What do you do when the drugs intended to benefit residents could very well be causing harm?

By Steve Moran

Last week the University of California San Francisco published a study that suggests a commonly used class of drugs used to treat dementia (cholinesterase inhibitors) is causing unintended weight loss in individuals being treated with these drugs.

This is a very real problem for any senior living community. This means drugs intended to benefit residents could very well be causing harm, real harm including:

  • Increased mortality

  • A decline in functional status

  • A poorer quality of life

This creates a sort Faustian trade-off where, on one hand, the drugs have the potential of limiting or slowing the progression of Alzheimer’s and, at the same time, cause problems that put residents in serious jeopardy.  

Out of the Box Thinking

The obvious solution is a risk benefit analysis to determine whether or not to use the drug. I was recently chatting with Chefs Sarah Gorham and Stone Morris, the founders of Grind Dining, a Senior Housing Forum Partner, about this challenge and they suggested a third way of looking at it, by posing this question:

What if you could modify the food program in such a fashion that dementia residents would eat more food, which would allow residents to continue to take these medications and maintain or even gain weight?

The Big Dementia Calorie Problem

According to Sarah and Stone, even without these drugs, providing memory care residents balanced nourishing meals, while preserving resident independence by feeding themselves, was a difficult conundrum to solve.

Many memory care residents can’t use utensils and resist being fed (to say nothing of the indignity of having to be fed). It was tough to figure out how to create meals that were finger-friendly, nutritionally complete, satisfying, require little to no chewing while, at the same time, provide a satisfying dining experience using the exact same meals being prepared and served to the rest of the community.  

From an operational standpoint, Sarah and Stone understood that this method had to be simple, cost effective, and easily streamlined into the kitchen’s daily production in order to maintain or reduce labor and food cost. By using the existing menu items there is no longer a need for a separate menu that marginalizes the resident and less care-partners are needed at mealtimes due to the residents’ ability to feed themselves.

The Big Switch Hit

There are really several big switch hits with the Grind Dining experience:

  1. Instead of avoiding touring prospects during memory care dining, you will look to schedule tours during dining hours because it will become one of your key differentiators.

  2. Residents who are still independent but may have difficulty chewing due to ill fitting dentures, tooth loss, physical or muscular disorders such as Parkinson’s, arthritis, or MS are able to eat and enjoy the exact same meal as the rest of the community without feeling embarrassed. (I mean who doesn’t like eating with their fingers if it is not too messy.)

  3. Family members are overjoyed and relieved their loved ones are eating not only well, but independently. No one likes to see their parents being spoon fed while wearing a bib.

  4. In several communities where Grind Dining has been implemented, residents who were on a pureed diet were able to easily chew and swallow meals again.

Follow this LINK to see some photos of what they are doing to transform memory care dining.