‘Instant’ Menu Makeover

Need to improve your dining?  Start your learning with a quick course on how to improve the food served in your retirement home. Whether you are a Residence Administrator, Food Services Manager, Co…

Source: ‘Instant’ Menu Makeover

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An Effective Menu for Seniors – Part 3

Dinner…

This is the meal which working people focus on daily. We tend to think all day about what we are going to serve for dinner. What’s in the freezer or fridge? What will I need at the market? And for those people who plan the weeks meals, the thoughts are about timing and cooking.

In the Retirement Home, Dinner was never a simple thing.  We plan the meals a month ahead and buy the fresh ingredients up to a week ahead. The frozen and pantry ingredients are helpful to allow the focus to be on the main dish.

When I first took over the kitchen at the Retirement Home, my administrator set out a mandate for me to improve the food quality, reduce waste, reduce the costs, and deal with the staff problems.  Three out of four of those things were easy.  The staff improvements would have to wait.

Regulation mandated that we serve 2 options at dinner.  We needed to provide a choice between two dissimilar main dishes and all the sides and extras which would adhere to the Legislated Food Guide.

PLUS: in my kitchen, we needed to prepare for the occasional resident who would reject all options and demand we make something else.

I came up with an idea which incorporated all of the above while complimenting the other meals during the day. In fact, the awesome lunch menu was created from the original dinner conception.

Here is how it works.

There are FIVE dinner entree options.  The residents can choose from Meatballs and optional pasta (some hated pasta), cabbage rolls, plain pasta with sauce or olive oil (we had a few vegetarian/piscatarian), simple poached chicken breast, or the feature meal.

Choices were made at lunch time. The servers would take orders and the meals were then prepared as desired.  NO guessing, little waste.  The occasional resident would change their mind but we usually prepared an extra serving of each dish to accommodate.  The list served as our record of what the residents ate and if they refused all food.

The beauty of this menu is that it appears to have variety while catering to the concerns of the residents for repeatable dinners. It also has a great preparation ease.  Not all of my cooks were very skilled so I had to provide non-packaged, budget-friendly meals using cooks who were challenged by baked fish.

The staples were prepared as follows:

Pasta and sauce or olive oil – straight forward, usually penne because spaghetti and fettuccine were sometimes difficult for the folks who had trouble with their manual dexterity. A small pot of pasta was usually all that was needed.

Meatballs – optional with the Pasta – great option for us because we made the italian-style meatballs from scratch, hundreds at a time and froze the raw balls individually. The cooking involved baking but I eventually switched to braising in broth or tomato sauce as the result between cooks was more consistent and tender.

Cabbage Rolls – These were made in bulk and frozen individually. Filling was a combination of cooked ground meat (beef and/or pork) plus rice and seasonings. If there was a really good deal on green peppers from my produce vendor, we would also make a stuffed pepper variation. Both of these were braised in tomato sauce.

Poached Chicken – Simple boneless chicken breasts poached in broth.  Our chicken breasts were giant so we often were able to serve them sliced on the bias. This was easier to manage for the diners and allowed us to withhold a portion to be used for the Chicken Salad at lunch the next day. This dish was particularly good for residents with frequent tummy troubles.

Feature Meal – This was the special entree. I could make anything that might appeal to at least half the residents. Pork Roast, Lasagna, Turkey a la King, Chicken Parmesan, Shepherd’s Pie, and once I even made Goat Curry!  This was where I could have fun and treat the majority of the residents to some interesting food while still making palatable dishes that could be consumed by people who had trouble chewing or cutting. One of the surprise favourites was Liver and Onions!  I also had a recipe for ‘taste-alike’ Swiss Chalet Sauce so we made a great Roasted Quarter Chicken.

To stay in budget, I was able to choose more economical dishes some dinners and pricier cuts of meat for other dinners.

It’s not a trick.

It can be accomplished.

 

 

 

 

 

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Can a Cupcake be Evocative?

Indeed!

Special occasions deserve desserts that are a little more special than every day.  Most people do not have desert daily but in the residential home, dessert is served at lunch and at dinner.  Fruit salad, apple sauce, jello, pudding, cake squares are a common occurrence.  To make a special dessert for the residents, we need to consider the occasion. My residents get particularly excited about rosette frosted cupcakes.  For the kitchen, this is an easy treat to create because its the flair of the rosette that gets the diners all excited.

