​A facility that adopts a buffet style of dining may also encourage staff to dine with residents and implement room service simultaneously.

There are many ways to make the shift away from institutional, centralized dining to more resident-centered

models, such as family-style, buffet-style, or tableside dining. Such options also need not be mutually exclusive. For example, a facility that adopts a buffet style of dining may also encourage staff to dine with residents and implement room service simultaneously.

A paper prepared for the Pioneer Network’s 2010 dining symposium describes a range of resident-centered dining models that have been implemented and, in some cases, tested:

  • Family-style. Providing food in serving bowls, thus enabling residents to serve themselves as they did in their own homes. This model is used in Green House homes and many nursing facilities, as it enables residents the opportunity to serve themselves what they want and as much as they want.
  • Buffet-style. This type of dining entails the use of steam tables or chafing dishes that are set up in the dining room where residents select their items and, in many cases, are served meals at the table after staff have plated them.
  • Home-style. Designed to resemble experiences residents had when they lived in their own homes. Features of home-style dining include the use of small tables that seat four to eight residents; tablecloths, table decorations, china, and eating utensils that are not plastic or disposable; the reduction of background noise, clutter, and activities that distract from the dining experience; and the addition of soothing or person-appropriate background music.
  • Tableside. In a tableside dining approach, residents are seated at tables of five to eight people, where they choose their meal from a menu of items. Orders are taken, and the resident is served by facility staff.
  • Café or bistro. This style of dining can be accomplished either as a facility begins its transformation process or as an add-on to an existing program. In either case, an area of the facility is used to place small tables and chairs, and a counter is installed where residents order items such as coffee, tea, bagels, sandwiches, or salads.
  • Room service. Similar to a hotel, room-service dining typically complements another dining style but can be used to serve residents who are unable to travel to the dining room or do not wish to dine with others. Some facilities maintain room service 24 hours per day, seven days a week, while others deploy the service during all mealtimes.
  • Neighborhood. Residents eat in smaller dining rooms in their neighborhoods and are supported to sleep until they wake and eat when they want. In some cases, kitchenettes and even full kitchens with shared decentralized production kitchens placed between two neighborhoods are installed.
  • Convivium. Bill Thomas, MD, founder of the Eden Alternative, has resurrected this concept from an old Roman word that describes the pleasure that accompanies the sharing of good food with people one knows well. Instead of fast food such as soup from large cans warmed up, soup is made from scratch and cooked slowly. It simmers on the stovetop all day for all to experience, from the preparation, if they so choose, to the aromas, to enjoying it for the evening meal.
  • Staff dining with residents. Staff dining with residents is a culture change practice that has been implemented to build relationships between staff and residents. It opens up the opportunity for friendships to form and grow among residents in a nursing facility and those caring for them.

Source: “The Food and Dining Side of the Culture Change Movement: Identifying Barriers and Potential Solutions to Furthering Innovation in Nursing Homes,” pre-symposium paper to the Feb. 11, 2010, Creating Home in the Nursing Home II: A National Symposium on Culture Change and the Food and Dining Requirements. Prepared by Carmen Bowman.