Followup question from introduction thread

itissteve said:

Nick, one question I have is if these people are being fed in a group setting, eating meals prepared by someone else (like you) or if they are making their own meals. Any ideas as to what food sources they have available to them (like farmer's markets, food distribution programs, etc.)?

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All the people in this residence live in their own apartments but have home care staff go to them to assist in medical/personal needs and cook meals daily. All these people either buy their own grocery's (through me) or order from Meals on Wheels. One of my jobs is to go to their apartments and order food online for them as they either don't have a computer/cell phone/tablet and don't want one and don't deal with modern technology.

I show them pictures of produce and meats dairy and pantry staples from my laptop and suggest food items to them to try to encourage them to eat healthier by purchasing veggies and fish/meats. I'm not suppose to preach to them about their purchases so I am careful in what I can say.

A lot of the people need home care staff to cook simple meals for them which is often an egg, toast, coffee tea or soups. The time frame for each resident can be 10 - 20 minutes for meal prep. In the summer its a challenge as a good number of the residents do not or refuse to have air conditioning as its an added expense on their rent. For our staff to be stuck in a small hot kitchen in an overheated apartment is hard on them so simple meals is the norm.

We had a ''SALAD DAY'' program once a week where people can order a large salad with various toppings and a salad dressing on the side. These salads cost $3.00 and are huge ... the salad can easily make 3 or even 4 decent size meals for the person. (salad day was cancelled due to covid the last 2 years and is being set up again now)

The 2nd part of the Salad Program is the AIR FRYER program where the resident can ask the staff to cook them a piece of fish or a pork chop they have in their fridge/freezer. We own the air fryers and can cart/roll them from unit to unit. It's a bit of a challenge to move the fryers around but it cuts food cooking time in half, doesn't heat up a kitchen or unit and is easy for the staff to deal with.

The building is large there are over 130-140 people who need staff to do meal prep so they all can't have their dinners at the same time with the air fryer option and there are only 3 staff on each shift to cook for these many people.

I hope this gives you an idea.

Yes, that does give me an idea -- it's a considerable effort on your and your staff's part!

Let me think about it a bit more.

Salad Program is an excellent idea. Maybe a corollary to that could be "Sandwich (or Unwich) Program" where a cart carries sandwich proteins (beef, chicken, ham, cheeses, maybe egg salad or tuna salad, etc.), condiments, and bread for those who are interested and iceberg lettuce leaves as bread slices for those who want to cut down on carbs. Pickles or cut-up veggies on the side. Residents order their sandwiches and they come to them or are assembled in front of them. Lunch meat isn't the greatest nutritional choice but some are better than others -- real sliced chicken or turkey breast, the prepped salads made with an olive-oil mayonnaise, and so on.

Another option might be setting up slow cookers in a central location to do roast pork or chicken or turkey; they generate less heat than an oven and can finish meats that can be used many different ways (on salads, on sandwiches, as a serving on a plate with vegetables, etc.). I don't know if the residents are allowed to use slow cookers (my MiL's assisted living unit came with a stove that you had to petition the facility to hook up).

How's the storage? Refrigerators, obviously, but freezers?

As for providing recipes that are easy for residents to choose from a list and order for/prepare, I'll come back later with some ideas for those.

itissteve said:

Yes, that does give me an idea -- it's a considerable effort on your and your staff's part!

Let me think about it a bit more.

Salad Program is an excellent idea. Maybe a corollary to that could be "Sandwich (or Unwich) Program" where a cart carries sandwich proteins (beef, chicken, ham, cheeses, maybe egg salad or tuna salad, etc.), condiments, and bread for those who are interested and iceberg lettuce leaves as bread slices for those who want to cut down on carbs. Pickles or cut-up veggies on the side. Residents order their sandwiches and they come to them or are assembled in front of them. Lunch meat isn't the greatest nutritional choice but some are better than others -- real sliced chicken or turkey breast, the prepped salads made with an olive-oil mayonnaise, and so on.

Another option might be setting up slow cookers in a central location to do roast pork or chicken or turkey; they generate less heat than an oven and can finish meats that can be used many different ways (on salads, on sandwiches, as a serving on a plate with vegetables, etc.). I don't know if the residents are allowed to use slow cookers (my MiL's assisted living unit came with a stove that you had to petition the facility to hook up).

How's the storage? Refrigerators, obviously, but freezers?

As for providing recipes that are easy for residents to choose from a list and order for/prepare, I'll come back later with some ideas for those.

