Ontario nursing homes feed seniors on $8.33 a day

The lives of many vulnerable elderly people would improve if the government committed to an annual increase of a few pennies a day in its “raw food allowance” for long-term care, say the two associations that represent Ontario’s 629 homes. Both associations are hoping the province’s spring budget will commit to annual increases so that homes aren’t forced to go begging each year.

A minimum of 33 cents a day more would be enough to make a difference in meals and residents’ quality of life, said Cathy Gapp, chief executive officer of the Ontario Association of Non-Profit Homes and Services for Seniors.

Without this boost, which would cost an estimated $9.5 million annually, many homes “just can’t provide the fresh fruit and vegetables that you would expect someone to have,” said Gapp, who represents nearly 200 homes with 27,000 beds.

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The province provides money in a series of funding “envelopes” for care in nursing homes — amounts for diapers, nursing or food. Generally, nursing homes purchase food in bulk and prepare meals in a basement kitchen, then dole out breakfast, lunch and dinner from serving stations on each floor.

While the increase would provide better quality of food, critics say another issue is the preparation — food cooked far from the residents due to the typical layout of a long-term-care home, served in a cafeteria-style dining room without the enticing smells of a home-cooked meal. Improvements in that area would require major renovations in homes. Advocates say a positive first step would be increasing the food budget.

The Ministry of Health and Long-Term Care sets the per-day food amount, which currently sits at $8.33. It did move up from $7.80 in 2014 but there is still no guarantee of an increase.

When asked to respond Friday, the ministry said homes are required to follow a series of guidelines related to nutrition, hydration and food quality. Menus must be approved by a registered dietitian and reviewed by the residents council, it said.

Homes are also “challenged” to provide the culturally diverse foods that can make a huge difference in the lives of residents, particularly those suffering from dementia-related problems such as anger and aggression, Gapp said.

“Research shows one of the ways to de-escalate behaviours is to give people the food they are comfortable with and familiar with,” she said.

“Many people with dementia revert back to their younger thoughts of what life was like, and comfort food is one of those. It’s very hard to react to a situation like that on such a restricted budget.”

Candace Chartier, chief executive officer of the Ontario Long Term Care Association, which represents private chains and not-for-profit homes, is lobbying the government for “stable and predictable” annual increases.

“It would be a huge start for us,” said Chartier, who represents roughly 430 homes and 50,000 residents.

“There are some darned good meals out there and the homes are pretty good at planning their menus to meet all requirements — but it’s literally nickel-and-dime.”

For long-term-care residents, breakfast, lunch and dinner are often the most anticipated events of the day — but many end up disappointed, said Kathy Pearsall of Concerned Friends, a long-term-care advocacy group.

Residents are often fed cheap, processed food available through bulk purchasing, she noted.

“You can usually tell the homes that got a good deal. There will be a run of cold cuts, processed meats or hotdogs,” Pearsall said.

“Some people call us and say the portions are smaller than they used to be. Others don’t get the food they need in a special diet. I know of a diabetic lady who is getting chicken nuggets and turkey pot pie.”

Some not-for-profit or municipally run homes have the freedom to dip into outside funds to spend extra money on food. But, as Pearsall points out, those facilities are increasingly contracting out operations to private nursing home companies that run on tighter budgets.

A resident of the Extendicare-operated West Park long-term-care home, near Weston Rd. and Jane St., told the Star she has a series of health challenges that require a special diet but often doesn’t get the food dietitians prescribed. She asked that her name not be used for fear of repercussions.

A few years ago, she said, the home regularly served “delicious” meals such as roast beef and turkey with stuffing, potatoes and fresh vegetables. Staff now serve more pizza, sandwiches, hotdogs, sausages and mushy frozen vegetables, the resident said.

“I don’t feel like I’m getting the nutrition I would like to get,” she said.

Asked about the criticism, Extendicare cited a company survey that gave West Park a 91-per-cent approval rating for the appearance of its food, 85 per cent for aroma and 76 per cent for taste.

Extendicare also sent the Star sample menus that included dinner choices of roast turkey, sausage, ham and “Swiss steak.”

The ministry has marginally improved food funding over the past few years (without an annual commitment to do so), but the ongoing struggle to give residents healthy and culturally appealing meals is well documented. A 2015 report by the Dietitians of Canada concluded that Ontario homes are “serving cheaper protein foods and fewer fresh fruits and vegetables due to budget constraints.”

The 320 long-term-care nutrition managers and registered dietitians surveyed in the report said that improved funding would result in better nutrition for the residents.