Serving Up Connections with the Coffee

Judy, the dining services director in a large Continuing Care Residential Community (CCRC) in Oregon, recently shared this story with me. Judy's father is a resident where she works. One day, he suggested she hire her brother, who is autistic, to serve meals in the dining room. She kindly said, Dad you know it wouldn't be appropriate because with autism its difficult to connect with people and Michael doesn't have serving skills. Her dad looked at her, shrugged his shoulders and said, "but, honey, you hire people like him already.

How many residents might make the same comment about your community?

Until recently, dining operations in senior care communities have primarily focused on the food itself and delivering it efficiently, rather than nurturing relationships as part of mealtime service.

During my graduate research ten years ago I discovered that little effort had been spent measuring residents service expectations during the meal. In fact, twenty years of literature covering the topic of food service in hospitals and the long-term care industry rarely, if ever, referred to the relationship between the resident and person serving a meal as one of service. It was referred to as the exchange or interactional component. While unintentional and regardless of type of community, level of care, or style of service, providers discounted how much seniors value social interaction at mealtimes.

My own work experience confirmed this state of affairs. Starting out as a dietary manager in a skilled nursing home it seemed as if the food was being dispensed rather than served. Residents had little or no say about what they were offered and when. The ambience of the dining room was institutional rather than homey or inviting. The dining room staff was efficient but mechanical. And while congenial, servers often conversed among themselves while doling out meals, as if the residents weren't even there.

Becoming a foodservice director in an assisted living community did little to quell my surprise at poor service offerings. Even though the dining room furnishings were beautiful and the menu upscale, the day servers dressed like housekeepers because they were the housekeepers. The evening servers were teen-agers with no training and little service sense. Staff turnover was constant, often hitting 100%. Mealtime atmosphere was haphazard at best, certainly not conducive to an enjoyable dining experience.

I found these situations unsettling, devoid of genuine human interaction, and totally unfulfilling for the residents and staff. Even more puzzling was that nobody seemed aware of or concerned about such situations. Our clients, the residents, who were paying good money to live there, didnt merit the same level of courtesy and service any other paying customer in a day-to-day setting would.

The customer service component of the dining room dynamic wasnt recognized as valuable or even necessary. Instead, this basic need had been overshadowed by single-minded adherence to numerous state and federal regulations, medical regimens, and costs pressures.

Fortunately, these attitudes are changing. Care communities serving seniors are recognizing that customer service should be on the menu at every meal, along with nutritious food. We are investing in our staff, now giving them the training they need to help fulfill residents service expectations. However, this is just the first step in the right direction. The customer service component is critical but even it doesnt go far enough.

Recent research now confirms that the mealtime relationship offers an important opportunity not just to serve, but to connect. Servers have a direct effect on residents emotional well-being and quality of life. When a server takes the time and is educated on how to communicate properly, genuine connections can be made and residents will gain a feeling of respect, appreciation, and a sense of belonging. As a bonus, so will servers.

Customer service isnt just a nice thing to do; its a valuable tool in accomplishing many of the health and quality of life goals we hold for our communities. As the long term care profession moves increasingly towards person-centered care, the time is right for providers and dining service directors to take the lead, advocating for, adopting, and evaluating their current dining programs against best practices in serving meals that will enhance a residents experience. Join me! Together we can create a new paradigm in care community dining service, serving up meaningful connections along with that cup of coffee.