‘Well-balanced’ approach to eating
Meals at B.C.’s 300 care homes can range from no-frills fare to home cooked favourites
Chef Nader Tabesh stands inside a massive walk-in refrigerator, surrounded by 30 dozen eggs, a stack of salmon fillets, and boxes of fresh fruit and vegetables, as he gets ready to make dinner for 100 seniors at Burnaby’s Normanna care home.
“For most people at care centres, the biggest challenge can be the food. So we make sure visually it has to be good, nutrition-wise it has to be proper, and the food has to be edible so residents enjoy the meal,” said Tabesh, whose company Angel Food Services provides three meals and two snacks a day for five seniors’ homes in Metro Vancouver.
“When they are in the care centre, activities and food are the biggest part of their day.”
But the meals at B.C.’s 300 care homes are likely to range from no-frills fare to home cooked favourites, as revealed in a recent investigation by the B.C. seniors advocate, Isobel Mackenzie, which found large differences in how much money was spent on food.
A home in White Rock had the cheapest food budget, spending just $4.92 a day to provide three meals and two snacks per resident. The average cost across the province was $8 a day — far less than the $10.21 spent on feeding inmates in provincial jails, Mackenzie said.
If you are investigating care homes for yourself or a loved one, experts suggest you ask many questions about the meals: Are all four food groups included? Are they low in sodium and saturated fat? Are they cooked from scratch and not processed? Are the ingredients fresh and not from a can?
“One of the things people should consider when they are looking at homes is to look at menus,” said Rachel Murphy, an assistant professor in UBC’s faculty of medicine, who has an expertise in both aging and nutrition. “All age groups are not really getting the nutrition we require, but I think it can particularly be challenging for seniors.”
The ideal meal, Murphy said, includes fresh fruits and vegetables on half the plate, along with a high-quality, lean protein (such as chicken, fish or eggs). Because seniors tend to eat smaller portions, having two healthy snacks a day is also important so they get sufficient nourishment.
“Often times in seniors homes they rely a lot on tea and toast, which is a comforting food but it doesn’t provide a lot of nutrients,” she said.
Older people also need more vitamins and minerals, such as B12 and calcium, which they ideally should get from food rather than supplements, Murphy said.
Postmedia analyzed the data collected by the advocate’s office for the 300 homes, and found there were about 50 that only spent between $4.92 and $7 daily to feed one person three meals and two snacks. Three out of every four of these low-spenders were run by private companies, with the others operated by the local health authority.
All seniors’ homes — whether privately or publicly run — receive their funding from health authorities, which have traditionally provided lower funding contracts to private operators. The disparity in contracts is something the health minister says will be addressed with new money that was earmarked for seniors’ care in February’s provincial budget.
Ten care homes spent far more than the others, between $12 and $18 a day, but they were all in the North or in isolated areas, and in
most cases had a small number of residents. Mackenzie referred to the highest-spending home, a small facility on Haida Gwaii, as “an outlier.”
The next 30 homes with the highest food tallies budgeted between $9 and $11, among them Langley Gardens and Surrey’s Crescent Gardens. A spokeswoman said the co-owned facilities supported Canadian farmers by incorporating locally sourced ingredients and seasonal food into their “well-balanced” dishes.
The vast majority of the homes — 200 of the 300 — spent between $7 and $9 a resident per day.
Fraser Health oversees the largest number of seniors homes in the province, and also has the highest tally of low food budgets. All homes must meet the requirements of Canada’s Food Guide and have their menus approved by a dietitian, said a Fraser Health spokeswoman, Tasleem Juma.
The health authority’s role is to examine how the home is self-monitoring key issues such as food audits, a minimum four-week menu cycle, and menu planning, Juma said.
She would not comment on how some facilities can feed a resident for as low as $5 a day, but said cost can be reduced by factors such as buying power when purchasing a large amount of items.
“If anyone is concerned about the quality of the food they or their loved one is receiving in residential care, we have a rigorous complaint process,” Juma said. “While we don’t receive many complaints regarding the food in residential care facilities, those we do get are typically related to variety or unaddressed dietary restrictions.”
Normanna and its sister home Dania in Burnaby allocate about $8.50 a person each day, using bulk buying and other money-saving steps to create wholesome meals that cater to demand for such things as puréed foods and cultural dishes.
“When a person comes into care, everything is foreign to them. The room is strange, the people are strange, they are going to be sitting with different people at the dining table. But looking at the food: Does the mac and cheese look like what I made at home? Is there fresh green beans on the dinner plate? That is where we can make a difference, giving them the familiarity of what they got at home,” said Stella Buttner, director of environment at the two facilities.
“The better the meal looks, the more likely they are to eat it and enjoy it. And of course it is about the socialization. It is not just about the food on the plate, it is about the socialization at the dining table as well,” added executive director Penny Hill.
“Nutrition is really important for any senior. It’s about everything. It’s about their skin integrity, it is about them being able to keep more mobile because, obviously, if they get all their vitamins and nutrients, it helps to keep their bone density good.”
Tabesh, the homes’ chef, argues health authorities, which already fund these homes, should provide set menus and budgets so that meals taste good and don’t come from a can or a box.
“(Even) the simplest thing: mashed potatoes. If you buy a russet potato and peel it — I know there is a bit of time in that — instead of an instant mashed potato, then your starch is much fresher just by spending a maximum of five cents per resident more,” he said.
“Some facilities, they try to cut the budget, but a lower quality (of ingredients) really impacts the food. Fresh product will cost a bit more, maybe (jumping) from $6 to $8 per day, but it makes a huge difference.”
Dr. Kenneth Tekano, regional program medical director of residential care for Vancouver Coastal Health, said homes should make every effort to improve the quality of life for people who are nearing the end of their lives.
“The fact that these numbers are now being examined is good because I think it will shine a light on: Does that seem like a reasonable amount to offer someone for food? It doesn’t seem like enough to me,” Tekano said.
“We need to invest more in improving the food quality.”