Friday, 26 August 2011 15:23

AHS decides the best way to feed seniors is to buy in bulk

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Opinion by Susan Quinlan

Reporter for the Prairie Post West

Alberta Health Services (AHS) recently announced they were going to “(Make) the healthy choice the easy choice,” meaning those who either work at or visit long-term care facilities will be given healthy food options. I was subsequently asked by Rose Sanchez, assistant managing editor of the Prairie Post, if I’d like to write an editorial, given I had been reporting on nothing but complaints due to the lack of palatable, healthy food choices for residents in long-term care facilities, enduring AHS’ 21-day menu.

I wondered how AHS could, in good conscience, announce they’re going to improve food choices for visitors and staff, when options for residents in long-term care facilities toggle between tasteless mystery entrées and hunger or starvation? That may sound slightly extreme, so I should clarify. I now understand Ensure, a meal replacement beverage, has become a permanent fixture on most residents’ meal trays.

As I thought about what to include in this editorial, I had the option to again report on complaints received from as far away as St. Paul and Elk Point, or to recount my own experience sampling the 21-day menu. I’ll talk about both.

Initially, I wondered if the registered dieticians consulted about the 21-day menu were actually given an opportunity to taste the end result. I tried to reach one for comment, but they’re not allowed to speak directly to media. However, I eventually tracked down a dietician in Grande Prairie, not employed by AHS, who spoke freely about the detrimental mental and physical effects on the aged of feeding them sub-standard food.

That dietician told me mealtime in long-term care facilities is the high point of every residents’ day. She said the quality of food served was the number one item residents wanted to talk to her about. Nothing mattered more.

Regarding the food quality of the 21-day menu, and not to take anything away from the knowledge of registered dieticians, but the average person knows that cooking/ boiling/roasting a given food item, then straining, slicing, mashing and freezing it, then trucking it a few hundred kilometres and steaming it back to, well, not life, but something, is going to leave it devoid of nutrients. You would have to track down the water it was boiled in and drink it, or lick the pan it was initially roasted in, in order to get any nutrients and those items are way back at the starting gate.

I strongly suspect dieticians only assessed nutritional content of the 21-day meal plan on paper, so it serves as a stunning example of something sounding good in theory, but failing miserably in practice.

As mentioned, I now have firsthand experience eating this … stuff. I sampled two meals at the Willow Creek Auxiliary Hospital in Claresholm, meals completely devoid of aroma and worse yet, short of the chili powder in the chili, devoid of taste. I have to say they looked okay, except for the vegetables which I’ll discuss later, so that makes me wonder if residents’ families aren’t complaining on their behalf because they as well see a well-organized plate when they visit, so they have no cause to actually taste the food.

It’s also worth pointing out the generation having to consume this food has likely known what it’s like to go hungry. They come from a time when you ate what was put before you, without complaint. As well, these older folks simply don’t complain like those who are younger.

To cut a long story short regarding what I ate and without exaggeration, with one meal, had I been blindfolded I would not have known what I was eating. With the other meal, as I took a progression of about three bites I could no longer taste it. The fat had coated the inside of my mouth.

The vegetables on both plates, a blend of broccoli and tiny cubes of carrots, were truly disgusting. I’ve been told the carrots are a real stinker for most residents, who simply leave them on the plate. The 90-plus resident I ate with painstakingly picked each and every fleck of orange out of the pile of green goo (broccoli), but didn’t eat any of the ‘vegetable serving’ anyway.

The dessert on offer was quite another story; moist, delectable chocolate cake. The thick slice of white bread covered with a thick coating of what may have been butter was truly tempting, but I suspect both items were included to fill residents up. These items are both very unhealthy given the load of sugar in the cake and icing, and the starch and lack of fibre in the bread along with the high cholesterol butter, so they were left on my plate (except for the tiny bite of chocolate cake I just couldn’t resist).

AHS insists some institutions report residents are okay with the food; their wording is “mostly satisfactory.” Of course, that could mean one person more than mostly unsatisfactory and further, I have to wonder if the institution that claimed to have no complaints has so few long-term acute care beds they don’t realize their claims are not actually statistically significant and in fact pose a detriment to change coming about for the larger group.

Government has some sort of gag order on kitchen staff. Numerous attempts on my part to speak with these individuals has been met with “can’t comment because I will lose my job,” which in fact has proven true and which I wrote about in a prior article (Sept, 17, 2010, Quality of food at care centres raises concern). As well, when I asked Andrew Will, executive vice-president of clinical services for AHS to comment on staff losing their jobs, he said he had no comment on issues pertaining to human resources.

I recently learned from the Alberta Union of Provincial Employees they are now investigating the job loss issue, as a direct result of AHS 21-day menu, because there is no longer a need to have any cooks at any institutions. Heating or steaming frozen products does not require a cook’s level of culinary skill.

AHS has received complaints the food is gross, and has subsequently claimed to improve its quality. They recently held a taste test and announced publicly that quality had improved; however, I’ve heard nothing but the opposite.

