VA Maryland Health Care System
Good Food Supports Good Health
Any chef, foodie or Food Network devotee will tell you that you eat first with your eyes and then with your nose. If food does not look appetizing and smell and taste delicious, no one wants to eat it. At the VA Maryland Health Care System’s Loch Raven and Perry Point VA Medical Centers’ community living centers, food service staff and registered dietitians understand this truth and work diligently to provide Veteran residents with meals that look appetizing and taste delicious, even for those residents on a strictly pureed diet.
“Food is more than sustenance,” said Sharon Goldstraw, a registered dietitian who took over the Food Operations position and who at Loch Raven kicked the food service up to a whole new level, demonstrating that institutional food is a thing of the past. “It’s culture. It’s love. It comfort,” she said. “Providing our Veterans with fresh, good food that tastes good is the least we can do,” she said, noting that the name of the food service game at the VA Maryland Health Care System is quality, personal care and Veterans’ choice.
“Food choice is important,” said Goldstraw. And choice is especially important for those Veterans who struggle with chewing and swallowing because of health issues such as stroke, brain injury, Parkinson’s Disease, dementia, dysphagia, and lack of teeth, among other conditions. “When Veterans come to us in the community living center, they are already dealing with a lot of things they cannot control—their bodies, their ages, their losses. What else is left besides choosing what you can eat at your meals?”
Patients struggling to chew and swallow are often restricted to pureed foods. “A speech pathologist often is consulted to assess a patient’s ability to chew and swallow safely. The assessment may include swallowing foods and liquids mixed with barium in a special test in the radiology department. We want to make sure that Veterans who are unable to chew and swallow safely are quickly identified and placed on the proper diet,” said Bonnie Pike, a speech pathologist at the Loch Raven VA Medical Center.
Many patients wince at the thought of a diet restricted to pureed foods, the image conjuring up long past stereotypes of institutional foods that look like mush and taste like paste. Those days are gone.
To achieve culinary finesse that speaks to food choice, individual care and dignity, Food and Nutrition Service has stepped up its offerings to Veteran residents with the Enhanced Dining Program that encourages Veterans to choose from a menu of fresh food items such as crisp gourmet vegetable salads, egg and tuna salad sandwiches, pork chops, freshly made soups, cheese steaks, vegetables with cream, cookies, and other selections that are then served bistro style in the dining room. For Veterans whose dietary needs restrict them to pureed foods, fresh foods are blended into culinary puree food molds that maximize flavors while offering a healthy meal--beautifully plated--that enhances the socialization involved with eating.
“Often a family or a resident has a negative perception of a pureed diet,” said Sue James, assistant chief of Nutrition and Food Services. “Research has shown that this negative perception will impact how much they eat. Typically, residents with swallowing issues don’t eat a full meal, and these pureed foods molded to look like foods in their original forms increase a patient’s food intake.”
The beautifully plated puree foods appear like their original forms—peas and carrots look like peas and carrots-- and are prepared, plated and garnished as artfully as any gourmet meal. The pureed food menu includes options such as eggs and waffles for breakfast, and cod fish, mashed potatoes, peas, carrots, corn, beef patties, pork, chicken, turkey, ham, and other selections for lunch and dinner options. Desserts include fresh fruits such as peaches, pears, pineapples, and a berry mix with whipped cream.
“If you ask Veterans if they want the pureed diet, they often will tell you they don’t. But after they receive the menu and make their selections, they usually eat more of the meals, which can help them gain or maintain their weight,” Goldstraw said.
The desserts on the puree menu look and taste so delicious, one of the residents who was not on a restricted puree diet, saw it being served and ordered the mixed berry offering for himself.
“He loved it. He ate it all,” Goldstraw said.