Planning Micronutrient-Dense Menus in Ontario Long-Term Care Homes: Strategies and Challenges

Prevalence of micronutrient malnutrition is high in individuals living in long-term care (LTC) homes with many individuals consuming low levels of vitamins B6, D, and E; folate; calcium; magnesium; and zinc. The focus of this research was to identify strategies and challenges encountered during development of micronutrient-dense menus for use in Ontario LTC homes and to examine costs associated with development of a menu with acceptable micronutrients. Semi-structured open-ended interviews were conducted with 13 menu planners (7 dietitians, 6 nutrition managers) in diverse LTC homes in Ontario. Data were thematically analyzed. A 7-day hypothetical menu meeting all nutrient requirements was developed and costed. Analysis of the interview data showed that menus are planned according to the Canada’s Food Guide (2007) and focus placed on Dietary Reference Intakes of protein, fibre, calcium, and sodium. Little focus is placed on micronutrients. Flexibility in foods offered was important to accommodate the small volume of food consumed. Resident preferences were balanced against nutritional requirements. Challenges included planning for diverse populations, managing portion sizes, and balancing the budget. A hypothetical menu planned to contain adequate levels of all micronutrients is 49% higher in food costs than the amount currently provided to Ontario LTC homes.

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Nutritional adequacy of food consumed by elderly residents in long term care facilities

Journal of the American Dietetic Association ◽

10.1016/s0002-8223(01)80149-8 ◽

2001 ◽

Vol 101 (9) ◽

pp. A-49 ◽

Cited By ~ 1

Author(s):

C.O. Lengyel ◽

S.J. Whiting ◽

G.A. Zello

Keyword(s):

Long Term Care ◽

Nutritional Adequacy ◽

Term Care ◽

Care Facilities ◽

Food Consumed

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Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.100 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

R Waitzberg ◽

A E Schmidt ◽

M Blümel ◽

F Barbabella

Keyword(s):

Long Term Care ◽

Economic Status ◽

National Level ◽

Oecd Countries ◽

Limited Attention ◽

Eligibility Criteria ◽

Term Care ◽

Low Levels ◽

Equity Of Access

Abstract Background Long-term care (LTC) is organized in a fragmented manner. Payer agencies (PA) receive LTC funds from the agency collecting funds, and commission services. Yet, distributional equity (DE) across PAs, a precondition to geographical equity of access to LTC, has received limited attention. We conceptualize that LTC systems promote DE when they are designed to set eligibility criteria nationally (vs. locally); and to distribute funds among PAs based on needs-formula (vs. past-budgets or government decisions). The objectives of this cross-country study is to highlight to what extent different LTC systems are designed to promote DE across PAs, and the parameters used in allocation formulae. Methods Qualitative data were collected through a questionnaire filled by experts from 17 OECD countries. Results 11 out of 25 LTC systems analyzed, fully meet DE as we defined. 5 systems which give high autonomy to PAs have designs with low levels of DE; while nine systems partially promote DE. Allocation formulae vary in their complexity as some systems use simple demographic parameters while others apply socio-economic status, disability, and LTC cost variations. Conclusions A minority of LTC systems fully meet DE, which is only one of the criteria in allocation of LTC resources. Some systems prefer local priority-setting and governance over DE. Countries that value DE should harmonize the eligibility criteria at the national level and allocate funds according to needs across regions. Key messages A minority of LTC systems in OECD countries fully meet distributional equity in allocation of resources across payer agencies. Countries that value distributional equity should harmonize the eligibility criteria to LTC at the national level and allocate funds according to needs across regions.

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Working With Resistance and Encouraging Buy-In to New Programs

Perspectives on Gerontology ◽

10.1044/gero16.1.18 ◽

2011 ◽

Vol 16 (1) ◽

pp. 18-21

Author(s):

Sara Joffe

Keyword(s):

Long Term Care ◽

Term Care ◽

Optimal Outcomes ◽

Speech Language Pathologist

In order to best meet the needs of older residents in long-term care settings, clinicians often develop programs designed to streamline and improve care. However, many individuals are reluctant to embrace change. This article will discuss strategies that the speech-language pathologist (SLP) can use to assess and address the source of resistance to new programs and thereby facilitate optimal outcomes.

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Feeding Dependency Issues in the Long-Term Care Environment

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd10.1.19 ◽

2001 ◽

Vol 10 (1) ◽

pp. 19-24

Author(s):

Carol Winchester ◽

Cathy Pelletier ◽

Pete Johnson

Keyword(s):

Long Term Care ◽

Term Care ◽

Care Environment

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Communication Disordered: Program Implementation in Long-Term Care

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig15.64 ◽

2016 ◽

Vol 1 (15) ◽

pp. 64-67

Author(s):

George Barnes ◽

Joseph Salemi

Keyword(s):

Program Implementation ◽

Long Term Care ◽

Family Satisfaction ◽

Regulatory Compliance ◽

Care Staff ◽

Term Care ◽

Staff Members ◽

Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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