Image

I made these Maple Chestnut cupcakes and I think the flavours remind me of Christmas.  The creamy frosting is smooth and super soft and quite easy to produce from scratch or in combination with other pre-made frostings or mixes.  We use a product from Rich’s that is like a very light buttercream frosting.  Beat it with soft cream cheese and icing sugar to make one variation of the frosting.  You can also use the cans of Betty Crocker Whipped Cream Cheese Frosting.  These sometimes appear at the grocery store for $1, so they can fit the budget of a small residence. I will still add a little extra icing sugar to add some body to the Betty Crocker cans.

Inside the CupcakeThe cupcake batter is from scratch but could be created using a basic boxed white or vanilla cake with the Chestnut Puree added.  My recipe is an adaptation of one I found on The Huffington Post and my altered version produces a light and very very tender cake that seems to defy the weightiness of its ingredients.  You can even cut back on the sugar a bit, but as I have mentioned, sweet is a popular taste for seniors. To use a cake mix, prepare as the package recommends and then mix in some chestnut puree to match the numbers (my recipe makes 48 cupcakes).  Again, you may find occasional bargains on cake mixes for $1 at local low cost grocers.

Maple Chestnut Cupcakes:

(scroll down further for the easy version)

  • 1 lb Roasted and Peeled Italian Chestnuts
  • 2 cups milk
  • 1/4 cup Amber or Dark Maple Syrup
  • 1 lb (2 cups) softened butter
  • 2 cups white granulated sugar
  • 2 cups light brown sugar
  • 4 large eggs
  • 2 tsp vanilla extract
  • 2 tbsp lemon juice
  • 4 cups Cake & Pastry flour
  • 2 tsp baking soda
  1. Put peeled chestnuts into a saucepan and cover with milk.
  2. Add maple syrup and simmer covered for 10 minutes.  Do not let the liquid evaporate.
  3. Remove the chestnuts and mash by hand or in a food processor.  Add some milk back into the mash if needed.  Set the chestnut mash aside.
  4. Set the remaining milk aside.
  5. Cream together butter with sugars and beat until evenly blended.
  6. Beat in eggs, one at a time until incorporated and then beat until fluffy.
  7. Beat in remaining milk, vanilla extract, and lemon juice.
  8. Add in the Chestnut Mash and mix well until fully incorporated.
  9. Combine Flour and Baking Soda in another bowl and whisk well to mix thoroughly
  10. Carefully incorporate the dry ingredients into the wet mixture and thoroughly combine.
  11. Fill paper lined cupcake tins 3/4 with batter.
  12. Bake at 350 (325 convection) until golden (about 20 mins).  You can check doneness by looking for the tops to spring back when touched or when a toothpick inserted in a cupcake comes out clean.

Cream Cheese Frosting:

  • 1 lb softened cream cheese
  • 1/2 cup softened butter
  • 1 cup powdered sugar
  1. Beat together butter and cream cheese until light and fluffy
  2. Beat in powdered sugar
  3. Beat on high until fluffy and smooth

Easy Version  (makes up to 48 cupcakes)

Maple Chestnut Cupcakes:

  • 1 lb Roasted and Peeled Italian Chestnuts
  • 2 cups milk
  • 1/4 cup Amber or Dark Maple Syrup
  • 2 boxes vanilla or white cake mix  (to make 48 cupcakes total)
  1. Put peeled chestnuts into a saucepan and cover with milk.
  2. Add maple syrup and simmer covered for 10 minutes.  Do not let the liquid evaporate.
  3. Remove the chestnuts and mash by hand or in a food processor.  Add some milk back into the mash if needed.  Set the chestnut mash aside.
  4. Set the remaining milk aside.
  5. Prepare cake mix according to instructions BUT use the remaining maple chestnut milk in place of the milk or water in the instructions.  If you need extra liquid just top it up with more milk or water.
  6. Add in the Chestnut Mash and mix well until fully incorporated.
  7. Fill paper lined cupcake tins 3/4 with batter.
  8. Bake according to the cake mix directions.  You can check doneness by looking for the tops to spring back when touched or when a toothpick inserted in a cupcake comes out clean.

Cream Cheese Frosting:

  • 1/2 lb softened cream cheese
  • 2 containers (4 cups) of ‘canned’ vanilla frosting
  • powdered sugar (optional)
  1. Put canned frosting into a bowl with softened cream cheese
  2. Beat until combined and smooth
  3. Beat on high until fluffy and smooth
  4. Beat in extra powdered sugar until frosting reaches desired consistency

So, the easy recipe has a very rough pricing of $2 for cake mix, $2 for frosting, $3 for cream cheese, and then the chestnuts say $4 per pound.  That’s about $11 for 4 dozen full sized cupcakes with frosting for a special occasion.  Compare the $0.23 cents each to the 10 cents for an average dessert and it’s still affordable.

