A common complaint of most residents of senior living communities is food satisfaction. As an executive director (ED), it is one of the more challenging complaints to resolve.
There are many times when an ED or chef is sampling the exact same dish about which a resident is complaining and having a completely different experience. For example, a resident might say a dish is lacking in flavor and is difficult to chew, while the ED or chef is finding it flavorful and easy to eat.
As a result, the food and beverage departments often become demoralized as they find that no matter how hard they try, the level of satisfaction remains an issue. This article hopes to impart a better understanding of the complications related to taste in an aging population, categorize the type of complaints, and offer
some cooking suggestions that have brought about increased resident satisfaction.
Those who oversee the food service in senior living communities will benefit from shifting their orientation and developing an approach that incorporates the common issues of diminishing taste sensations into their daily work.

Taste And Elders

When an individual reaches a particular age, the sense of taste deteriorates. Some studies have estimated that a person could lose 20 to 60 percent of their taste buds after the age of 60.
A younger person’s threshold for tasting salt, sweet, bitter, and sour is much lower than an elder’s. This means that while elders’ senses are able to create a response to the flavor of salt, sweet, bitter, and sour, but their responses are not as strong as the younger person’s.
What Impacts TasteAt the same time, some elders’ main tasting abilities become relatively strong when their other abilities weaken as they age. For example, they may taste pronounced salt because other taste sensations have weakened.
Taste is impacted by sense of smell, which also declines significantly as one ages. Thirty percent of people between the ages of 70 and 80 have a problem with their sense of smell. Smell that declines with age is called presbyosmia, and it is not preventable.
The sense of smell, or olfaction, is part of people’s chemical sensing system, along with the sense of taste. Normal smell occurs when odors around in the vicinity, like the fragrance of flowers or the smell of baking bread, stimulate the specialized sensory cells, called olfactory sensory cells. The ability to smell these odors impacts taste.
Dysgeusia is a distortion of the sense of taste and a common problem among elders. An alteration in taste or smell may be a secondary process in various disease states, or it may be the primary symptom. The distortion in the sense of taste is the only symptom, and diagnosis is usually complicated since the sense of taste is tied together with the individual’s other sensory systems.

Complaints Could Be Flags

It is common for residents to be unaware that their lack of enjoyment of the food may be caused by other factors unrelated to the community’s food service. It is therefore a challenge for the ED and director of food and beverage to discern the true source of the dissatisfaction.
The first place to look is always the quality and variety of the food being offered, as well as its preparation. This should be relatively easy for the trained professional. If, on a daily basis, it is determined that the quality and food preparation are very good, then it can be hypothesized that the issue may be with the resident.
Resident feedback on menu selection is very important, as is offering a variety of dishes and changes to the menu. Boredom with the menu can mimic changes in taste sensations.
EDs should listen to all food complaints and work with the food and beverage department by keeping track of who is making the complaints and the types of complaints being made. Determine how many people are making the same complaint. A resident who complains on a daily basis that the food is lacking flavor is likely to be suffering from Dysgeusia but does not know it.
Without a complaint/feedback log it is difficult to distinguish between food preparation errors and an aging palate.

Educate Staff, Residents

Residents need to be educated on the things that impact one’s taste buds. Educational programs should be conducted to help create awareness for residents.
Residents who are chronically dissatisfied with the food should be encouraged to speak with their doctor. Their level of satisfaction may return simply by changing a medication.
There is little awareness and discussion of Digeusia. Doctors may not be aware of what impacts taste. It is therefore up to the residents and leaders in the field to encourage doctors to learn more.
 Where does responsibility lie?
The table above highlights the types of complaints received by residents and attempts to categorize them in two groups. The first group reflects possible issues with the food preparation and service. These complaints tend to be more specific and presented by residents who are generally satisfied with the food service. The second group is likely to be related to the resident’s sense of taste. These complaints tend to be more general, making it more difficult to pinpoint a solution. It is time for this type of discussion to become as common in senior living as other health-related topics are common to the older population.
There is much to learn. These issues spark creativity and a challenge for food and beverage departments.
Changing the orientation from one of expecting residents to complain to one in which a provider can make a difference may attract more chefs to the industry.
Click here for some palette-pleasing recipes.
Robin Granat, LCSW, CALA, is executive director and Robert Derin is executive chef at Five Star Premier Residences of Teaneck, N.J., part of Five Star Senior Living. The research, opinions, and conclusions in this article do not constitute professional advice or advocacy of particular practices by the community and/or Five Star Senior Living.