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We can't do anything with slow cookers. Unless the resident has their own slow cooker in their unit we couldn't offer a soups or stews for people. We can't make and sell sandwiches either, we don't have the time to do this because our services are more geared to providing personal hygene/baths and toilet care then medication needs which is first and foremost. Meals come next and then light house keeping if there is any time available.

Our division can't afford to buy foods for soups and stews financially on our end and we don't have the time or staff to prepare these types of food either to serve or sell to residents, we just don't have the time. We have a couple of volunteers who come in to do the chopping for the salad day which we are grateful for!

We only do the Salad Day and the air fryer option which is as far as we can go right now so people have something to look forward to a few times a week. The hope is that a salad can last a few days, an air fried piece of frozen fish or chicken breast is healthier and better for the resident instead of a bag of popcorn and a can of soda or ramen noodle soup. These residents buy their own food. We can't tell them what to buy.

Our salads are made with fresh varieties of lettuce and spinach, cucumbers tomatoes, assorted bell peppers, chick peas are the only can veg we can provide. Other toppings can be a few varieties of cheese, berries and crunchies like pork rinds, hard boiled eggs as well as sunflower seeds/almond slices/walnut pieces.

We can suggest recipes, but these are often ignored due to the cost of the ingredients going into a dish. The residents feel most ingredients may be too expensive or will spoil over time if its not used up right away and therefor they are wasting money.

Okay, so you're not providing any food out of a central kitchen, your staff is assisting residents in either preparing their own meals or preparing the meals for them. Some other thoughts, then:

• Induction cookers are fast and don't heat up very much at all while they're working. I don't know how practical it would be for staff to bring a portable induction cooker into an apartment where they will be preparing a meal, but it might address the time element (less time spent waiting for frying pans to get to temp, for water to boil, etc.) and the heat. Just an idea.
• could your residents be encouraged to buy fresh veggies that the staff then cut up for them and dress with a salad dressing or some other sauce (like a satay sauce or a hummus)? Protein intake would be a bit of an issue if just eating vegetables but that might be addressed with canned fish or meats (chicken breast, etc.).
• Eggs are not expensive and could serve at other meals as stuffed omelets, scrambles, egg bakes, quiches, etc. The baked dishes may have to wait out the summer or staff could get the meal assembled and started and the resident could take it out of the oven when finished (or someone could return to the apartment to get it out of the oven).
• As you noted in the recipes thread, maybe something that's vegetable-forward with enough meat and maybe a simple dressing. Squash is good for that. Broccoli (even frozen florets) with a cheese sauce or a shredded chicken or pulled pork?
• Maybe just try to amp up the nutrition of what residents are already eating? That will be tough because you can suggest unwiches and whole grain bread but if eating those items are a bridge too far for residents, you haven't gained much of anything.

itissteve said:

Okay, so you're not providing any food out of a central kitchen, your staff is assisting residents in either preparing their own meals or preparing the meals for them. Some other thoughts, then:

• Induction cookers are fast and don't heat up very much at all while they're working. I don't know how practical it would be for staff to bring a portable induction cooker into an apartment where they will be preparing a meal, but it might address the time element (less time spent waiting for frying pans to get to temp, for water to boil, etc.) and the heat. Just an idea.
• could your residents be encouraged to buy fresh veggies that the staff then cut up for them and dress with a salad dressing or some other sauce (like a satay sauce or a hummus)? Protein intake would be a bit of an issue if just eating vegetables but that might be addressed with canned fish or meats (chicken breast, etc.).
• Eggs are not expensive and could serve at other meals as stuffed omelets, scrambles, egg bakes, quiches, etc. The baked dishes may have to wait out the summer or staff could get the meal assembled and started and the resident could take it out of the oven when finished (or someone could return to the apartment to get it out of the oven).
• As you noted in the recipes thread, maybe something that's vegetable-forward with enough meat and maybe a simple dressing. Squash is good for that. Broccoli (even frozen florets) with a cheese sauce or a shredded chicken or pulled pork?
• Maybe just try to amp up the nutrition of what residents are already eating? That will be tough because you can suggest unwiches and whole grain bread but if eating those items are a bridge too far for residents, you haven't gained much of anything.

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I do like the idea of the induction/hot plate but I doubt we would be able to do that. We fought like mad dogs just to get access and let us use the Air Fryers.

