Dining is much more than serving meals. Formal dining and regimented eating schedules are being replaced with homey eat-in kitchens, farm-fresh food options, wellness programs that improve health, and memory-support activities that elevate resident spirits. Here's a look at some innovative programs.

Phoebe Berks Village

This retirement community of Phoebe Ministries located in Wernersville, Pa, has decentralized food service to nine new extended-family dining rooms where a household of people care for the residents. "Our goal is to provide more personalized dining that allows residents to select what they want to eat from a variety of fresh dining options and overall, create a family dining experience that is inviting for residents, staff and guests," says Michelle M. Doleniak, MA, RD, LDN, general manager of dining services.

The purpose of this style of dining is for residents and employees to interact with the same people daily, as you would with your own family. Everyone is responsible for the household, whether it's helping to take a residents' order, assisting with dining, setting and clearing dishes from the table, or just sitting to socialize.  

Employees who are part of the family may be from physical therapy, administration, activities and nursing. All are trained on how to serve the residents in this new setting, says Doleniak.

Employees complete training modules on being a gracious host/hostess, food safety and food service sanitation and handling practices. Team members are also provided with a booklet containing tips on how to serve and present themselves. 

Weekly and daily menus are available in each kitchen so anyone assisting in service will be familiar with menu variations and menu modifications specific to residents needs.

Within these extended family dining rooms are deluxe country kitchens. These resemble home-like, eat-in kitchens outfitted with a refrigerator, stove/oven combination, microwave and dishwasher. Residents can sit at the traditional kitchen table or at an open breakfast bar in the personal care units. 

Food is plated and served when residents are ready to eat. Twice per month, the personal care areas offer chefs' special presentations, such as made-to-order omelets and pancakes, in addition to weekly theme meals. The Community Life department uses the kitchens for localized kitchen workshops, cooking and baking activities. Living room areas have also been incorporated, so residents can visit any time to sit and have a cup of coffee, socialize or participate in an activity.

Dining flexibility was also implemented for residents who wish to dine at various times of the day.  For example, breakfast is served from 7:30 a.m. to 9:30 a.m. so residents can come and go at any time during this time frame to enjoy a breakfast prepared to order.

Episcopal Church Home

In St. Paul, Minn., Episcopal Church Home transitioned assisted living to six households where 18 to 24 residents receive a higher level of care. 

"While everyone in the household is involved in the residents' care, the biggest culture change was how we involved the residents in their own care.  According to Steve Patterson, district manager for A'viands, LLC, a food and services management company in Roseville, Minn.  As members of the household, residents help to set and remove dishes from the table, fold laundry and with assistance, even prepare a simple meal like a sandwich or dessert.  "These are purposeful exercises that help residents feel like they are doing for themselves which is important to their overall self worth," says Patterson.

Residents participate in learning circles where chefs will work with them to plan the kinds of meals they want to eat or dining activities they want to do. "Although we still prepare the majority of food in the main production kitchen including cakes and pastries baked from scratch, we supply the households with all kinds of ingredients... so we can prepare just about anything including a favorite family recipe from the kitchenette. Our director also offers cooking classes with the residents such as baking cookies," says Patterson. 

Residents can come and go when they please, as well as sit where they want to sit. "Families love to visit, dine and socialize with family members in the new households. Resident weight loss has also decreased by 30 percent and behavior issues decrease when residents are involved in their own care," says Patterson.

In transitional care, residents select from a variety of made-to-order items from a menu specifically created for them including omelets, cheeseburgers, steak and fish, as well as several options for patients who follow therapeutic diets.

For 2011, Episcopal Church Home will be adding low-sodium home replacement meals for people who participated in the cardiac program. "Residents will be able to order and receive a variety of low-sodium, heart-healthy frozen single-serving entrees to use at home," says Patterson.

Penn Hall at Menno Haven Nursing Center

This community in Chambersburg, Pa., creates an exceptional experience amid simplicity. For example, instead of just setting a dining tray in front of residents, every plate is removed from the tray and placed on colorful, seasonal placemats (decorated with leaves for fall, holly for winter, and pansies for spring and summer).