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An Effective Menu for Seniors – Part 2

Well, hopefully, breakfast was a hit!

Let’s move on to the planning of a daily lunch.  This is the easier of the meals because I have found that typically, seniors have developed a more rigid pattern or consistency to their lunch eating.

Initially, we served 2 choices at lunch.  There was a hot and a cool option.  So let’s say a pasta dish or a sandwich.  Our local regulations require a minimum of two options on the menu.

This idea of variety was problematic.  If a resident did not like either item, my staff was running in and out of the kitchen making cheese and toast, egg salad, fried eggs, ham sandwiches, whatever.  This caused service delays and dissatisfaction. My staff was inefficient and pandered to every resident whim.  Customer Service aside, I only have so much of a budget for staff and time during service is precious.  If there is too long of a wait between the start and finish of service, we often would get a mob of anger.  Keep in mind that this is based on the environment I entered at the start of my time here.  The status quo was indeed unacceptable with respect to my mandate of better food, better service, better budget.

So, solution…

There is a relationship between lunch and dinner that will become more obvious in our next part, but, for now, we will consider lunch as an independent entity.

Looking at the odd requests from our residents over the course of a month, I found that the most suitable menu included ALL of the following:

  • Cheese Sandwich
  • Egg Salad Sandwich
  • Tuna Salad Sandwich
  • Chicken Salad Sandwich

This covered all requests and allowed us to make only one special daily lunch meal.  The lunch meal could now be almost anything because there was so much available as an alternative.

So now lunch is simple.

  • Soup of the Day
  • Daily Special Lunch Meal or one of the sandwiches above (ordered at Breakfast)
  • Side Vegetable dish to meet dietary requirements
  • Dessert

It is the responsibility of the menu planner to ensure the options provide all the needed nutrients and at first it seems like a daunting task.

We cannot force feed anyone. I have had this argument with my colleagues.  It is not possible to say that any menu will ever provide exactly what everyone needs. These residents are thinking people with feelings, needs, wants, and dislikes.  My personal philosophy is to allow them to eat what they want to a degree.

The meals I design, when combined with all the daily meals and food items, will provide more than enough nutrition for anyone. The menu contains items that when consumed in large quantities in an irresponsible manner, might cause weight gain or malnourishment but I have been able to personally disconnect from the possibility that a resident might not eat everything we provide, or may have items in their rooms that are somewhat unhealthy.

This is a retirement home, not a prison and I refuse to make anyone feel like it is a place where their choices have been removed.  We provide, we do not control.

I fully understand the need to eat a variety of foods, but, and many of you out there know, there is no way we can ever get a person with a lifetime of experience to do everything we demand from them.  They will just say ‘no’.  To reduce the arguments in the dining room, we must provide food that is acceptable to almost every RESIDENT, not just the cooks, the administrators, the families, or the regulators.

So at this point, I am hoping that you have your own understanding of nutritional needs for seniors.  This will dictate the amounts of food you provide.  In this post, we are only discussing the actual choices we make to serve, the dietary staff must make their own considerations for everything else.

So, that said… back to Lunch!

The beauty of our alternative menu is the cost.  Our cheese sandwich with real cheese (not processed slices) is the most expensive item at say, $1 per meal, but we take less than 10 orders of it per day, depending on the daily lunch special.  An egg salad sandwich is less than 50 cents (4 per day).  A chicken salad sandwich is about 60 cents (2 per day).  A tuna sandwich is about 60 cents (2 per day), also.

The daily lunch special is now a single dish and my kitchen’s repertoire includes over 40 items available for the lunch special. That’s more than a month of different lunches if a resident does not like to eat the same thing every day.

For our residents who do like to choose a consistent meal, we have four soft sandwich choices on three types of bread (whole wheat, white, or rye), soft, toasted, or grilled. Assuming that only the Cheese sandwich would be grilled, the total number of choices for lunch is now 25!  That’s a huge menu!

So how do we manage to pull it off with our staff?

Lunch is served at 12 pm.  Soup must be ready to serve at noon.  Depending on the soup, it is prepared from scratch or packet (most are scratch) by the breakfast cook.

Egg Salad Sandwich Mix: During the breakfast shift, hard boiled eggs are prepared.  Typically, 12 to 18 eggs are enough to use for the lunch and for the snacks for the day. An ample amount of filling is prepared to taste with mayonnaise, mustard, and pepper (note no salt).  Our two breakfast cooks each prepare it differently.  One likes a chunkier mix, the other likes to make it finer and both are accepted by the residents. In fact, the day-to-day difference in the mix is interesting for the diners. We label and date the mix when it is prepared and NEVER combine product from different days.  On Wednesday, Tuesday’s leftover filling is used first and Wednesday’s fresher mix is used next. We try not to keep any product into a third day.  If we serve finger sandwiches for evening snack, we try to use up the mix in the evening.

