Food is Part of the Quality of Life

22.07.2015 — Food nourishes the body – and the soul. This is the belief of those responsible at the care facilities for the elderly operated in the Rhine-Main-area by Mission Leben. Several years ago, they developed a holistic catering concept in cooperation with Dussmann Service which focuses on individual service for residents. An appraisal.

In this restaurant, food is served according to individual preferences: the meat is served in one piece, or cut into pieces, or pureed; milk products or gluten may be excluded; a diet that is high in protein or low in purine can be provided. Does it sound like every cook’s nightmare? At the home for the elderly operated by Mission Leben in Rhineland-Pfalz and Hessen, these challenges are part of day-to-day routine. In 2007, the charitable organization developed an ambitious catering concept for the elderly together with its long standing caterer Dussmann Service. For three years, 14 facilities have been putting the concept into practice. Before 2007, food was being freshly prepared but each house had its own system. This was changed. The objective was to be able to provide each resident with enjoyable food to meet his or her individual needs and preferences including consistency, meal type and service method, all in an atmosphere which contributes to wellbeing. The name of the concept, Speisenkultur – food culture, reflects the fact that it is not primarily concerned with calories and nutritional tables. Speisenkultur has turned the kitchen into one of the major components of geriatric care alongside nursing, support and housekeeping. In 2012, a service company named DSE Dienste für soziale Einrichtungen GmbH was jointly founded by Mission Leben and Dussmann Service. It employs 80 kitchen staff and 80 cleaning operatives. The kitchen team focusses on the individual eating habits and needs of the elderly residents. After all, good food makes you feel good.

Not Just Older Diners 


In later years, it is not only sight and hearing that suffer. The sense of taste also dims and so it is easy for the elderly to lose their enthusiasm for food. This frequently results in weight loss and undernourishment. Combatting this process is the task that the kitchen team at Mission Leben has taken on, a task that differs substantially from that of a staff restaurant. The diners at a staff restaurant eat only lunch or a snack at the outlet. Elderly residents at the facilities eat all of their meals in the restaurant. It is their dining room and an integral part of their home. The meal plan must provide all of the necessary nutritional components and this is not simple as residents often have only a small appetite and require fewer calories than younger people. Nutritional requirements, however, remain unchanged throughout life. An additional complication is the difficulty that many seniors experience chewing and swallowing. Dussmann Service has proved a competent partner in Mission Leben’s ambitious project. The catering division at headquarters in Berlin offers many years of experience in catering to the needs of the elderly. These experts have developed a concept for Dussmann Service named Vitalance which emphasizes enjoyment of good food and simultaneously, focuses on the fulfillment of nutritional requirements which help the elderly remain healthy into old age. During the development of the Speisenkultur concept, two decisive factors emerged: Firstly, the state of health of individual residents differs vastly and therefore they require hugely differing meals. Secondly, nutrition is an issue which involves everyone in the facility who have contact with residents; not only the kitchen staff but also nursing and housekeeping personnel.

Each to His Own 


The objectives of Speisenkultur are to promote enjoyment of food, to support continuing independence and to contribute to the health of residents. The DSE kitchen team goes to great lengths to meet those objectives: three forms of preparation are available to residents who have difficulty swallowing; two further options are offered for those who have difficulty chewing. Gluten and lactose intolerance is taken into consideration as is the need for a diet which is high in protein or low in purine. These options apply to all meals and to both lunch options which are provided each day. “Sometimes, it means 14 different bowls for one dish” explains Alexander Noll. As the kitchen manager at Haus Priska, he is responsible for the culinary needs of the residents at the most recently established facility for the elderly operated by Mission Leben. Haus Priska in Dieburg was opened in October 2013 and provides 108 in-house places for the elderly and others needing care. There are also 16 sheltered accommodation apartments. The effort invested has been worthwhile and is rewarded by the growing well-being of residents. Many residents who were previously served only pureed food now enjoy recognizable ingredients on their plates. Older residents who arrived at their new home significantly underweight put on weight within a short time. Kerstin Wick-Suttner, who heads Haus Priska, is convinced of the benefits of the concept – and of the efficiency of the kitchen team. “It is mutual success. The cooks understand the processes here in the facility and the needs of the residents.” Reaction speed is one of the huge advantages of Speisenkultur. When a new resident moves to one of the Haus der Mission Leben facilities, an assessment of the type of diet needed is made. Nursing staff enter not only the medical condition and diagnoses into the so-called “communication card” but also food preferences and aversions as well as, importantly, how well the resident is able to eat. “Repeatedly, we discover that a resident does not have difficulties swallowing, as assumed by the family, but that the difficulties are with chewing" explains Kerstin Wick-Suttner. In such a case, it is sufficient to prepare food so that is soft and to divide it into small bite-sized pieces instead of making a puree. “This makes a huge difference to the resident. Food tastes better, and of course, it looks better too.” A grid makes it simple to pass the relevant information to the kitchen.

More Responsibility for Staff 


Speisenkultur influences not only the residents' quality of life; the work of personnel in the various departments and the way they interact has changed significantly. The skill of the nursing staff is indispensable when it comes to observing residents and judging the state of their health. A new position was created: the housekeeper. She is the interface between nursing operations and the kitchen in the seniors’ facilities. Her staff order meals according to the directions of the nursing department and supervise during meal service, ensuring a pleasant atmosphere. They know the diners personally: they know who needs a little more time to finish their meal and they notice if the method of food preparation is wrong. “We have discovered that the catering concept doesn’t work without this support” reports Kerstin Wick-Suttner.

Constant New Challenges 


It was three years ago that Speisenkultur was introduced in the 14 facilities but the development of a process as complex as this is never finished. New nursing and housekeeping staff are always familiarized with the background and processes of the concept and they learn about the options available in the DSE kitchen; this knowledge is important to enable them to order suitable meals for residents. Newcomers in the kitchen need to learn that “pureed” doesn’t always mean “pureed”. All of the kitchen managers are trained at the Dussmann Campus in Zeuthen, Brandenburg as “Dussmann Service Specialist for Seniors’ Catering”. Regular audits and quality checks guarantee that processes conform to prescribed standards. The Dussmann Service catering division at headquarters in Berlin supervises the project and keeps abreast of developments in gerontology and in associated legislation. EU consumer protection regulations, which apply from 2015, prescribe that the ingredients of all goods which leave the kitchen must be fully specified. This is largely due to the increasing number of allergies. The establishment of the relevant processes is already underway.
Michaela Mehls

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