Residents enjoy their meals on tables also topped with colorful linens. The tables are set with salt and pepper shakers and sugar caddies.  Burgundy cloths are used for the fall and winter; yellow for spring and summer. Flat screen televisions were added so residents can enjoy some entertainment while they eat.

Socialization is a large component of a positive dining experience and the people who dine with a resident will improve or detract from the dining experience. The nursing team re-arranged tables so residents have the opportunity to sit together, family style. Dining and nursing worked together to determine the backgrounds, interests and preferences of residents so they can sit with others who share a common denominator. Whether it is a hobby like sewing, or a career such as teaching, residents who have something in common will socialize and therefore eat better during their meals.

Cura Hospitality  

A LivingLife wellness philosophy is driving dining trends at Cura Hospitality, a senior living and healthcare dining services provider headquartered in Orefield and Pittsburgh, Pa. LivingLife is based upon six components of overall wellbeing: vocational, spiritual, emotional, physical, social and intellectual. 

Cura's LivingLife activities, customized for each client community, can include: 

·        chef challenge competitions, where residents compete side-by-side with executive chefs

·        resident gardening and greening clubs

·        health fairs where residents receive health screenings and attend workshops where they learn about healthier food choices and the basics of good nutrition.

Everything from food entertainment events to memory support activities including how food is prepared and served also encourages residents to socialize and stay involved.  According to

Deb Santoro, RD, SPHR, director of staff development, clients are experiencing a growing demand for specialized services that provide care for individuals with Alzheimer's disease, dementia or related disorders.

Strategies include converting menu items to well-balanced portable meals, reviewing the colors of the serviceware to ensure that place settings are appealing, and developing tabletop recommendations and guidelines that are calming and distraction-free.

Sycamore Manor Health Center

Food-related activities support seniors with memory loss, says Drew Kendall, director of dining services for Cura-managed Sycamore Manor Health Center, a Presbyterian Senior Living Community in Montoursville, Pa. The facility recently started a home brewing club for residents. 

"Our brew club lends itself to an activity our male residents may have enjoyed prior to moving to Sycamore Manor. Activities like this help our residents reminisce about something special or unique from their past and overall lifts their spirits."

Kendall invites residents once or twice a week to view, experience and smell the aromas of foods like fresh-baked cookies. Research shows that smells can have dramatic effects on how we perceive our surroundings. Memories and scents are linked to your brain and your nose which helps bring back memories and events from previous times. 

 "By involving them in the preparation process, it helps them to remember that we baked these cookies earlier in the day, creating a connection during their dinner, even if it's only small bits of information," says Kendall.

Sisters of St. Joseph

In an effort to obtain fresh food, partnerships with local farmers and growers continues to be a dining trend in senior living that is here to stay. At the Sisters of St. Joseph in Wheeling, W.V., residents are taking it one step further by starting community gardens with dining services that gives them an activity they enjoy doing and helps them to become more sustainable while enjoying fresh and healthy food.

Gardens were started in the spring of 2010 for this community that offers independent living, assisted living and hospice. Residents and members of dining services planted a 50 ft. by 50 ft. garden with peppers, tomatoes, cantaloupe, pumpkins, beets, onions, potatoes and watermelon, yielding $5,000 to $6,000 worth in produce used by dining services to prepare menu items for the residents.

Local students from Wheeling Park High School and members of the Wheeling Jesuit University swim team helped the residents plant 25 herb containers including five types of basil, cilantro, thyme, oregano and parsley.  "Assisted living residents are responsible for the care of these plants all winter long, which gives them something to do during the colder months," says Jeff Freshwater, director of dining services.

This year Freshwater and the sisters will be focusing on high-dollar grocery items, like specialty peppers and edamame.

"We are also planning to expand the garden. Because this is also a retreat center, we served an extra 1,643 people last year.  So, we will plant an additional ½ acre parcel with pumpkin and watermelon," he notes.

Grace Zarnas-Hoyer is public relations manager, Cura Hospitality, Orefield and Pittsburgh, Pa.