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14 Mar 2019

Breakfast in Bed – Aged Care

Breakfast in Bed is a Luxury. Majority of people mention their experience of receiving breakfast in bed as an amazing experience, feeling pampered or feeling special. Mother’s Day, Father’s Day, Anniversaries, A Great Holiday, Special Occasions & Great Surprises……… All of these start with Breakfast in Bed.

Then why not the same for Aged Care residents. Why do we think that breakfast in bed is not the best way to provide services in aged care? Why the majority of aged cares have decided “Buffet Breakfast” is a better service model.

The following are the top most arguments I hear in response to “Why not breakfast in Bed”:

Ø Breakfast in bed takes away residents dining experience / social engagement
Ø Residents do not get multiple choice/variety at breakfast
Ø No Flexible times for breakfast (extended service hours)
Ø Residents feel more independent as they can walk to a buffet and help themselves
Ø It is an institutionalized approach

Let’s look at each of these arguments individually :

Ø Breakfast in bed takes away residents dining experience / social engagement

Typically, there are at least 6 meal services in any aged care facility. Breakfast, Morning Tea, Lunch, Afternoon Tea, Dinner & Supper. Not to mention additional cooking activities and other food-related activities that are part of the lifestyle calendar. How is it that serving 1 meal in their room will take away their dining experience and seriously affect their social engagements!!!!

Sitting down with loved ones and sharing a meal is without a doubt one of the most essential aspects of life, but how many of these residents have actually thought of Breakfast as the meal of the day to share with families and loved ones (except weekends, maybe). These residents have had their fair share of a busy life back in those days and hence always looked forward to Dinner or some days Lunch as the family time or social engagement. I am not sure if breakfast with family has been on top of the list unless it is a special occasion. Breakfast might be the most important meal of the day but it definitely isn’t the most socially engaging part of the day, has never been.

Now, lets look at the other side of this Dining Experience / Social Engagement argument. Mostly I see care staff running around in the morning to get residents up and ready to go in the dining room. A resident may have flexible times for breakfast but the shower times, medication times and other morning activities times are not flexible. This only puts immense pressure on care staff to make sure every resident is hopefully showered, dressed and ready for the day before breakfast time.

I will say it out loud to actually go in some of the facilities and see if all residents are actually showered properly in the morning because of this work overload on care staff. Residents also are rushed in the morning to get to the dining room and if not then they walk up in their nightgowns, pajamas or any sleepwear.

Serving breakfast in bed means resident or staff are not rushed in the morning. Residents can enjoy their breakfast without having to worry about a shower or being dressed up. Receiving breakfast in bed is always that feeling of being pampered or a luxury. Also, the food safety software will be pleased because the fresh breakfast is served to the resident well in time. Do we not experience the joy of having breakfast delivered to our hotel room while on holiday? Do we not let the hotel staff know on piece of paper that what would you like delivered to your room in the morning? Do we feel that we are missing out on 100s of items to choose from? Do we not enjoy that freedom of waking up and not having to rush for breakfast?

Ø Residents do not get multiple choice/variety at breakfast

Serving breakfast in a room doesn’t mean residents are stuck with the same thing forever. By all means, they are welcome to change their mind at any stage. However, I see the majority of the residents going for the same breakfast every morning, regardless of the 100s of choices on the buffet. Come to think about it, how many varieties of cereals do we have in our home (on regular basis). How many of these residents are used to being served a huge range of options at breakfast?

We say that Aged Care is their home if that is true then why do we organize a hotel style buffet in residents’ home? why not have options available same as home?

Ø No Flexible times for breakfast (extended service hours)

This one is a classic. If I was served a tray in my room, I believe I have more flexible times to enjoy that meal when I prefer. Buffet service may last 1 and a half to 2 hours but I still have to be there within that time frame. So where is the flexibility???? Also, extended breakfast times have only made catering staff jobs harder because out of their 7.5 hours shift, they end up spending 2 hours (almost 40% of their day) only in breakfast service.

One important thing to remember also is that part of being healthy is also to make sure to eat the right meal at the right time. If residents are offered breakfast late mornings, it will affect their eating habits and food cycle if you want to use that terminology. Every other meal will get pushed back due to late breakfast and residents may not be ready for meal time when it really matters. 

We talk about flexibility and variety of choices at mealtime yet I do not see flexible times for activities in lifestyle calendar. I do not see residents’ have a buffet of lifestyle activities to choose from at the same time. If BINGO is played from 10 to 11 in the activity room then residents better be there in time to enjoy this. I don’t recall any facility to offer additional staff just in case the resident wants to play BINGO at 1 PM.

On the contrary, if I was to stay in a hotel or a resort or even at home, EVERYTHING is flexible except meal times. Even in hotels there are set times for breakfast, lunch, and dinner. There are no set times for extra activities such as game zone, swimming, gym or any other activity for that matter. Those facilities are open from let’s say 6am to 9pm every day. It is only the other way around in Aged Care.

Ø Residents feel more independent as they can walk to a buffet and help themselves

We can use this word “Independence” if residents are low care and able to still do most of their activities with no or minimum support. We all know that due to homecare packages and in – homecare model being promoted, by the time residents come to aged care they require a lot more assistance and are frail. Most of the time I see care staff bringing the resident in the dining room and ask them what they would prefer for breakfast and serve it to residents at their table. It is no different to “in room service”. I hardly see many residents walking to a buffet and helping themselves.

So basically, we do not worry about residents’ “independence” in a shower because they need to be ready in time and also health and safety reasons. We do not worry about residents’ “independence” when it comes to dressing them up. We do not worry about residents’ “independence” when it comes to choosing individual activities, yet the moment the resident enters the dining room, That “independence” matters.

Ø It is an institutionalized approach

Does serving one meal a day in the residents room makes the whole aged care facility institutionalized?? or not serving breakfast is room keeps them away from being institutionalized??
In my opinion,

Telling a resident that they can’t have runny poached egg is institutionalized
Deciding what time residents will do what activity is institutionalized
Calling it residents’ home yet have a hotel like looking aged care is institutionalized
Deciding for residents on what’s healthy eating and what’s not is institutionalized
Reducing staff ratio and not having enough hours for decent care is institutionalized
Reducing the number of RNs and skilled staff is institutionalized
Wanting 5-star meals and services & not providing budget, resources or sufficient staff is institutionalized

Many people may or may not agree with this article but I guess I am only trying to portray the true picture that I see in Aged Care. I do not believe in putting all the eggs in one basket. There are 100s of aged cares doing an outstanding job and achieving great results but there are also 100s of aged care who have got it so wrong that they don’t even know where to begin to fix the issues. Many aged care facilities are using food safety software to help the aged people get the right food even.

Having worked in aged care kitchen for a decent time, I strongly believe that “Breakfast in Bed” can be a real positive move in many aspects, IF DONE RIGHT.

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Written by Chirag Joshi Founder & owner of HDS.

Chirag Joshi is the founder & owner of HDS. Chirag possesses over 12 years of experience in Aged Care industry. Having worked as an aged care chef for a long time he understands the complexity & challenges to maintain residents diet profile, food safety records, food labelling, procurement invoicing procedures & staff rostering. Chirag has also completed a Bachelor in Computing with major in multimedia & system design. He has developed number of systems to help provide efficiency in aged care and also help eliminate paperwork and manual processes.

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