One Size Does Not Fit All

 

onesize storeOne size fits all seems like a dream come true, but is just that; a dream. I recently read an article wherein a group of women tried on the same articles of clothing all touted as “one size fits most” and took pictures documenting the experience. While their bodies were different but nothing terribly extreme, the clothing looked very different on each individual. Now, can you imagine making the same claim with food, and specifically menus? We don’t: all share the same favorite foods, like the same textures, appreciate nutritional value, have the same foods available to our region, or even like the same colors on the plate in front of us. No matter how perfect the product is, there is no way to satisfy everyone; there is no such things as a perfect menu.

Though universal satisfaction isn’t possible in menu planning, great success is possible with certain considerations. According to Linda S. Eck Mills, “A number of factors impact your planning – food habits and preferences of your customers, production capability, type of service, food budget, availability of foods.” We will explore these among other factors giving you the tools and information you need to make the best choices for you and your facility.

By definition alone, facilities span a wide range of services and abilities. Just within residential care, there is: Independent living communities, Memory Care Facilities, Assisted Living Facilities, Residential Care Facilities, Continuing Care Communities, and Nursing Homes. Desirable menus for those in Independent Living Communities would differ from Nursing Home Residents even if only based on chewing ability. Can you imagine the span if you were to ask preferences between a Juvenile Group Home and a Assisted Living Facility?

Even within the same kinds of facility, size, or number of residents has to be considered. While home-made Ravioli from scratch would be labor intensive, but feasible for a small home of 10, it would be an impossibility for a 200 bed facility . Because size can vary greatly, food preparation is drastically different. In a small home, the care-taker is also the maid, activities planner, and chef. In a large facility, cooking is a full-time job and there is often chef which does nothing else. This leads us to who plans the menu.

Consider this information in an article I read titled “Who pays for science?”. In a perfect world, money wouldn’t matter — all scientific studies (regardless of funding source) would be completely objective. But of course, in the real world, funding may introduce biases — for example, when the backer has a stake in the study’s outcome. A pharmaceutical company paying for a study of a new depression medication, for example, might influence the study’s design or interpretation in ways that subtly favor the drug that they’d like to market. There is evidence that some biases like this do occur. Drug research sponsored by the pharmaceutical industry is more likely to end up favoring the drug under consideration than studies sponsored by government grants or charitable organizations. Similarly, nutrition research sponsored by the food industry is more likely to end up favoring the food under consideration than independently funded research.

While we aren’t talking about pharmaceuticals, you still have to recognize who’s agenda is being supported during meal planning. Are the menus created by the vendor being used to increase sales? Are the chef’s creating the menu as part of their job description, regardless of dietary requirements? Are dietitians writing the menu to fulfill nutritional requirements while not considering the preferences of the residents? Is it a tray card system? Did a facility owner hire their health-wise sibling who needed a job? There are good systems and program out there, but educate yourself and scrutinize who’s menu you’ll use.

Regardless of who plans your menu, frequency of menu rotations plays are roll in planning and pleasing residents. By simple mathematics, if a menu makes a complete cycle in two weeks, those recipes will be seen many more times annually than another menu perhaps on a 6 month cycle. Within the rotations, the recipes should accommodate seasonal changes as well as regional produce availabilities and cultural preferences. A warm pot of hearty squash stew with some roasted apples and a slice of pecan pie should remind you a crisp autumn day while a fresh, cool meal of melons, berries, and maybe some barbecue is desirable for summer. Additionally, regional agriculture and traditions play a role in our diets. In searching for signature dishes by state, I came across a website listing a few. You’ll likely agree as you read this selection: Chicago-style Deep-dish Pizza (Illinois), Shrimp and Grits (South Carolina), Crab Cake (Maryland), Peach Pie/Cobbler (Georgia), Gumbo (Louisiana), Key Lime Pie (Florida), Green Chili Enchiladas (New Mexico), Cedar Plank Salmon (Washington).

One factor in menu planning that debatably holds more weight than some others is controlling food costs. In a perfect world, money wouldn’t matter and we could all eat whatever meal struck our fancy, but as it is, food costs are as variable as the weather. For example, a simple pound of wholesale ground beef averages about $3.00. Beef Tenderloin runs about $10.00 per pound. If you were to serve all of one versus the other for every single dinner for one year, the difference in cost is $2,555.00. That is just for one pound; can you imagine if you needed 5 pounds per meal?

The last thing we would like to emphasize is that a good menu should include compliance, customization, and feedback. About half of the states in America require a dietitian approved menu which meets with state standards and regulations. Wherever a facility may be, the menu must be within given guidelines and meet respective standards. Whomever writes the menu must understand this principle. Customization is something we have touched on previously. To recap, menus need to be written to accommodate, traditions, preferences, location, and season. Within these parameters, creativity is essential. As this is achieved, satisfaction will increase. Lastly, feedback not only from residents, but from professionals as well will help in your “recipe” for success. It is good to know what recipes do and don’t please, what the chefs think will work on a large scale and what wont, how well recipes convert for size, what pinches a budget and what doesn’t, just to name a few.

It would be easy to feel overwhelmed by the variables to a good menu, but you will have the most success if you try to do right by the residents. A CEO of an assisted living company wrote, “I still remember walking into the very first assisted living facility I owned, on the first week of opening and hearing a resident loudly proclaim for all to hear, “This food tastes like $#!&”. Regardless of the delivery, the message is clear; food is important to people. Often, the highlight of the residents day, and even our own, is meal-time. Louise Fresco said, “Food, in the end, in our own tradition, is something holy. It’s not about nutrients and calories. It’s about sharing. It’s about honesty. It’s about identity.”

As you consider all the moving parts to this big picture hopefully you feel better direction as you think of what goes into your menus. Recognize that no matter how good a product looks, be it a shirt, or the best menu you have planned in your life, it will not please everybody. One size does not fit all. However, focus on what you can control, consider all the factors and make it about the residents. When you do these things, you will please most, and with that you can take pride in your menus and have fulfillment in the product.