Time is the biggest factor for our staff ... people have a frozen ''Meals on Wheels'' for dinner which is quickly taken from a freezer and popped into a microwave - oven or toaster oven. Salads are made if there is ingredients to make this in the unit. Often there is not ingredients.

While a person's meal is nuking the staff deal with meds and toiletry needs and do dishes and tidy up where its needed. 20 mins doesn't give a lot of time, the meal is served with tea/coffee and that's it. The most any of the staff really cook for anyone here is a fried egg, toast, soup, tea/coffee and porridge/oatmeal in an instant pack. It's not out choice to cook this for a resident, its really the only type of food the resident will buy.

People here are on a very limited low income. They don't buy meats or fruits and veggies fresh due to the high costs. Many people tell me they don't want to buy fruits and veg because it spoils too quickly if they don't eat it up in a few days, often our residents are not feeling well and don't want veggies so things do end up in the trash so they are reluctant or even angry about buying this type of food in the future.

Sadly today there is a huge surge in prices for food in most stores so fresh fruits veg and dairy are too costly and people are avoiding it buying things that are not healthy.

The main types of food people buy here are ...

Ramen noodle soup. These are inexpensive ... 3 or 4 for $1.00
Instant packages of oatmeal .... a box can last a week for breakfast and dinner
Inexpensive bread, usually no name white bread. No grain breads.
Can soup, again inexpensive if its the no name brands.
Large bags of no name popcorn - salty and carb laden.
Potato chips and salty flavored no name store brand munchies of all sorts.
Eggs in a carton - good for breakfast or dinner.
Milk and tea and coffee BAGS OF SUGAR. No one buys stevia or other sugar free products. Too expensive and it tastes BAD to most
Bags of frozen french fries or frozen tv dinners (when they are on sale)
Ketchup - mayo - mustard
Inexpensive lunch meat - ham turkey chicken. Which are high in salt and nitrates
Can tuna, can flakes of ham
Margarine
Brown beans .... everyone here loves CAN BEANS - beans on toast is a favorite
Frozen No Name pizza.
Frozen breaded chicken breast stuffed with ham/cheese broccoli/cheese
Pasta - frozen instant microwavable if they are on sale, these cost $1.30 or so ...
No name mac & cheese packages.

POP ... SODA ... cans and cases of POP. Never diet soda its always the regular sugary/syrup soda and they buy cases and cases of the drink.

Ice cream - inexpensive store brands
Cookies - '' ^ ''

Salt/pepper/garlic or onion powder.
Cheese slices and cheese bricks if they are on sale. They want grilled cheese daily.

Anything under $1.00 is wanted the most, unfortunately its harder and harder to find foods under $1.00 that are any good for anyone, not just a diabetic.


This is why we try so hard to do Salad Day each week.

Wow, Mr Peepers, you kind of are up against a wall nutritionally. Your residents are benefitting (??) from the reality that heavily-processed food is considerably less expensive than fresh whole food. Unfortunately, it's also not as healthful, and doubly so for diabetics. That meal prep has to be a sideline to more acute care (medication, etc.) doesn't make it easier.

Some more thoughts, as what you post always fits a few more pieces of the puzzle for me:

• Is there a choice in where people buy groceries if they're buying them with you assistance? What I'm getting at is that there are discount chains like Aldi and Lidl (at least in the US) that offer pickup or delivery (sometimes a fee, but...) that might make it possible to buy better food at the same price. I kind of have to think you and your staff have thought of this but I don't have all the details on how that works at your site.
• Can (collective) you throw enough business at one food supplier to wangle some sort of discount? Also, would residents consider going in with each other on purchases (group buys)? I'm sure you don't have the staff to administer that but I'm blue-skying here.
• Is there any taste (ha) among the residents for smoothies as a meal replacement? The ingredients in those could be better nutritionally; minimal prep, easy to eat. Could rely on canned fruit, etc. to reduce waste.
• can more be done with beans? Different beans as a platform for meals, like adding bacon bits or some ground turkey to canned baked beans, or adding cheese slices atop a side of black beans or pinto beans?
• canned chicken can be pretty cheap if bought in larger quantities and is better nutritionally than deli chicken breast. ftm rotisserie chickens (to-go) are not that expensive, ready to eat, and can serve in several meals (by itself, in a sandwich, as chicken salad, etc.). Again, not certain of availability or ultimate cost; just throwing it out there.