Tuna Salad Sandwich Mix: Again, enough filling mix can be made to cover a few days. We can also use smaller cans of tuna since we only need, at most, two sandwiches per day.  Three to four sandwiches will come from a six ounce can of tuna.  Mixed with mayonnaise, pepper, lemon juice, and a little finely chopped celery, our mix satisfies the few tuna lovers.

Chicken Salad Sandwich Mix: This one is tied to our dinner menu and is usually made up from leftover dinner chicken.  There is more involved and you will understand when you see the dinner menu.  This mix is made up of mayonnaise, pepper, herbs and a little finely chopped red bell pepper run through the food processor on pulse.  The red pepper makes it easy to differentiate the chicken from the tuna. As leftovers are not precise, we sometimes supplement the leftovers by poaching a boneless chicken breast during the breakfast shift.

Cheese sandwich: We buy our cheese as five pound block of marble cheddar that we can slice on our deli slicer. We slice to about one eighth of an inch thick and one and a half to two slices accounts for a proper food group serving.

Sandwich Construction: We default all of our sandwiches to Whole Wheat bread as this is the requirement by our regulators to ensure whole grains in the daily diet.  This makes the rest of the ‘alternative’ preparation a breeze.  Let’s imagine that a total of 20 alternative sandwiches need to be made.  Lay out 20 slices of bread, deviating from the Whole Wheat only when white or rye has been ordered.  Next, add the correct fillings, add the second slice of bread, cut the sandwiches and seal them in plastic containers to refrigerate until lunch service.  This is done by the breakfast cook at around 11 am. The grilled cheese sandwiches are cooked about 10 minutes before lunch is served and held warm until service.  They are so lovely and melty this way.

During the 45 minutes between the sandwiches and the grilled cheeses, the breakfast cook prepares a salad based on Romaine lettuce because it will count as one of the two servings of green vegetables. Sometimes this salad looks like a Greek salad with olives and feta cheese, other times bacon and croutons are used to make a Caesar salad.  We have also used a coleslaw, shredded carrot salad, cucumber salad, broccoli salad and the like.

So the lunch special meal can now be the focus of the staff member who starts work at 10 am (usually me).  Whatever needs to be done, can be done in the two hours before lunch having prepped if needed, the afternoon before.  The selections can surpass the quality of simple salmon sandwiches and ham sandwiches when one skilled cook can focus on one dish.

Some of the meals I have prepared for lunch have included:

  • Maple Rosemary Roasted Pork Loin Sandwich
  • Gourmet Hamburgers with fresh cut fries
  • Asian Chicken Noodle Salad
  • Gourmet Pizza
  • Pulled Pork Sandwiches with House Made mild Prune Sauce
  • Wild Alaskan Salmon Patties
  • Teriyaki Beef and Rice
  • Western Egg Omelette Sandwiches
  • Gourmet Quiche and Buttered Toast Points

The success of this lunch menu is seen in the reduction of complaints.  There are more satisfied diners.   Almost nobody changes their mind from the order placed at breakfast.
There is so much less waste now and the staff can focus better on serving the group than spend so much effort on one person at a time.

The preferences of each group of residents may be slightly different depending on the cultural differences present in your resident population but in a very short time, you will know what is best for your residents.

Good Luck with lunch and we will see you again when it’s time to cover dinner planning.

Caio!

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An Effective Menu for Seniors

When I look at all the things I can order for my menu today, I am excited as a chef.  There are so many choices.  Foods can come to us from almost anywhere in the world. As a Chef, we think of protein, vegetable, and starch as the basic building blocks of a plate. As a food manager in a residential retirement home, we have to think of nutritional food groups as well.

I used to think that the only limiting factor was cost.  With a tiny daily budget per person, I need to make every penny count.

There is more to planning a seniors’ residence menu than budgeting.  I believe that all people in residential care deserve good quality food, lodging and care.  I would go so far as saying that the food is the main concern for almost all residents. They arrive 30 minutes early for meals and make the menu a huge part of the resident council meetings.

The food service can be a source of entertainment and conversation as well as a source of pleasure or satisfaction for the residents.

I have always believed food to be a display of caring and love from the cook to the diner. I want people to feel sated and nourished when they have finished a meal.  Anything short of this and I can take it personally, as if I had failed at my job. Whether that makes me good or bad at my job, I don’t know.

