I discovered a few weeks back that my facility's kitchen manager provides a menu of the upcoming week's meals, along with alternates, for residents who would like to plan ahead. Like all of us, residents have food likes and dislikes, and the weekly menu allows them to have some control over what they are served. At the least, it allows them to avoid liver or brussels sprouts, if those are their "thing."
I have found that getting a copy of the menu on Friday and sitting down with a patient over it is a perfect way to target many therapy goals, to learn more about the patient, and to get the patient talking about something that many people have strong opinions about. Patients have opened up over the menu, whether it's because they hate the food or think it's just fine, or whether a certain meal brings up memories of cooking for family, many people enjoy talking about food. Some patients do not have much of an appetite, and discussing the menu ahead of time may allow them to pick out which foods appeal to them more, and possibly lead to better intake and reduced reliance on snacks or supplements.
When using the menu, I often start out focused on dysphagia goals. Reading the menu might show me if the patient can identify appropriate foods and textures, or is she is aware of her dietary restrictions. I can plan ahead for upcoming treatments sessions and develop compensatory strategies based upon what the patient is stating he would like to eat. I can also involve family in the session by taking this opportunity to teach them about which foods fall naturally within a certain diet texture category and which may need to be modified, as well as by discussing compensatory strategies, safety strategies, and so on.
Discussing the menu presents me with all sorts of language and cognitive tasks, including:
- decision making, safety awareness, and problem solving (what to do if you get the wrong tray, why certain foods are restricted, etc.)
- formulating and expressing opinions
- verbal sequencing - ask patients how they make a certain dish
- word recall
- orientation (if the menu is in a calendar format)
- reading comprehension
- following directions and/attention (have the patient circle or highlight all of his likes)
I find that using the menu this way also gives the patient a sense of control and helps me to develop a rapport with him. There is nothing like bonding over food!