Last updated on June 15th, 2023
In 2018, the Academy of Nutrition and Dietetics took an official stance supporting liberalized diets for seniors in long-term care facilities. They reasoned that liberalized diets would enhance residents’ quality of life and their nutritional status.
A liberalized diet is a critical component of person-centered care. These diets allow residents to eat foods they prefer while still supporting sustainable health and wellness. The Academy of Nutrition and Dietetics found that most residents in a nursing home with malnutrition were on restrictive therapeutic diets that could inadvertently discourage sufficient food intake.
Liberalized diets are also supported in the Centers for Medicare and Medicaid Services (CMS) guidelines for Long Term Care Centers. The F-tag F-692 states that “interventions related to a resident’s nutritional status must be individualized to address the specific needs of the resident.”
Obstacles to implementing liberalized diets
According to CMS, long-term care communities should minimize diet restrictions in the form of therapeutic or mechanically altered diets when possible.
What’s a therapeutic diet? CMS defines it as “a diet ordered by a physician or other delegated provider that is part of the treatment for a disease or clinical condition, to eliminate, decrease, or increase certain substances in the diet (e.g., sodium or potassium), or to provide mechanically altered food when indicated.”
These diets are designed to restrict intake for the resident’s benefit, however they can result in monotony and lack of options in the healthcare setting. A therapeutic diet can limit a resident’s decision-making power over their own health. To make the change from therapeutic to liberalized diets, your community needs to be prepared to involve residents in their healthcare plans and choices.
Liberalized diets may even help you reduce costs by consolidating kitchen production and potentially decreasing oral nutrition supplement use.
Some communities might be apprehensive about switching from a therapeutic diet model to a liberalized one. They may think that there will be liability involved or that liberalized diets won’t meet local, state, or federal regulations. However, many regulations today focus on person-centered care and providing a good quality of life for residents, and liberalized diets are a large part of that. It’s essential to work with your community’s medical team and registered dietitians when switching to a liberalized diet model to ensure all resident needs are met, and staff are educated on the importance of resident education and choice with liberalized diets.
How to liberalize diets at your senior living community
CMS recommends that your community’s team speak with residents, their families, caregivers, and/or representatives whenever possible about the risks and benefits of a liberalized diet. Also, speak with the resident about their needs, preferences, background, and health goals. Then, work with the resident’s medical team to determine the best plan for that individual.
Whenever Culinary Services Group starts working with a new community, we sit down with each resident and learn their food likes and dislikes. Then, we use this information to create a menu at your community that takes those food preferences into account. Our goal is to keep your residents happy and create a more person-centered care environment.
What about residents with serious health conditions?
Are liberalized diets realistic for residents with medical conditions like diabetes? Yes! As we mentioned above, overly restrictive diets can lead to unhappiness and malnutrition for any resident. According to the Academy of Nutrition and Dietetics, conditions like obesity, diabetes, chronic kidney disease, and cardiovascular disease have typically been “treated” with therapeutic diet prescriptions. However, the Academy’s position today is that a person’s diet “should be determined with the person and in accordance with his/her informed choices, goals, and preferences, rather than exclusively by diagnosis.”
Some recommendations for accommodating these residents while liberalizing diets include smaller dessert portions, giving residents who require low-sodium diets the same food as other residents but without a salt packet, and/or letting patients choose their meals from a list of “approved, preferred foods” that fit within their prescribed diet.
Are you ready to liberalize diets?
It’s important to remember that meals aren’t just about the food on the plate for residents in a senior living community. Meals are times when residents get to feel comforted and be social. If they like the food on the plate, they’ll be more likely to attend mealtime, stay longer while eating, and get the extra benefits that eating in a group can provide.
Liberalized diets also provide you the opportunity to educate your residents about balanced diets, portion sizes, and making healthier choices all around so they can continue to do so once they’ve left your facility.
Liberalizing diets at your senior living community may seem daunting, but with the right partner, it can be easy. Culinary Services Group will work with your dining team and residents to ensure you’re serving meals that match resident preferences and comply with CMS guidelines. We can also make sure your residents have the opportunity to eat when and where they want to. For example, a good dining program should provide food to residents 24/7. Some people may like to eat earlier or later than the set mealtimes, and they shouldn’t have to go hungry because of it. We will work with your team to figure out the best ways to make sure residents are fed well throughout the day.
Contact us here if you’d like to learn more about how we can help you liberalize diets and serve food that matches your residents’ food preferences.
