My Romeo has been a vegetarian since...well, a long time, he tells me. (If you're wondering, I am vegan and gluten-free.) His eating habits are stellar, although he has a sweet tooth that we indulge periodically. Romeo eats nutritiously and has done so for quite some time. So it was quite a shock when he moved into the nursing home, and we discovered that he is the only resident who is vegetarian.Now, you wouldn't think this would be much of a problem -- especially living near Boulder, Colorado, (we're in Longmont, a little east of Boulder) a vegetarian and environmental and spiritual mecca. The reality is that most of the people in Romeo's nursing home are about 20 years older than he, and there aren't many vegetarians in the 85+ age group.
As a result, I'm discovering that most nursing homes are simply naive about vegetarianism and aren't able to deal with serving nutritional vegetarian meals. It's so far out of their box of knowledge that it hasn't yet been institutionalized, perhaps they don't notice the glimmer on the horizon. Romeo's nursing home, at least, has us to practice on. We're the guinea pigs.
What that has meant for us is a lot of heartache and headache, banging our heads against the wall. And for me, being a ruthless advocate for Romeo.
You may think that they could feed him anything on the food cart without meat. Nope, doesn't work. They usually always have salad available. Romeo eats salad only occasionally. Besides, there's much more to vegetarianism than salad. The nursing home is big on white bread. Romeo does wheat, of course. They always have grilled cheese available. He will eat that, unless he notices it's made with white bread. But one week, they served it to him for lunch and dinner for three days in a row. I can't always be there during his mealtimes, of course, so this one got past me until one of the nursing supervisors brought it to my attention. Bless her heart.
Finally, finally, finally, we got to the dietitian on staff to discuss Romeo's diet. She agreed to sit down with us to plan his meals for the week ahead. We do this every week now, and this part of the process has been working well. I expect soon that she won't need to meet with us about this, that she'll have a firm grasp on what Romeo eats. She does a great job of seeing that his meals are nutritious and balanced.
However, there were (and still are at times) other hurdles in the entire food serving process for Romeo. For example, the cooks sometimes didn't prepare what was on his menu, so Romeo would simply not receive the protein portion of his meal. On one occasion, actually during the time he should have been eating lunch, one of the kitchen staff was at the store purchasing the ingredients (again, protein) for Romeo's meal. He had a very late lunch that day.
Another frequent problem involved the staff working the food cart. Their job is to look at his menu for that meal and plate it for him. Except they don't do it very well. They have served him pasta topped with beef tips and gravy. They have served him only asparagus and wheat bread, leaving out the tempeh and quinoa. They have served him meals without any vegetables.
Yet another broken piece of serving vegetarian food to Romeo involves the nursing assistants and nurses who take the food from the cart to Romeo's table. They'll bring him what food service has plated, then with all good intentions, they ask Romeo if everything looks okay. Well, he has dementia and doesn't know what he's supposed to have. Even when I'm with him for a meal, I refer to the menu the dietitian worked up with our help. Who can remember those details from meal to meal, from day to day? Not me. So when Romeo is asked if everything is fine, he says yes, being the British gentleman he is. His plate could come to him missing an important piece of the meal and he wouldn't know. So now a nursing supervisor checks his meal to be sure it's complete and will hunt down the missing parts if it isn't.
Romeo has been living in the nursing home now for more than two months. I think his meal process is pretty much fixed. Things seem to be running a lot better, although there has been an infrequent lapse.
I've beat myself up over this whole thing, I've beat other people up over this whole thing, I've been the advocate from hell. I want things to be right for Romeo. Just as meat eaters deserve to be fed well-balanced, nutritious meals, my Romeo deserves to be fed well-balanced, nutritious vegetarian meals. Any vegetarian in a nursing home deserves to be fed well-balanced, nutritious meals. What's up with vegetarians having to struggle for this? What's the big problem?
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I suppose you must have read my reply on yahoo seniorVeg by now. I greatly empathize with your situation, but I honestly think that, most likely, simply being an advocate for your husband is not going to be sufficient to get him the food he deserves - not unless you can be there at every meal to confirm what they are feeding him.
ReplyDeleteThat said, I wonder if asking for quinoa is a good idea. It is expensive. If they give it to your husbands, other residents are likely to say why can't I have some of that too. But it may be too expensive, unless it is limited to like once every 2 weeks or something.
What I did when I was hospitalized for a week (to have my inguinal hernias repaired) which I thought was the best way to go about things, was to tell the meal planner and kitchen staff, that except for where it didn't go with my religio-cultural requirements, or health requirements, I wanted to eat what everyone else was eating. I didn't want to be treated as being "special," or worse, as being "better." That said, of course a Lot of what they were giveing to everyone else, I found unsuitable. I also emphasized that it was really simple to feed me: I needed starches like rice (brown) and potatoes, lots of fruits, plenty of vegetables, some raw greens, and LEGUMEs, and occasionally nut and seeds. I had to show them how to cook red lentils - which cook very fast. I expected that they knew how to cook rice, or simple bake, steam, or microwave a potato. Of course they had soybean and olive oil blend, instead of real olive oil. But I tolerated that for a week. I brought my own flax seed oil (for omega 6), and my own blanched-almond butter, and unhulled sesame tahini. Either of the last 3 was unlikely to be budgetable for so many people, unless it was served like for just a small portion one meal every 2 weeks or so.
