"What I've Learned"

Esquire magazine has a regular feature titled "What I've Learned." In it, they list the knowledge of the featured person. They've done sports figures, movie stars, CEOs, musicians and even a warden on Death Row. This month they feature Antonio Pierro, World War I veteran and retired jet-enginemaker, 110, Swampscott, Massachusetts. (Read it here) It seems obvious - if you are looking for some good lessons go to someone who has had a lot of them. George Foreman can tell you lots of lessons about boxing and home indoor grills, but Mr. Pierro, whew - where do you start.

People struggle every day with all that it means to be human. You would think that someone who has been doing it for 110 (or even 80 or 74) years would have people lining up at his door with offerings looking for some small wisdom. But, we know that is not the way it works. Now, I'm not saying age brings brilliance, clarity or even good intentions. However, 80 years is roughly 30,000 days and there is a good chance that one of those days included a fight with a spouse, a loss of hope, a triumph (big or small) or maybe even a plumbing problem. I don't know about you, but I'd really like some guidance from someone who has been through it.

Of course we are trying to change institutional nursing home culture, but we must also change the culture of our society that supports the institution that denies home and choice for elders. I probably don't even have to say it, but we do this by honoring elders and valuing their experiences - by seeing every year as a treasure.

Back in January of 2005 we posted "Maturing With Soul" by James D. Henry on this blog (Read it here) and asked for your answers to "What Are Elders Good For." We received this thoughtful response. I invite you to share this with your organization and to also post your own additions in the comments. Taking every chance to remind ourselves and others of "what elders are good for" will help raise the awareness of their value to our society.

The way to residents' hearts...

We talk a lot about what “home” means to each of us. For me, and I’m sure I am not alone in this, food plays a big part. At my home I keep all our favorite snacks on hand, we usually eat dinner around 8 pm, we love to have friends over for dinner and I admit that about once a month I have ice cream for breakfast. Do residents in nursing homes have opportunity to do any of those things? Not in most places, but offering choices in dining is often one of the first steps for culture change.

One of the reasons this is such an important and early step is that there are countless ways to accomplish it. This process will help you get started.

Put together a Dining Action Team. In addition to folks from dietary, include some of those who work closest with the elders (CNAs for example) and even a couple residents. This way you will get lots of good feedback about elders’ dining desires.

Next the team starts exploring the options. They range from a snack pantry to household kitchens open 24/7. Even if you decide to shoot for the household kitchen, a large and lengthy project, you can start right away with a snack pantry. Talk to elders about what they like for snacks. By hallway (neighborhood, household or other small group) make a grocery list and stock those favorites. Let the elders know that snacks are available whenever they like. The pantry itself can be a small refrigerator, microwave and cupboard in a small, under-used space, or even simply a small cupboard centrally located near the residents it serves.

Other great options to get you started include:
Continental breakfast for early risers
Made to order eggs
Extended dining hours so people can choose when they eat
Using residents’ favorite recipes to make special treats

The action team brainstorms some ideas and then does some more brainstorming to figure out how to pull it off. This handout offers some questions for the team to tackle. Culture Change Now magazine vol. 3 (available here) also has lots of great info on planning new dining initiatives including regulations and hosting friends and family. Check your state regulations to make sure you comply. Whatever you decide to do, keep in mind eating is so much more than just nourishing our bodies. It nourishes our soul with traditions, communion, memories and comfort.