Creating Home
in the Nursing Home II
A National Online Symposium on Culture Change and the Food and Dining Requirements
Welcome to the Symposium!
Presented in cooperation with
American Health Care Association |
 |
is a joint effort by Pioneer Network and CMS to provide education and support to providers, researchers, policy makers and consumers who are engaged in eldercare reform; who are growing or sustaining culture change initiatives; or who are simply trying to develop a business model that meets the needs of an increasingly discerning aging population. Originally developed as a day-long event in Baltimore, the March mid-Atlantic storms forced a cancellation of the planned symposium. We have created this special online symposium as an alternate means for you to explore a wide-range of topics related to culture change and the food and dining requirements.
On this page, you will find all the information from our national panel of experts, presented as a series of webinars and accompanying papers. Special thanks to
The Picker Institute for underwriting the complete set of original symposium papers which we are offering as no-cost downloads for the benefit of the entire long-term care community, and the betterment of the quality of life of elders nation-wide.
Thank You! The SessionsInnovations in dining including liberalized diets, buffet-style service and reductions in bib and supplement use have been welcomed by providers, but they often struggle integrating new approaches with the regulatory guidelines. The sessions offered below will address dining initiatives and explore potential and perceived regulatory barriers so that both innovators and regulators can come to a common understanding of responses congruent with OBRA '87.
Introducing Our Host, Carmen S. Bowman Carmen S. Bowman, MSH, Regulator turned Educator, Edu-Catering: Catering Education for Compliance and Culture Change, is the host for each of the webinars. In addition, she has prepared a background paper which sets the stage for the symposium. We encourage you to read this paper in preparation for the webinars.
Meet the Host: Carmen S. Bowman
Remarks
Food for Thought: The Missing Link Between Dining and Positive OutcomesJudah Ronch, a psychologist and researcher, evokes author Marcel Proust's classic work that muses on the link between memory and the dining experience. Ronch notes that Proust described what modern neuroscience can now explain, that the act of eating, or even
thinking about eating, actually
stimulates neural pathways of memory and action in the brain. He further notes that if our elders are receiving institutional meals that are not memorable or tied to earlier memories, with nothing autobiographical to spark those neurons in a particular person, not only are they not remembering, they are at risk of
losing memories of self. This brings a critical question to light:
Is the food we are serving our elders, and how it is chosen, possibly causing them to decline in some way?Meet the Presenter: Judah Ronch, PhD, Interim Dean of the Erickson School
The Deep-Seated Issue of ChoiceBased
on her work as a culture change pioneer both as a dietitian and
administrator of one of the first nursing homes in the Household Model,
Linda Bump will challenge us to think about what is possible, what makes
new ideas difficult, and how to effect the deep organizational change
needed so that a person's right to choice in their own home is honored.
Difficult questions such as, "Who wins the care plan?" and "Who are we
to decide for people what is best for them?"will be addressed through
the lens of the OBRA mandate to honor the resident's right to
self-determination as well as the right to refuse treatment.
Meet the Presenter: Linda
Bump, MPH, RD, LNHA, CD, Culture Change Consultant and Trainer
Survey Interpretation of the
Regulations
As self-directed care becomes more common, CMS is striving to keep
up with regulations, guidance and survey procedures. Survey issues to be
addressed include: the requirement for menus versus resident choice;
facility responsibility for food safety and honoring resident choice for
'visitor' foods, potlucks, and food in personal refrigerators; the
14/16 hour rule; and compliance with the new guidance for
self-determination, dignity and homelike environment. Lastly, the story
of the California Person Centered Dining Pilot Project's collaboration
between the state survey agency, the CMS regional office and the
California Culture Change Coalition will be told and results discussed.
Meet
the Presenter: Linda
Handy, MS, RD, Consultant, Retired Specialty/Trainer Surveyor CDPH
The Food Code and the CDC Infection Control Guidelines The federal
regulations refer to the Food Code which is written by the Food and Drug
Administration, an agency of the US Department of Health and Human
Services, as a standard of practice and many state regulations require
it be followed. A representative from the FDA will describe how the code
gets written and revised.
Infection
control is an important element of the food and dining experience in
nursing homes. Federal regulations refer specifically to the Centers for
Disease Control (CDC) guidelines for infection control. A
representative from the CDC, an agency of US Department of Health and
Human Services, will explain the development and revision of the
guidelines.
Meet
the Presenter: Glenda
Lewis, MSPH, FDA Office of Food SafetyMeet the Presenter: Nimalie
Stone, MD, CDC
AHRQ/CMS Study of Paid Feeding
Assistant Programs
Research regarding the outcomes of utilizing paid feeding
assistants has been conducted by Abt Associates under contract with CMS
and the Agency for Health Research and Quality (AHRQ). Findings will be
shared and lessons learned discussed.
Meet
the Presenter: Rosanna
Bertrand, PhD, Abt Associates Inc.
Meet
the Presenter: Sandra
Simmons, PhD, Vanderbilt University, Center for Quality Aging
Outcomes
of Choice in Dining Positive outcomes related to choices in
dining documented in several studies, including her own on buffet style
dining, will be shared from the perspective of a nurse researcher who
will also address nursing challenges in implementing change to meet both
the nutritional needs and dining preferences of residents.
Meet
the Presenter: Robin
Remsburg, PhD, RN, GCNS, BC, FAAN,
Director School of Nursing and Associate
Dean College of Health and Human Services George Mason University
The Role of the Physician Order Hear from a physician who has been at the
forefront of providing self-directed care, how liberalized diets and
personalized medication pass can not only work but also enhance clinical
outcomes. Questions will be tackled such as how do we monitor clinical
outcomes? What is the role of the physician order? What should happen
when a person chooses not to follow a physician's order? From a clinical
perspective, what is the physicians', nurses' and facility's obligation
to the person?
Meet the Presenter: Matthew
Wayne, MD, CMD, Medical Director University Hospital Health System
Senior Services, Geriatric Services Southwest General Hospital,
University Hospital Foley ElderHealth Center, Legacy Health Care and
Provider Services Meet the Presenter: Karyn Leible, MD, CMD, Chief Clinical Officer for Pinon Management and Vice President for the American Medical Directors Association
The Role of the Pharmacist Pharmacists
become involved with non-time-specific medication passes, food and drug
interactions, appetite stimulants and nutrition supplements. Balancing
pharmacy practices with self-directed living will be addressed in the
context of liberalized dining.
Meet the Presenter: Denise
Hyde, Pharm.D., RP, Community Builder Eden Alternative Inc.
Return HomeDownload the Background Paper Meet the Presenters