I meant omega THREE fatty acids, from flax oil. I had to convince them to let me into the the kitchen, despite their regulations saying no patients allowed in the kitchen, and had to help them cook. I had to make sure they didn't toss a little glob of lard into the rice "to make sure it didn't stick to the pot." Not sure if they realized brown rice took 50 minutes to cook instead of 20 minutes like white rice. They managed to make "soup" from quick-cooking rolled oats, instead of a breakfast cereal of normal consistency - but they served the same rolled-oat soup to Everyone. But they did find me some canteloupe and fresh grapefruit at every meal, which I greatly expressed my appreciation for. I tried to have fun with the kitchen staff, being in there with them, against their rules. I helped wash the dishes. And I still had to rely a lot on reconstituted frozen orange juice concentrate, for some of my fruit, instead of fresh squeezed citrus juice, or "not from concentrate" pasteurized orange juice.
ReplyDeleteBefore I arrived, they told me that they had split peas as well as lentils. Turns out they only had lentils. They had those little red lentils that cook in 10 minutes, rather than the big brown ones that cook in 30 minutes. I had assumed they had the big brown ones, so I instructed them to cook for 30 minutes. So I had overcooked red lentils the first time, mixed rice, 3 to 1 and a little oil. I added a tiny bit of salt myself, at the table. I tried to make things as easy and cheap for them as them as possible. If other patients saw the rice and lentils, got jealous, and wanted it too, it wouldn't be something that the hosptital couldn't afford to do - as tofu or tempeh might have been. Nor would it have been something would have required them to find an additionsl supplier, for those particular items. So I made them happy about working with me, and tried to make it fun.
ReplyDeleteAnother way I made them happy: this was one of those hospitals whose official policy is that the best way to heal after surgery is to get up right away and start moving. They only wanted patients to lie around complaining about post-op pain, for 3 hours after surgery. Then they expected you to be ambulatory. I was fine with this. I share the philosophy. But I pretended I wasn't, and that I wanted to lie in bed and be depressed. So they needed to come up with a device to motivate me to get up and move around. They settled right in on: don't feed him unless he gets up and walks around. Thus I was able to use their attempt to control me, to control them. The only way they could "motivate" me to get up and move around, is if they let me into the kitchen. They still wanted me OUT, when the kitchen got really busy, 10 minutes before meal time.
ReplyDeleteI am telling you this to let you know how tricky I had to be, to get into the kitchen and oversee my food preparation. It was extremely difficult, even though I was there 24 hours a day. I think if I had to do this, for someone else, from a distance, it would have been impossible. They were often just - rather dopey - and I had to SHOW them how to do things. Telling them wouldn't work. How much flame to give the burner under the rice pot. How long to steam a potato. How big to cut the pieces so it would steam in 8 minutes instead of taking 1/2 hour to steam a whole potato. They already knew how to make evenly sized pieces, quickly, with a chef's knife and cutting board. And I had to just HOPE that they truly followed health department guidlines, and used separate cutting boards, one for meat, and another for fruits and vegetables.
This experience I've had helps explain why my philosophy is so "hands-on." Be there, and supervise, and do a lot of it yourself. Why I don't want to TELL or ASK big corporations, "grow vegan food for me," and why instead I want to FORM a corporation, of vegan investors, to grow food for vegans (and other too - vegans and vegetarians aren't the only ones eating fruits and vegetables).
ReplyDeleteWow, Theodore. Thanks for taking the time to go into detail about this. In my case, it is completely unrealistic for me to be there to supervise all of Romeo's meals. As any caregiver will tell you, we are under so much pressure (even if our loved one is in a nursing home) that the slightest thing we add to our list tends to break our backs. And there is more than just meal issues to deal with. There is our loved one's health problems to deal with as well, not to mention their personal care and hygiene. And remember, I myself must be home at mealtimes to prepare my meals and take care of myself. Not to mention that I have a life of my own as well.
ReplyDeleteAs I mentioned in the blog post, I sit with the dietitian each week to help plan Romeo's meals, and that has worked well. I may be fortunate in that the nursing home has had no problem supplying quinoa, although I bought a couple of boxes to show them what it was and to help get them started. Same with the tempeh.
The entire process, from planning Romeo's meals, to cooking, to plating and serving them took a long time to fix. And there was much heartache on my part the entire time. Things seem to be going much better now. I had hoped it would simply take time. Appears it did. And I feel for any other caregiver who must oversee that their loved one is being served a nutritious, balanced vegetarian meal.