Live-In Home Care: How best to manage food appropriations – Part 2.
Food appropriations combined with meal preparation is often one of the most challenging aspects of live-in home care for both the care recipient and the caregiver – not to mention for other individuals or family members involved in the process. To adequately cover what can be considered a broad topic with many parts, we created a 3 Part Series which will cover: • Part 1: Introduction to Food Appropriations • Part 2: Assessing Needs and Making Preparations • Part 3: Implementing Policies and Procedures Part 2: Assessing Needs and Making Preparations Once a family has determined the best method for handling food appropriations with their live-in caregiver, the next step would be for them to go to the home of the family member needing care to help facilitate preparations. More often than not this care recipient has been hospitalized and might be recovering in rehab for some time. It is not uncommon for this person to have been having a little difficulty managing before this decision was made for them to have care. Additionally, many elders are from a very frugal generation. Waste not want not! They do not like to throw away food or waste food. If you wait until mom or dad comes home this might create a high anxiety situation. If the caregiver winds up being the one to reorganize the food stock this typically creates even more tension. Time is of the essence. Get over there first! The care recipient’s kitchen might need a real “going through” and cleaning prior to them coming home. Some families opt to leave this for the caregiver to sort out thinking they will be the one cooking, so the caregiver will likely want to set things up their own way. But this is a common mistake. If a caregiver arrives at a house with nothing but expired canned goods in the cabinets and a fridge full of old condiments and questionable foods, it is a very awkward situation. The best thing to do is give everything a good clean, discard all the expired and spoiled food items in order to begin fresh. Put an order of new groceries in the house for both the care recipient and the caregiver. This will save families from having to run around on the day live-in services begin. The new caregiver will be able to see, based on what is available in the house, what mom or dad typically eats and how their home is typically stocked. This will also help the caregiver get started in regards to maintaining shopping lists for the household. This way everybody starts off on confident ground. After a kitchen is cleaned and stocked with adequate food supplies, families are encouraged to review some safety measures in the kitchen. Some recommendations include: • Maintain appliances in working order and ascertain ability to operate them. • Ascertain ability to manipulate sink faucets with hot water temperature settings reduced. • Make sure electrical cords are not dangling near water. • Ascertain ability to open/close refrigerator, freezer, stove door and cabinets. • Ascertain ability to reach dishes, pots, utensils and outlets. • Store sharp objects safely away. • Keep flammables away from the stove area. • Remove small non-food items that could be swallowed. • Cover stove burners, remove knobs/shut-off valves and install auto-pilots when needed. • Unplug or put away kitchen appliances not in use. • Disconnect or camouflage garbage disposals. Another issue that typically makes families nervous is…..what does my caregiver like to eat? This is a very good question. Obvious to everyone involved is the cultural differences. The humanity involved in the live-in home care business is what makes it so challenging. First, we have families with their own cultures and way of eating. Now we are bringing in the caregiver who in most cases has immigrated to the United States from another country with altogether different eating patterns and a cuisine completely unfamiliar to us with polar opposite cooking methods and flavors. It is enough to make anyone nervous! But it is really not as daunting as it seems. Although cuisines are different, typically caregivers do well starting out as long as some pretty basic items are in the home. Once you get to know your caregiver you will also get to know what he or she will need. But for now as long as you have a large bag of rice, some meat proteins, fresh vegetables and fruits in the house, maybe some fruit juices and tea and a couple gallons of bottled water most families are good to go. These items may appear to be things that will cost more but it is important to note that caregivers come from countries that do not typically use convenience foods and processed foods like we Americans do. They cook from scratch using simple methods like boiling and baking. When they come to the United States and try to eat these processed foods they become ill before long because their bodies are not accustomed to them. This actually, more often than not, turns out to be a good thing for care recipients. Care recipients will likely enjoy more home cooked food than they previously had which will be good for their health! Families also often worry about how the caregiver will be able to cook for their loved one. This is a challenge! When caregivers go to school and obtain their Home Health Aide license, the schools do not spend time teaching caregivers how to cook. They will glaze over the appliances in a typical home and show them enough about using them to provide basic safety in using the appliances. The schools will also spend some time talking about basic nutrition but that’s it. Caregivers learn about cooking for American seniors mostly by doing it. This is the true reality in the live-in home care industry. Some caregivers are better than others in the kitchen. Caregivers can create basic meals for their care recipients but they cannot be expected to create gourmet meals. There are caregivers who are excellent cooks and the majority can create some tasty basic meals; however, families should expect the latter and think of the matter as a work in progress at start of service. At Boardwalk Homecare, our Case Managers can provide some help to any caregiver struggling in the kitchen. We have some written training materials to help our caregivers understand the basic American diet. We also help with typical American recipes as well to help caregivers please their care recipient’s palate as well as to encourage healthful eating. Families can also help by offering some ideas to their caregiver about the foods their loved one typically enjoys. In most cases, sharing family recipes and using meal preparation as a shared activity between the care recipient and the caregiver will have a very positive result. A little time spent showing caregivers what meals your loved one enjoys and how best to prepare them can go a long way. While it is not a component of this 3 Part Series, we strongly recommend families and their caregivers are very clear on any care recipient dietary restrictions. While Boardwalk Homecare’s field nurse supervisors discuss this with our clients, families and caregivers will need to make sure they understand recommended meal preparation as it relates to various conditions including: Arthitis, Diabetes, High Blood Pressure, Irritable Bowel Syndrom (IBS), Acid Reflux, etc. In conclusion to Part 2, it is important for families to make preparations at home prior to their loved one returning home and setting up live-in home care services. Readying the kitchen in terms of basic cleaning and fresh food supplies for both the care recipient and the caregiver is a good start. Additionally, families are encouraged to go over safety measures with their caregivers as well as provide input on how best to prepare meals for their loved one to ensure their nutrition and well-being.