I try to imagine being a resident.  More than likely, I was moved here because I could not really live on my own anymore.  Perhaps I had an accident or minor stroke and my family felt it was safer for me to be among other people and with a close nursing staff to dispense my medication properly. Whatever the reason, I probably did not really want to move into any residential facility. Herein lies the real problem.  I was not happy from the first moment in the door. We need to calm that unhappiness and make the food delightful.

As the manager of a crucial support team in a residential care home, I think it is essential to make whatever budget I have stretch as far as possible to provide the nourishing and pleasurable dining experience the residents deserve.

Coming back to planning an effective menu.  For now, let’s just imagine the budget is set and we are using a moderately priced line of raw products. In other words, our budget is easily met, regardless of the choices. (I will cover serving good meals on a bologna budget in another post soon.)

The question then becomes, “What will my residents eat?”.  It’s easy to choose macaroni and cheese, spaghetti and meatballs, pot roast, pork tenderloin, as these are among the universally acceptable meals.  A week’s worth of different lunches and dinners is not a difficult task for a planner with little knowledge of the likes and dislikes of a small population of residents.

It becomes a more difficult task when the menu is extended into a month.  Repeating the same basic foods can cause complaints among the residents.

Some diners may even focus on a particular dish or item that they dislike a great deal and exaggerate its presence on the menus. This might cause a great deal of stress for residents and staff alike.

Now, it needs to be said that among seniors is the occasional individual who complains about everything, regardless of the subject.  We can’t do much about them. We can only hope that within our menu is a dish or two that is tolerable. In my experience, this is likely a person who eats only white bread and bland food.  Later in this post series, I will show a part of the plan especially built for these picky types.

Starting with a general population of people in their 70s, 80s and 90s, we need to imagine what they have experienced.  Those in their 70s were born during the depression and might not have remembered the leanest of times while those in their 80s and 90s would indeed recall some of their most difficult financial times.  Many may have served in any of several twentieth century wars. And still others would have done the majority of their ‘cooking’ during the age before convenience foods and microwave ovens.

For instance, my residents hated rice when I first started.  Their concept of rice was limited to dark colored stir fried Chinese style take-out rice.  As you will read in my earlier post, I eventually converted them to a nice baked rice pilaf. It’s healthier and easier to make and has good flavor. Their anger over the plain white rice was peppered with comments that today would be interpreted as racist.  These were people who at some point in their lives viewed Asians as enemies.

Believe it or not, they also dislike pasta in general.  Again, it’s viewed as a foreign dish and was probably not an easy thing to cook properly as an average non-Italian.

My residents wanted just meat and potatoes every day.   This is what they had lived on for their entire lives. Cheaper cuts at lean times and more special cuts for Sunday dinner.  Potatoes… white, boiled or mashed.  Canned vegetables except in summer months. Very little fresh fruit outside of local harvest times. (I recall my grandfather’s stories of his black bananas stolen from the fruit market trash.)  The average family had poor refrigeration and cooking appliances well into the 1950s.

The culture of these particular residents is evident.  Our managing of their menu and maintaining the dietary requirements set by authorities is less so.

The food guides used currently are our best guidelines to set our menu.  This may not be ideal for any particular individual, but it is the accepted healthful balance of food for proper nutrition.  It is our legal responsibility to provide the elements of proper nutrition.

Check out the 2010 Dietary Guidelines for Americans consumer publication or the Canada’s Food Guide. Both documents and their parent sites can help plan an appropriate and well balanced menu.  Before you can begin planning your menu, you will need to understand the requirements. I also have a monthly planner for use in MSExcel that helps to create the menus.  I will make it available at the end of the post series.

Now, back to our residents. We know they want meat and potatoes for every meal.  We know they cant have meat and potatoes for every meal.

Start with breakfast. We used the breakfast meal to maintain some consistency on a daily basis.  It’s a simple idea and allows the residents some control.  This Breakfast Menu sits on every dining table throughout the day so that it can be viewed at any time.  The made-to-order breakfast is hot and should start the day without stress.  Breakfast is such an important and intimate meal that it needs to be right. Even a cold breakfast is a ritual that is important for many people.

You will notice the simple choices.  There are so many combinations available that everyone can have their favorite or regular breakfast items.  The raisin bread is the most expensive item on the menu at about 20 cents per slice.  Stewed prunes and seasonal fruit are actually rarely ordered and usually used therapeutically for constipation. We make it an option on the menu so that they can be ordered in a dignified manner.

