Mealtime in Maine

Contributed By:  Diane Bergey, OT Consultant

As with most individuals, mealtime is an important part of the day for the residents of the Fellowship’s Neuro-Cognitive Behavioral Programs located in Bangor, Maine. Food and its surrounding rituals; e.g., group meals, celebrations, favorite snacks at meetings, or frequent activities like popcorn and a movie, add structure and predictability to the daily schedule. Staff may rotate, weather may cancel expected events, physical health may shift, but mealtime ALWAYS happens. However, the way it happens at the Ralph Street residence has developed from a strict ‘staff is responsible for meal preparation’ to a collaborative effort.  Even as recently as five years ago, meals were something that magically appeared at a certain time; residents arrived in the kitchen, sometimes milling about as they waited to be waited on, and food was served. This is not the case any longer! Each resident is now responsible for at least one meal a week, start to finish.
 

Naturally, there was a learning curve and lots of planning required to help facilitate success. First, we engaged each resident in a discussion about what he or she liked to eat. Everyone had favorite meals and was willing to chat about them. Next, we submitted those ‘favorites’ to the nutritionist responsible for the menus. We tweaked the meals, (yes, beans and franks was one of them) and created a weekly menu, meeting nutritional guidelines. We then completed an activity analysis for each menu. With consumers’ individual strengths and needs in mind, staff developed step-by-step process directions, complete with visual cues for equipment, a list of ingredients and a flip chart recipe. Some folks are great at collecting supplies, while others prefer to chop and stir. We selected recipes with simplicity in mind, choosing ingredients easily prepared. Considering that some residents do best with frequent breaks, meal tasks occur in ten or fifteen minute intervals. Additionally, a visual list guides the cook of the day while shopping for groceries for ‘their’ meal. This grocery trip is an important part of weekly one-on-one time for resident and staff.
 

The Ralph Street meal program has grown from a successful program requiring frequent cues and reminders with a moderate level of hands-on support from staff, to an expected and familiar routine for the residents. As the meal program progresses, we expect residents will require less verbal instruction from staff and will move toward the independent initiation and use of recipes. As confidence grows, residents and their Instrumental Activities of Daily Living skills (IADL), grow too.