents. It was not an efficient process and, more importantly, the experience of having food brought to them on a rolling cart three times a day was not an enjoyable one for residents - nor did it make sense for dietary employees.
"What was supposed to be warm was cold, and what was supposed to be cold was warm," said Doug Frazier, food service director. "And in the kitchen, it was chaos."
Working with Morrison Management Specialists, the company contracted to provide nutrition and dining services to the facility, LSS scrapped the tray line in 2011 in favor of "restaurant-style dining" for its residents. The initiative has been an overwhelming success, both staff and residents report.
In dining areas in each wing of the center, residents now gather three times a day to socialize, be waited upon, and enjoy food that comes to them as they ordered it - at the right temperature, in the correct portions, and to their specifications.
"The residents love restaurant-style dining because they can get seconds, because they don't have to have what they don't like - everything doesn't just come on a tray," said Suellen Carlson, director of volunteers.
"They're empowered to make their own decisions, which is key," Frazier added.
Patty Eckwahl, LSS' director of marketing, had mentioned the new dining layout at the center to me a couple times in the past. Earlier this month, I finally had a chance to become part of the experience for just one meal, just one day.
DRESSING THE PART
I met Doug in his office and he gave me an official outfit to wear for the day, consisting of a polo shirt and a chef's hat. The chef's hat was just for fun, I knew, but I didn't want to pass up the opportunity to wear it. I kept it on all day. When else would I ever get the chance?
After introducing me to the kitchen staff, including executive chef David Bollman - the only other guy wearing the big white hat - Doug led me on a tour of the facility. The crown jewel of this specific tour was the dining rooms, where residents enjoy their meals among the company of their peers and the hospitality of the dietary staff.
Each room is equipped with warming trays to keep the food at proper temperatures as it is dished out to the residents, juice machines and coffee makers (the residents love their coffee, I quickly found out), and many more amenities that provide warmth and comfort to its guests. Tables are set ahead of time with silverware, cups and other necessities at each place. Each place also has a pre-printed ticket showing what each resident had ordered for the coming meal.
Though residents choose ahead of time between two options - chicken and spaghetti were the options during my visit - the set-up of the dining experience allows for alterations to be made on the fly.
"If her neighbor has spaghetti and meatballs, and she sees that and decides she wants that instead of chicken, she can have it. It's right there," Frazier said.
In the old days, he added, a last-minute change of heart such as that was not so easy to accommodate. It involved a staff member running downstairs to make up a new tray of spaghetti and meatballs and rushing it back upstairs to the resident, he said - a scenario that is a thing of the past.
"Literally, everything we serve is right up here," Frazier said.
The difference goes beyond ease of service, Carlson added. It comes with the entire atmosphere that having hot food served in a single space provides.
"When you walk in, you smell the spaghetti, you smell it all, rather than having these trays," she said. "When you come in, you smell food cooking - not heated up."
It all sounded quite wonderful, but I couldn't know for sure until I became a part of it - which I, in my chef's hat, would soon enough.
TAKE A BITE
We made it back downstairs to the kitchen just in time for the pre-meal meeting.
I joined all the staffers as they gathered around a table and received a briefing on the food that would be given out at the meal. They learned from the kitchen staff what is in each dish and what an appropriate portion size looks like. Sample plates of each meal are demonstrated, and any questions are answered.
And there are specific questions. It is very clear that the servers know their residents well. The queries they had about the food ranged from what options they had for lactose-intolerant residents to what they could offer residents who are very picky about their flavors - perhaps a dash of parsley?
At the end of the meeting, each staff member is invited to take up eating utensils and sample a bite or two of each dish - giving them an understanding of how the food tastes, should a resident inquire.
"The thing about having chefs here is that they sell the food," Carlson said. "They say, 'Tomorrow, we're going to have whatever-it-is, and it's going to be great.' It's changed the entire place. It all runs on its stomach."
I was starving, and the food smelled delicious, so I was eager to dig in - particularly, into the mashed potatoes and the meatballs. Most of the veteran staffers, I noted, nonchalantly took a small sliver of food with a knife and tested it before walking away to go to their stations. I hunkered down at the table for a bit longer, taking a big forkful of mashed potatoes and a hefty wedge of a meatball.
Chef Bolland had done well. This stuff was good. One of the dietary staffers, seeing me enjoying a bite, told me the great taste wasn't just for my benefit.
"Those mashed potatoes are the bomb, aren't they?" she said. She was right. They were, in fact, "the bomb." I could have eaten the whole plate and then some. But there was work to be done.
A WELL-OILED MACHINE
I met up with food service assistants Brenda Kay and Tracy Atwell in their dining unit, where they were preparing to serve lunch to the center's rehabilitation residents.
Brenda told me that while there is a bit more turnover in this unit than in the others at LHRC - some of the residents of this unit are there for only weeks, and some for even just days - the staff still gets to know each resident quickly.
Though there was still about 15 minutes left before the scheduled meal time, a few residents had already been brought to the dining room by their nurses. Brenda was in the process of serving them coffee, and I joined in to help. Each was very appreciative to have his or her coffee delivered, fresh-brewed to the table.