Very few residents deviate from their regular breakfast meal and most can be counted on to appear at a regular time daily during our 7am to 9am breakfast service period.

I will move on to Lunch planning in the next post.   For now, review your legal requirements and get that daily, per person budget number down for reference. We will be using it in the future planning.  For the time being, you know where we will be heading and we will use these tools to make a great menu.

Have an awesome day!

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Who loves nuts?? Dealing with Nuts and Denture users.

People with all their teeth forget that nuts are one of the more difficult foods to handle as a denture wearer.

I have found that my residents crave nuts but most cannot actually eat them.  There is a pride factor in there too that makes it difficult to say ‘I can’t eat this’ and the diner will often simply not eat the item or sadly, say they don’t like it when indeed it just hurts to eat it.

You could add peanut butter to an appropriate recipe but peanut is a common flavor and you may want to bring something a little more exciting to the table.

The solution to bringing nuts back into the senior diet is simple and just requires digging out your food processor.  There are so many flavorful nuts available in bulk and all you need to do is grind them a little to reach a more ‘chewable’ level.

Pecans are expensive but add a beautiful nutty sweetness to any baked good or salad and can be mixed into pancake batter.  Combine pecans with more affordable nuts to reduce your food costs while still adding the great taste. My favorite flavor with pecans is banana and maple syrup or caramel.  Try a pecan, banana, and maple cream cheese topping for bagels or waffles or anything.  Try using a little butter to quickly warm pecan meal or crumbles in a saute pan and use as a topping for mixed greens salad or blanched vegetables. Warmed nuts are a whole different experience.

Crush or grind cashews into Asian style chicken dishes or Brussels sprouts.  Remember that if you are using a sweeter nut, such as cashews or pecans, combine them with bitter and salty foods to balance the palate. If your salt is reduced, no problem, nuts are still great in many dishes.

I make a nice nutty snack bar.  Its soft and chewy.  It can be made by using any nuts, seeds, crispy cereal and dried fruit as desired.

Denture wearers and those without teeth or dentures can enjoy a more ground nut meal version of the bar.  Make sure that the bars are soft enough to break apart with fingers and can be dissolved quickly in the mouth.

I have included the basic small batch recipe here.  If you need a large quantity batch conversion and instructions, please feel free to comment and I will add it.

Imagine all the protein in these bars when they are made with seeds and nuts.  They are an excellent alternative to cookies and pastries loaded with processed ingredients. The great thing is that any budget should be able to handle this recipe by simply altering the solids.

This is not really suitable for diabetics but the recipe and its ingredients can be swapped around to increase or decrease carbohydrates, nut protein, salt, or even organic or vegan status.

Enjoy!

Chef Kazoo’s Soft & Chewy Honey Nut Bars

Ingredients for the Caramel Syrup1/3 cup honey
1/4 cup packed brown sugar
1/4 cup butter, margarine or coconut oil
1/4 tsp salt
1/2 tsp vanilla extract
4 cups nuts, seeds, fruit, cereal for bars

Combine these ingredients, except the vanilla extract and the nut mix, in a saucepan over higMelt and dissolveh heat and mix until well combined.

You will notice that the mixture is opaque which shows that the sugar is not dissolved.

Melted, wait for boilAs the sugar dissolves the mixture will begin to look more like clear liquid honey.

Soon it will come to a boil.Boil the Caramel

Once it boils, continue stirring for about 1 minute.  If you want your bars to be firmer, you can increase this time to boil. I recommend first trying 1 minute and testing the finished bar.  If you over cook this caramel, the bars may be to hard to bite for some people.

Add VanillaRemove the syrup from the heat and slowly add the vanilla extract.  The vanilla will boil so be cautious here.

Mix well and pour over 4 cups of well mixed solids.

pour over nuts

You can use any combination of nuts, nut meal, seeds, dry cereal such as puffed quinoa or rice crisps. coat evenlyMy combination is Pepitas, sunflower seeds, toasted sesame seeds, flax seeds and chia seeds.  This is all to your taste and to the chewing abilities of your diners.

Mix the solids and syrup until everything is well coated. This mix will begin cooling quickly lined panso you should not take too much time to get this part finished.

turn into panPour the mixture into a parchment lined pan.  My recipe suits an 8×8 or 9×9 pan.

press mixture into pan

Distribute the mix evenly in the pan. Cover the top of the mix with another piece of parchment and use a smooth and solid item to press and smooth it into the pan.

pressedWhen it is pressed well, it should not move much when you press gently.  This is a bar that needs to have some firmness to it to transport.

