A case study on health and safety from the kitchens of Delmanor retirement living
By Chef Divakar Raju
When you work in the industry of serving older adults, health and safety is key. One of the harsh realities we have been preparing for our entire career, but hope to never face, is a pandemic such as the one we’re seeing today in COVID-19.
Each day, around the world and at home in Canada, we are experiencing the impact of COVID-19 in retirement and long-term care communities. On March 11, the World Health Organization (WHO) declared the coronavirus outbreak a pandemic. Upon the release of this notice, WHO director general Tedros Adhanom Ghebreyesus said, “This is not just a public health crisis, it is a crisis that will touch every sector — so every sector and every individual must be involved in the fight.”
What it means to serve a vulnerable community
According to WHO, vulnerable communities are the ones that are most likely to take the brunt of disease emergencies, such as the one we are facing today. Vulnerable communities include children, pregnant women, older adults, and those who are already ill, malnourished, or immune compromised. Those who check more than one box see an even greater increased risk of complications due to infection.
Within the early days of this fight it became clear for those working with seniors that we were serving one of the most vulnerable communities impacted by this global healthcare crisis. By late May Ontario alone had reported over 1,200 deaths within the province’s long-term care homes and outbreaks at 211 long-term care facilities, with regional deaths making up 62 per cent of COVID-19-related deaths in the province.
We’ve seen the median age of the population increase by nearly a decade since 1970, with 8 per cent of the world population over the age of 65. This means a rather notable portion of our global population relies on our protection.
Why healthy food matters
We’ve all seen the jokes and memes online about people turning to comfort and junk food to cope with the stresses associated with the pandemic. However, within vulnerable communities proper nutrition remains one of our best allies in winning this fight.
When catering to communities over the age of 70, it’s important to structure menus to best serve the realities of aging healthily, ensuring that each calorie consumed packs a nutritional punch.
At Delmanor, we have asserted our best efforts to keep our farm-to-table approach, helping to avoid interruption in receipt of supplies and to keep our menus consistent with what was originally planned pre-pandemic.
Reports such as the one recently released by McGill University showcase the value of using locally sourced food, stating that local practices ensure “that food has passed some of the highest safety standards in the world. [Canada implements] very strict regulations regarding additives, pesticides, herbicides… [to ensure that our] food is safe.” This close-to-home approach applies to our menus at Delmanor and has been particularly helpful during a time when border closures and shutdowns have delayed consumable goods, particularly foods that are shipped in from different provinces or countries.
Thanks to our suppliers such as Sysco and CPS, we were able to continue receiving the high-quality food we needed, with nominal changes to our menus. During a time when restaurants and airlines could not use their regular food orders, Delmanor stepped in and accepted some of their unused food stock to ensure minimal waste and the maintenance of high-quality foods in our communities all while meeting our sustainability goals.
In addition to uninterrupted supplies, there is also the benefit of maintaining the nutritional value of the foods we serve. For example, according to McGill, some produce like broccoli, green beans, kale, red peppers, tomatoes, and stone fruit like apricots and peaches can lose some of its nutrient value when transported long distances from where it was harvested. However, heartier fruit and vegetables such as oranges, grapefruits, apples, and carrots don’t suffer as much nutrient loss when travelling long distances.
Dining has remained one of the biggest feathers in the cap of the Delmanor community through this pandemic, and we have been fortunate to have the capacity to continually offer nutritious, balanced, and high-end gourmet meals with little to no change to menus planned long before COVID-19 hit.
Using past crises to prepare for the next
Earlier this year when COVID-19 first hit, thanks to continual systems and procedural upgrades each flu season, all five Delmanor communities were able to swiftly implement safe and nutritious dining at each location. This includes maintaining a steady supply of personal protective equipment (PPE) to keep our team members and residents safe.
Following an initial weekend planning meeting just prior to the announcement of the pandemic, we were able to implement proactive measures in all five communities (such as in-room dining service on disposable dishware, implemented weeks before other communities) that increased the wellbeing of the people we care for tenfold. Menu items that are best enjoyed directly from the kitchen were replaced by other favourite comfort foods until the dining room was able to reopen.
By continually reviewing our process with core staff across all departments we’ve been able to prepare for the worst and serve our community effectively with a safety-first focus, routinely analyzing what’s working and what needs to improve as a part of our ongoing planning.
Our team has worked hard to raise their expertise in emergency management day after day, week after week. We have managed to keep our vision of sustainability in mind, even in crisis, and work to practice meal plating techniques that reduce overall waste.
Because we began this process ahead of the curve, we have had ample time to reflect on and implement a new level of best practices in sanitation, avoiding cross contamination, and will be able to keep these as the norm moving forward.
Mental health in a time of crisis
Protection against COVID-19 remains a priority, but humans by nature are social creatures and lockdown cannot continue in perpetuity. The National Institute on Aging reports, “Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.”
Early on we recognized the negative impacts the lockdown was having on our community members, who are unable to see family and friends. Our team has increasingly become an important touchstone to the outside world for those in our high-risk communities practising self-isolation.
Members of our kitchen team helped keep community spirits high by sketching cartoons and writing inspirational quotes on in-suite delivered meal containers and Delmanor-branded pizza-style boxes. On holidays like Mother’s Day, in-suite dining included flowers and care packages meticulously prepared by our team to help keep special occasions celebratory and fun.
With this in mind, we have already begun to work on planning for phasing in dining room experiences for our community, all while maintaining our stringent safety measures. As social distancing requirements are lifted throughout Ontario and globally, we want to maintain the safety of everyone as a key focus. We recognize there are inherently greater risks when reopening the dining areas and shared spaces, particularly as the idea of a second phase of outbreak looms.
Dining has been shifted into three seatings with only one person dining at each table (unless they are a part of the same household/suite). All serving staff wears applicable PPE and follows strict cleaning protocols after each seating as determined by the province of Ontario, the Ontario Retirement Communities Association (ORCA), and the Retirement Homes Regulatory Authority (RHRA). The health benefits of enjoying outdoor time is integrated into our dining experience each summer, and in 2020 we continue to prepare for members of the community to enjoy safe al fresco dining.
Looking to the post-COVID world
While Benjamin Franklin’s adage “an ounce of prevention is worth a pound of cure” surely applies here, it is also important to understand that it only takes one person to infect several and that the threat of an outbreak is ever-present.
Though there is so much that is unknown about COVID-19, and we are all still learning, there is also a lot that those in healthcare can do to protect their communities. While preparation and protection are key as we open things up, we know there are numerous risks. Temperature checks and health screening surveys for visitors and staff will become commonplace everywhere, but asymptomatic and pre-symptomatic people can still infect others. Sharing knowledge with one another within the industry will allow for all of us to better serve our communities.
We are continually reassessing and building new best practices every day. By working together, rather than pointing fingers, we can learn from each other during this pandemic and beyond.
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