I received several compliments about the big, tall chef's hat that I had forgotten I was still wearing. I later was told that several of the residents thought I was "the boss" because of my official-looking hat. Nothing could have been further from the truth, but it made me laugh.
And I felt pretty important, following the instructions printed out on each resident's ticket and supplying him or her with the appropriate amount of coffee or other beverage. Some, because of dietary restrictions, could only have a certain amount, so it was important to be careful and precise in my distribution.
Soon, the whole crew had made its way into the room and it was time to begin giving out the meals. The tickets were collected from the tables and placed in a stack for Tracy, who positioned himself in front of the warming trays to begin doling out the food. The wing's certified nursing assistants (CNAs), meanwhile, lined up to prepare to serve the meals.
Once the process began, it was fast and furious. Tracy began dishing out food at a torrid pace, with CNAs grabbing plates and taking them out to their eager and hungry recipients. I quickly felt lost.
I found Brenda, who was making rounds assisting residents, and asked her how I could work my way into this obviously well-oiled machine. She instructed me to get in line behind the CNAs and be ready to grab a ticket.
My turn came quickly.
ARE YOU BEING SERVED?
Tracy, with skill and precision, took note of the order on the ticket and dished it out onto the plate in the proper portions. I then grabbed the appropriate cookie (the ticket lists whether the resident should get a regular cookie or the sugar-free variety) and - after Brenda pointed me in the right direction - I found the resident to whom the plate belonged.
He was happy to receive his meal as I placed it in front of him. I asked him he needed anything else, and he told me he was quite all right. He began to eat as I headed back to the end of the line and waited for my next ticket.
The process repeated itself until each of the 30-or-so residents in the dining room had received a meal. All were quite appreciative of the personal and prompt service they received, individualized to their preferences. Some received their food in bowls, as they desired. Some received two meatballs instead of one, or heftier portions of spaghetti than others. No one received a pre-fabricated meal trucked up from the basement on a tray.
While the residents in the dining room enjoyed their lunch, I assisted in the delivery of a handful of meals to men and women who for one reason or another were unable or unwilling to come to the serving area for the meal. Just as with those who came to the dining room, these were not pre-made trays: each individual had submitted a ticket with his or her specifications, and the plate was filled by Tracy just before it was covered and taken out of the room on a rolling cart.
I rolled the cart down the hall, being careful not to take corners too quickly or stop too abruptly and lose my cargo. At the direction of a CNA leading the way, we stopped at four rooms and delivered hot meals. The residents - in the middle of visits from relatives or watching their favorite television programs - responded with smiles and good-natured greetings. They thanked me for the delivery and I thanked them for being good customers.
When I returned with my empty cart, Brenda told me that my duty was simply to make sure everyone in the dining room was attended to until the room was fully vacated.
I worked the room to ensure each resident was in good spirits. I asked how folks were feeling, how they enjoyed their meal, and if they would like refills on their beverages. With some, it was a matter of asking if they needed a little help with their sugar packets or other small items that proved difficult to maneuver. It was just about noting their needs and trying to attend to them.
I received cordial responses from all. They enjoyed the interaction with their "waiter."
Later, after everyone had finished their meals, I noted that one of the CNAs was making her way around the room with a clipboard, making notes in a file. Brenda informed me that she was taking inventory on how much food and liquid each resident consumed during the meal, as part of the facility's ongoing attention to each resident's health and wellness - a task that is never neglected.
Soon, CNAs began taking residents back to their rooms one at a time. The time for cleanup was nigh.
CLEANING UP
Brenda had told me that I could go after the residents had eaten. But I knew that the full experience included one more not-so-glamorous task.
It involved what Brenda slangily called "the slop bucket."
Many of the plates the residents left behind still had plenty of food on them. And a lot of the coffee cups still were far from empty. All this needed to be taken care of before these items could make it to the dishwasher.
So once the task of accounting for all those leftovers in each resident's file had been completed, a more down-and-dirty task began - disposing of those leftovers.
Grabbing plate after plate and taking them into a back-room cleanup area, I dumped solid and liquid materials into a large clear bucket at a dizzying rate. It reminded me of a reality-show challenge as I worked toward filling the plastic container to its brim with the foul-colored substance.
While I was doing this, I had one last opportunity to interact with the few residents who remained in the dining room. As I whisked plates and cups away, I made sure to ask if they were completed with their meals and if they had a good experience during their lunch. More big smiles and appreciative responses. It was a good experience for us all.
I finished cleaning off all the tables - and I never did fill that bucket all the way to the top - and called it a day.
Though I apologized to Brenda for being in her way for so much of the afternoon, she told me she'd happily have me back again the next day if it meant she'd get so much help again. I was a natural, she said.
No one got the wrong food, no one got too much coffee, and no one got anything spilled on them. All in all, the day was a success.
And I had a chance to see something that has changed the attitude revolving mealtime at LSS. Everyone is happier when it's time to eat. And that's the way it's supposed to be.
I was happy when I left too, because I took home a chef's hat out of the deal.