Perhaps the biggest challenge you and your staff face, though, is residential inertia. It seems your residents are quite set in their ways and suggesting that they buy multigrain bread instead of fwuffy white and buying fragile fruit instead of cheap ice cream will be a non-starter and a waste of your time. Things are not set up in a way for you to successfully influence choices because there don't seem to be many alternatives. Interesting puzzle, though.

itissteve said:

Wow, Mr Peepers, you kind of are up against a wall nutritionally. Your residents are benefitting (??) from the reality that heavily-processed food is considerably less expensive than fresh whole food. Unfortunately, it's also not as healthful, and doubly so for diabetics. That meal prep has to be a sideline to more acute care (medication, etc.) doesn't make it easier.

Some more thoughts, as what you post always fits a few more pieces of the puzzle for me:

• Is there a choice in where people buy groceries if they're buying them with you assistance? What I'm getting at is that there are discount chains like Aldi and Lidl (at least in the US) that offer pickup or delivery (sometimes a fee, but...) that might make it possible to buy better food at the same price. I kind of have to think you and your staff have thought of this but I don't have all the details on how that works at your site.
• Can (collective) you throw enough business at one food supplier to wangle some sort of discount? Also, would residents consider going in with each other on purchases (group buys)? I'm sure you don't have the staff to administer that but I'm blue-skying here.
• Is there any taste (ha) among the residents for smoothies as a meal replacement? The ingredients in those could be better nutritionally; minimal prep, easy to eat. Could rely on canned fruit, etc. to reduce waste.
• can more be done with beans? Different beans as a platform for meals, like adding bacon bits or some ground turkey to canned baked beans, or adding cheese slices atop a side of black beans or pinto beans?
• canned chicken can be pretty cheap if bought in larger quantities and is better nutritionally than deli chicken breast. ftm rotisserie chickens (to-go) are not that expensive, ready to eat, and can serve in several meals (by itself, in a sandwich, as chicken salad, etc.). Again, not certain of availability or ultimate cost; just throwing it out there.

Perhaps the biggest challenge you and your staff face, though, is residential inertia. It seems your residents are quite set in their ways and suggesting that they buy multigrain bread instead of fwuffy white and buying fragile fruit instead of cheap ice cream will be a non-starter and a waste of your time. Things are not set up in a way for you to successfully influence choices because there don't seem to be many alternatives. Interesting puzzle, though.

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You are a god-send itissteve! Thank you for the Smoothie suggestion as we use to do smoothies once a week here and it was always successful, unfortunately Covid happened and we shut down Salad Day and Smoothie Day and the Breakfast Club as well as the Hamper Box, because we couldn't have seniors and people with illnesses all congregating in the common rooms for these functions.

We use to have a program once a month of a Veggie Hamper Box set up by a local grocery, we sold the box for $15 a few years ago which was a great price. (with todays costs for fresh produce I shudder to think what this might cost now)

The veggie hamper box was very successful in the winter as people were unable to get out to shop for grocery's when we had bad snow or it was freezing cold and slippery out there. A hamper would last a person a month if they got meals on wheels or had someone shop for them bringing meats and other things to them.

Residents in the building who were friends would often split the cost and contents of the box. The hamper always contained a bag of new potatoes, sweet potatoes cabbage broccoli cauliflower and varieties of squashes (what ever was in season at the time) apples pears bananas (which are cheapest) onions and lettuce kale, swiss chard, cucumbers a few tomatoes, spinach, mushrooms and the store often gave us free pre-washed salad kits to add to the hamper. The hamper box was less successful in the summer months as people liked going out and picking up their own produce then.

Again this was all shut down due to Covid ... but I will see if this can be set up again.

We are in Ontario Canada and the main store we shop at is Walmart Super Store, this is the cheapest place to get fresh produce right now as well as meats and anything else needed. We have senior citizens who volunteer and go pick up the orders for us delivering it to the building where our staff collect it and take it to the person's unit. People here refuse to buy grocery's at Sobey's Zehrs or the Super Store as these places are always $2 or $3 more in cost for any and every food item or product they wish to buy. People on a fixed income can't afford to shop those stores. So Walmart it is!

2 years has come and gone and so many changes to the many programs we had in 2019 were cancelled but slowly we will start them up again.

Many of the residents who enjoyed these programs are gone now, either they have passed away or they have gone to Nursing Homes for continuous care 24 - 7. It will be interesting to see if the new residents will take us up on these programs and if it can help people eat healthier.

Thanks for the ideas itissteve!