Now, refrigerate the pan of bar mix until it is chilled.  It will be quite firm at this point and can be removed easily by lifting the parchment liner.

Cut the bars as desired and return to the pan or to an airtight container.

Serve only as many bars as you need, keeping the remainder refrigerated.

IMG_2533[1]As the bars reach room temperature, they will become even softer and chewier.

Experiment with the flavors and nut combinations.  I am sure you will hear both positive and negative comments about these bars.  Simply adjust the recipe as your diners desire and you will eventually have the perfect snack bar for them.

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Expanding the Topics in this Blog

Hey Everyone!

I have decided to begin expanding topics in this blog to include more than just seniors’ food and dining.

If you want to see anything specific, please just let me know and I will try to please.

Have a great day!

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Eating Disorders in a Senior – Time for Tough Love?

When does customer service in a retirement home become a disservice to the resident?

I am dealing with a difficult situation at the moment that is leaving me with sleepless nights and stressful days.

Jane is an 84 year old resident in our retirement home. She suffers from age related deterioration of her body but has a relatively sharp mind.

When I arrived at the home almost a year ago, Jane was the first resident to treat me fairly well. She approached the administrator with some dietary concerns and I was brought in to discuss these issues. Apparently, Jane could not eat cheese, acid, or tomatoes.

A private discussion with the administrator revealed that Jane was an ‘Attention Seeker’. In general, an AS personality can be the eternal victim. In health care, this is a person who is never well or satisfied with care. They can be known as frequent flyers to ER staff who see them repeatedly for any issue the sufferer develops. The form of attention seeking might be subtle or aggressive.

I believe that this is a common condition in the elderly which results from identity crises after the nest empties and the spouse passes away. The senior will seek out assistance for every possible symptom when the condition is simply aging. This may be simple loneliness.

Here is my problem, Jane is starving herself. At least she was starving herself all summer.

Jane refused to eat the nutritionally balanced meal legally required to be served by a residential home. After counseling Jane about diet, discussions revealed that she herself believed it to be somewhat psychological.

Alright, so we all agree that Jane may have an illness that keeps her from eating properly. In our home, I like to blatantly call this an eating disorder.

Jane has been caught eating our food heartily in private and is believed to make herself vomit on occasion. If she were 15, the diagnosis would be Bulimia, so I believe she has an diagnosable eating disorder.

For about 3 months this past summer, Jane ate nothing but an egg for each meal and an occasional bite of toast. She drank only black tea as an accompaniment. I urged her to eat the standard balanced meal but she refused over and over again. We obliged her requests out of a sense of Customer Service. This is a decision I now regret whole heartedly.

Jane starved herself into the hospital with this behavior.

The registered dietitian at the hospital could not make her eat and after about 10 days she was returned to the home with no dietary plan. Her doctors admitted that she is suffering from mental illness and there is nothing that can be done.

Here is my problem as dietary manager of a small retirement home. Liability.

For a period of time, me and my staff provided the egg to Jane instead of the balanced meals. Eventually, I grew very concerned that she was not receiving proper nutrition and begged the nursing staff to intervene. I begged my own kitchen staff to refrain from providing the egg. I asked the other managers to help and their response was only that we needed to think of customer service and give her what she wants.

We were all wrong.

Residents have come to us, usually by the urging of their families, so that they are properly cared for, have enough to eat, and are kept active. They really want for nothing as we provide more than ample food and entertainment. They have social lives within the home and some are still romantically and sexually active.

Allowing any one of the residents to harm themselves is against everything that their families want from us.

Self-induced starvation is absolutely unacceptable.

On Jane’s return to the home, I made a decision which I cleared with my administrator. No longer would Jane’s eating disorder be a factor in the food we provide to her. She would receive the balanced meal, and only the balanced meal at all mealtimes.

Within a day or two, Jane started to refuse meals brought to her room and requested a small bowl of rice krispies with a small amount hot milk. I explained the situation with my staff and said that our kitchen would not be responsible for starving her and told everyone that they were to refuse Jane’s requests.

I thought people would deny my order but instead, they all understood that there was a serious problem. We have been providing the balanced meal now for three weeks. Jane doesn’t always eat it, but she gets it at her table every single meal.

Lately, Jane has been seeking attention from her fellow residents since our staff are holding back their attention from her. Recently, she tried to refuse her meal in exchange for a small portion of plain rice. Of course, the kitchen refused and yet somehow, she ended up with a small amount of plain rice. We believe another resident gave it to her.

For confidentiality reasons, we cannot discuss Jane’s condition with the other residents, so I appear cruel and unconcerned when I will not give her what she wants. For this, I will take a huge hit form the residents. They will be furious with me and I will be unable to defend myself. They will complain more to the servers and to my administrator. I will spend my days and nights worrying about my job constantly.

