Oklahoma City nursing facility looks to finger food to combat malnutrition

Sept. 04--Oklahoma City -- When Herb Magley's late wife, Gail, had to move to a nursing facility, eating became a repetitive rotation of finger foods because Alzheimer's disease had taken her memory of how to use a fork.

"It was french fries, sandwiches, that kind of stuff," he said. "There were times she'd just leave her food, because you can't make everything finger food."

Magley was one of about a dozen people who took part in a tasting lunch Thursday at the Fountains at Canterbury, an assisted living and nursing complex in north Oklahoma City. The "Thrive Dining" menu consisted entirely of finger foods served in the facility's dementia care unit, including meatloaf the size of miniature muffins, breakfast casserole wedges and chicken baked into turnovers.

Kim Smith, assistant dining services director at the complex, said people with dementia may struggle with utensils, and many of them have a tendency to wander, even during meals. Not every resident needs finger foods, and some need them only on days when they're feeling restless, so the caretakers tell dining staff how many meals to modify, she said.

"It can be a struggle to get residents to sit down to eat a meal," she said.

The dining staff gradually phased in the finger foods, starting with breakfast and moving up to dinner, Smith said. It took some experimentation to turn their typical recipes into meatballs, turnovers, crepes and other finger-friendly forms, she said.

"When I started (27 years ago), it was 100 percent acceptable to have fish sticks," she said. "I feel that we're cheating them if they're not getting the same thing" as residents without special needs.

'You can taste every bit ...'

Deborah Rosser, an Oklahoma City woman who came to the tasting after seeing a flyer about it, said she thought the dining staff did a good job blending the foods without losing their original flavors. She particularly liked the breakfast casserole, which included egg, sausage and pancake.

"You can taste every bit of the breakfast. You can differentiate everything," she said.

Making meals in nursing homes tastier and more attractive has become an area of emphasis in recent years, said Jon Dedon, a geriatrician internist at Truman Medical Center in Missouri, and adjunct professor at University of Missouri-Kansas City. Until about a decade ago, many nursing home residents had restrictive diets -- and malnutrition was rampant. Since then, nursing homes have shifted to offering less restrictive meals, because undernourishment was a bigger danger than a little more sodium or sugar, he said.

"Older people don't eat the sodium-restricted, fat-restricted, glucose-restricted diets, and they lose weight and end up dying more quickly," he said.

Finger foods could be a good idea for people with dementia, because older people tend to do better with small meals that are dense in nutrients and calories, Dedon said. They may not work for people who have trouble swallowing, however, because that group typically needs ground-up or pureed foods, he said.

"I think finger foods would present an opportunity for patients to feed themselves farther into their life expectancy," he said, but "it would be kind of messy to eat a pureed diet with your fingers."

While finger food might not be right for everyone, Magley thinks modified meals would have made meals easier and more enjoyable for Gail, at least in the earlier stages of Alzheimer's. The disease eventually takes a person's ability to chew and swallow, but until that point, many patients can still enjoy eating.

"This would have been ideal for her," Magley said.

The facility will offer tastings again on Sept. 28 and Oct. 26. To attend, call 751-3600 at least two days in advance.

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