Results of the AHS independent review included recommendations such as hiring an executive chef, implementing further examination of procedures, hiring a “dedicated change management team” led by a “dedicated project director to facilitate implementation of recommended actions,” and so on. To read the results, search the Internet for ‘Alberta Health Services review of 21-day menu’ then click on the link for the review. You’ll note the issue of improving food quality and taste is never addressed.

Among those interviewed for previously-written articles on this subject, Edith Read said she continues to hear complaints from across Alberta about the poor quality food in the 21-day menu, receiving these complaints in her role as the Alberta Council on Aging’s President of Region 2 (Northeast Alberta), as well as from regions across the province.

Having spoken with Read as recently as Aug. 18, she again told me the complaints are endless. She has spoken to many AHS staff about improving the 21-day menu and has also sat through many presentations where AHS talks about how they’re going to make changes.

Read said at the first presentation she attended, AHS went on about cost and how the 21-day menu would save money, as they could buy food in bulk for all long-term care facilities and in this way could standardize menus. However, at a more recent presentation, Read said AHS recanted on the original intent; claiming  cost was never a factor.

Another individual who recently contacted me found out from a highly-reliable source working for AHS that in fact, the 21-day menu is costing taxpayers more than when meals were prepared onsite at each institution.

Read added AHS has now created a multi-layered bureaucracy to deliver the 21-day menu, a bureaucracy that was never needed when meals were prepared onsite. Back then, the province’s long-term care institutions each had qualified cooking staff who consulted directly with a registered dietitian, ensuring nutritional and special dietary needs were met.

 “ …I’m still getting dozens of complaints from all jurisdictions. The group from Ontario did the independent review and none of their recommendations came down to the kitchen level ... They fixed something that wasn’t broken. This is the biggest insult to residents in long-term care and patients in long-term care. This is their home,” explained Read.

Noel Somerville, chairperson for the Public Interest Alberta (PIA) task force assessing the 21-day menu and other issues affecting seniors’ care, has as well been inundated by complaints.

“I’ve heard nothing but complaints about the menu. It’s a way of contracting out food services to the cheapest provider. This is just one of so many things that are wrong with seniors’ care in this province,” said Somerville.

Meanwhile, Somerville offered up a recommendation to improve this and other negative situations concerning the delivery of poor senior care in this province. PIA Executive Director Bill Moore-Kilgannon supports his recommendation.

“We’re advocating for the establishment of patient/family councils in each institution. These are each micro communities and everyone within has the right to express their views, as to how the institution is operated,” said Somerville.

Moore-Kilgannon added this set up would be similar to that dictated by the Alberta School Act, where family councils, made up of a majority of parents, provide input to the school’s administrator as to how best to meet the needs of students.

With seniors’ care, explained Moore-Kilgannon, a family and resident council, again with a majority of family and resident members, could be formed and report concerns about care to the administrator sitting on that council.

Somerville further recommended a seniors’ advocate should be put in place to report directly to the legislature on an annual basis regarding concerns about seniors’ care. That would better insure those allocating dollars to seniors’ programs are informed about what requires attention.

As Read stated, “…government fixed what wasn’t broken.”

“Food is a perennial issue; if you have a council that can express concern, residents then have a voice. Empower families in a collective way … Without a council, people are afraid to speak up for fear they’ll no longer get good care,” said Moore-Kilgannon.

For now, I would encourage families of those in extended care facilities to write letters and make phone calls to their respective MLAs and of course, cast informed ballots in the 2012 election. I’m convinced the only way meal preparation will revert back to onsite preparation, and

I mean preparation of real food not reheated/steamed/reconstituted packets of food, is if more residents’ families get involved.

Same with those of us who haven’t got relatives in any of these facilities. You don’t have to have a relative onsite to go in and eat at places such as the Claresholm Care Centre cafeteria, which as well has been forced to implement the menu. There you can sample the food and decide for yourself. If you’re like me, you’ll pick up a pen and write to your MLA or give them a phone call to express your concern.

Even if we only think about ourselves, if something isn’t done now about this 21-day menu, it will be the food we all will consume once we enter long-term care.

Every MLA in this province, whether directly affiliated with health care or not, should have to endure one 21-day cycle of such delectable options as frozen mashed potatoes, scrambled eggs in a bag, globs of mac and cheese, souffles that taste like styrofoam and sweet potatoes too hard to eat. These are all comments I’ve heard describing what’s on those plates; imagine eating that for the rest of your life.

Serving substandard food to one of our province’s most vulnerable populations, responsible for creating the infrastructure and wealth we currently enjoy, is deeply disturbing. The 21-day menu may have been a project undertaken with the greatest intent, but in practice it has proven to be an abysmal failure.

Let’s wipe the slate clean and dial back to what actually worked. Everyone makes mistakes, but as the saying goes, it’s not the mistake that matters, it’s what you do to rectify it.

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