Healthful Munchiesk for Happy Residents
Today’s Dietitian
By Becky Dorner, RD, LD
Vol. 6 No. 6 p. 42

Approximately 15 years ago, the administrator of a large skilled nursing facility I consulted to came to me about our “supplement situation.” To put it kindly, he was unhappy about the rising cost of supplements. I began to investigate and what I found was shocking. Over time, as a team of well-meaning professionals, we had requested and/or ordered an extreme number of supplements—and many of those supplements were literally going down the drain. It was time to make some major changes. If you can relate at all to this story, you will appreciate some great ideas for being more effective with nutrition interventions while jazzing things up for your residents.

Make Eating an Anticipated Experience
Eating is a social time for fun and gathering with friends. Eating involves emotional decisions—choosing the food you really feel like eating at the time.
Do you like to snack between meals? I know I do, and so do many of the older adults in our care. Snacks are a great way to provide some of the extra calories, protein, and other nutrients many of our residents need.

Focus on Food First
Offer appealing foods that are enjoyable and also help meet the nutrient needs of each individual. Make snack time less institutionalized, scheduled, and mundane. This can be achieved by offering a variety of choices in snacks. Allow residents to choose what they feel like eating at the time the snack is offered.

Instead of adding extra foods and supplements, choose foods residents enjoy most and enhance them by adding calories and protein. Boost calories with margarine, mayonnaise, sour cream, or whipped cream. Boost protein with cream, milk, cheese, peanut butter, yogurt, cottage cheese, or powdered milk.
Enhance the foods residents like most:
• super cereal for breakfast;
• fortified soup, mashed potatoes, or high-calorie/high-protein casseroles at lunch or dinner; and
• power pudding for dessert or snack.

Snack Carts
Remember when you were a kid and you looked forward to the ice cream man coming down your street every night? Or when you were in the hospital and the candy striper came by with the cart full of goodies (eg, snacks, magazines, newspapers)? Why not create a similar feeling for your residents?

Decorate a cart with a canopy or an umbrella to make it look festive. Make snack time an event residents look forward to every day by playing music and having positive energy while passing snacks with a smile. Offer newsletters, newspapers, activity announcements, or information fact sheets. And just like the ice cream man or candy striper, offer candy bars or ice cream novelties once in a while. These are foods we enjoy every day—our residents will enjoy them, too.

If you plan to develop a snack cart program, determine the following:
• who can order specific snacks for those residents with special needs (weight loss, malnutrition, or special diets);
• who will pass the snacks and supplements and at what times; and
• how acceptance will be communicated with nursing and dietary.

Snack Kitchens
Snack kitchens should be easily accessible to residents, families, and staff. Keep the kitchens stocked with fresh and varied choices of foods and beverages daily. Snack kitchens are popular for a number of reasons:
• Foods and beverages are readily available. Residents can visit the area any time of the day or night to snack between meals, at bedtime, or anytime they like.
• Healthful snacks appropriate for most special diets can be on hand (eg, fresh fruit, applesauce, pretzels, crackers and peanut butter, cereal and milk, sugar-free and vitamin C-fortified beverages).

If you decide to have a snack kitchen, determine the following:
• who will stock the kitchen;
• what the stocking rotation of foods will be; and
• who will keep the kitchen clean and monitor for safe food handling.

Follow the Holidays
Use seasons, celebrations, or themes to guide your snack rotation. Try a few of the following suggestions:
• In fall, serve cider and doughnuts or s’mores and hot chocolate.
• In winter, serve tea and scones, traditional holiday cookies and milk, or valentine or shamrock cookies.
• In spring, serve hot dogs and “near beer” for baseball season (or real beer for those who can have it).
• In summer, have an ice cream social and serve root beer floats and fruit smoothies.
• Anytime of year, have pizza night, candy time (chocolate candy and milk), milk and cereal, or resident choice snacks.

If you’d like to have healthier and happier residents, satisfied families, reduced weight loss, and fewer complications, use a variety of the ideas presented here and let your residents have a snackin’ good time!

— Becky Dorner, RD, LD, is a speaker and author who provides publications, presentations, and consulting services to enhance the quality of care for our nation’s older adults. Visit www.beckydorner.com for free articles, newsletters, and information, or call 800-342-0285.

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