Cultural sensitivity in healthcare food service
As our diverse population continues to age, emphasis is being placed on ethnic-centered care and cultural sensitivity in long-term care (LTC) homes. A perfect example is the Yee Hong Geriatric Care Centre, which has locations in Mississauga and Scarborough, Ontario, and has a 5–10-year waiting list. It provides care focused to Canada’s Chinese population specifically. However, Yee Hong Geriatric Care Centre is not the only ethno-culturally focused LTC centre in Ontario; there are more than 50 centres that offer culturally sensitive care throughout the province. Emerging research demonstrates that many seniors with culturally specific backgrounds can experience culture shock when they transition to LTC, which can lead to poor health outcomes. In addition to experiencing such things as ineffective communication, isolation, and misdiagnoses, residents with strong cultural roots placed in mainstream LTC homes also experienced more nutrition problems and an overall decrease in quality of life compared with those who transitioned to homes with culturally-sensitive practices. This raises the question – can foodservice operations contribute to culturally sensitive care in LTC centres to improve residents’ well-being?
A study exploring how resident-centered menus could be achieved interviewed key stakeholders, including LTC home nutrition managers and registered dietitians, throughout Ontario. A major barrier to accommodating residents’ food preferences was a lack of sufficient resources. Increasing transportation and food costs from items imported internationally and access to specialty items to cater to cultural and religious preferences majorly contributed to this barrier. LTC centers in rural areas specifically were greatly affected, as they do not have access to the wide range of products offered in urban centres. To aid with this barrier, initiatives to increase the use of locally-sourced foods and products, such as the Refresh initiative by Burlodge, may help by cutting on costs and promoting diversified menus.
Moreover, a centre with residents from many different cultures makes it difficult to meet all individuals’ preferences. A potential solution to this problem would be to determine common elements of different cultures, and standardize products across these cultures. A stakeholder stated: “There are some standardized products that cut across cultures. For example, offer rice, pasta, and a staple of the common culture” (Ducak et al., 2011). Ensuring that some items specific to various cultures are offered can help in making residents feel more at home all while saving costs. Further, while the Ministry of Health and Long-Term Care states that meals cannot be repeated for a duration of five days to increase the variety of meals, many cultures enjoy eating the same foods every day. Therefore, ministry standards may have to change if meal planning is to become more culturally sensitive
Additionally, a foodservice director from a LTC home in the United States found that implicating the residents themselves in food choices was a great way to appeal to their preferences in culturally-sensitive ways. Enabling vendors to come in and let residents sample food and place their input approximately once monthly increased satisfaction.
Lastly, different cultures may have various meal customs that they may not be able to perform in a LTC setting. Enabling residents to perform these, including serving food in appropriate plate-ware and offering meals at different hours may contribute to more culturally-appropriate food service practices. For example, individuals from cultures who are used to eating dinner later in the evening may have enhanced nutrition if their meals are offered at the “appropriate” time.
Overall, while barriers exist in ensuring that culturally sensitive care is given to our diverse and aging population, food service operations can play a role and contribute to ethnic-centered care in LTC centres.