The Big Idea 2014: The purée alternative
Stone Morris and Sarah Gorham
Grind Dining, Atlanta
Gorham: The Arbor Co., operators of senior living units based in Atlanta, hired us last year as consultants to come up with a solution for residents who have chewing or cognitive disorders and cannot use utensils when they eat.
Morris: We had never been involved with senior care, but Mary Campbell Jenkins, Arbor’s VP of operations, knew we were chefs and asked if we could help. Sarah went in and did an observation, and what she saw was disheartening and depressing. The solution, for most people with such problems, was simply soft foods: scrambled eggs, mashed potatoes, etc. We thought that with 60 years in foodservice collectively, surely we could come up with something. But it would have to be simple, streamlined for production and easy for semiskilled labor and nutritionally complete.
I had a memory of my great-grandmother grinding up fish with a meat grinder to make gefilte fish. It had body and texture, and you could feed it to toddlers. So we bought a grinding attachment for our mixer and three chickens and went to work.
Gorham: We focused on breakfast, lunch and dinner entrées and sides. Desserts, we found, were not a problem. We developed some foods and we piloted the program as Arbor Co.’s Dining With Dignity in two of their communities. We did it in an engaging environment, elevating the experience across the board with plates, linens, décor of the dining room and other things to engage the residents and preserve their dignity. In those two communities, residents’ caloric intake was up 30%, and because the nutritional value of the food was still there dietitians saw better clinical outcomes.
Morris: Grind Dining is not a purée program. Our method is just to grind the cooked proteins, carbohydrates and vegetables so that they will be easier for residents to chew and swallow but formed in a way that they can pick up with their fingers. We found that just by making the food small, compact, neat and easy to pick up, the mechanics of eating with the hands came quite naturally to folks after a while.
As toddlers, eating with our hands and fingers was quite acceptable and tolerated until society put the pressure on us to conform and become “civilized.” Older adults have to unlearn 60 to 70 years of using utensils and that it is now OK and perfectly fine to eat with their hands.