All I am trying to do is ensure that a woman is provided with proper nutrition.

As I type this, I realize that I am going to have to do some hard counseling with Jane today. I feel like I am on my own in these situations because nobody wants to appear the heavy but someone has to be.

Wish me luck.

—sigh—

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Cooking with Wine

I bought 8 gallons of cooking wine for the Retirement Home kitchen.

Yeah, that sounds like a lot of wine but you would be surprised at how much I use while cooking for my seniors.

To keep a cooking wine from falling into the wrong hands, it is laced with some salt and pepper to discourage drinking.  The wine itself is a generic burgundy (red) and a generic sauterne (white).

I was hesitant to use it as the new chef because I had not heard of the previous cooks using any alcohol in cooking.  I didn’t know if the residents were abstainers and would be offended if I used alcohol in the food.  I checked with a few of the other managers at the home and learned that wine in the cooking would probably be fine.

So, I added the burgundy to the beef stew and my residents loved it.

Now I wanted to use the white cooking wine.  My budget could handle this generic foodservice wine.  The taste in the food was acceptable and so I wanted to experiment with a more sensitive recipe.

I tried a white wine, butter, lemon and garlic sauce for chicken.  It was nice.

In the dining room, the white wine sauce was a success! We know the food tastes good when the dining room stays quiet.  People are putting food into their mouths and not talking about the food.  That is a good sign in our dining room.

So simple, wine added to stews and sauces is a great boost in our kitchen.  I will go through the 8 gallons like it is water.

Cheers!

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What is Taste Fatigue?

Well, I never thought there was anything like it before, but Taste Fatigue is a real problem in the retirement home. My residents are about 80-90 years of age on average and endure limitations such as decreased mobility, severe arthritis, memory dysfunction, mild dementia among other conditions that might take away a person’s ability to live alone safely.

Taste Fatigue is a phenomenon whereby a person can no longer taste a particular food because they have eaten too much of it over too long a period of time.

Let’s imagine you love the taste of avocado.  You have it for breakfast, lunch and dinner for months.  One day, you realize, you can’t really taste it any longer.  You lost the ability to detect the subtle elements of avocado that made it a pleasure for you. You may even wonder if its simply a bad crop at the market so you keep trying to reconnect with that gastronomic delight that made you love it.  You can’t differentiate between the ‘green’ flavors and that undertone that reminds you of banana. It all tastes like mud. This is Taste Fatigue.

If you have worked with the elderly or just watched the eating habits of a few older people on the verge of needing assisted or long term care, you may have noticed that they sometimes eat the same thing every day.  Perhaps for convenience or frugality, my 92-year-old grandfather ate Salsa and Sour Cream sandwiches on Rye Bread for weeks on end.  This is the recipe for Taste Fatigue.

When does Taste Fatigue become a problem in elder care and what can we do about it?

I think that the problem starts in the menu planning.  Over and over I see these four week rotating menus but when I dig down into the details, they are simply the same ‘base’ food week after week with a few changes to the vegetable blend on the side.

When I started my present job, the menu rotated over four weeks for six months.  YES, six months! The previous cook didn’t change anything week to week.  She fed the residents the same anemic sandwiches every lunch, tuna on Tuesday one week and Thursday the next. Supper was similar, the same 10 or so entrees and when an alternate was offered you could bet it was a leftover from a prior meal.

People were unhappy and losing weight.  This is not good in a normal kitchen, let alone a health care kitchen.

In the Long Term Care or Palliative Care situations, people will sometimes have to be spoon fed by a Personal Support Worker not because they are physically challenged but  because the limited diet they have been consuming has exhausted their interest in eating.

Ah, now there is a clue in the mystery.  The solution may rest in the idea of a Limited Diet and Interest in Eating.

Residential homes took their food service pages from hospitals.  The problem with this approach is that Hospitals are not meant for Long Term Residence.   The menu is very limited.   Salisbury Steak, Scrambled Eggs, Boiled Potatoes, Plain Rice.   These foods are not bad to taste, just boring and over time, they just become an endless parade of bland portions on a plate.  A resident can easily tolerate and even enjoy the simple and clean taste of plain white rice in the beginning, but, there will come a day when he can’t stand to put another grain past his lips.

My public health mandate requires me to serve rice two or three times each week and I was initially greeted with disdain as I tried to pawn off the simple grain to my residents. My feelings were mildly hurt because I made perfect plain rice with the budget friendly parboiled Sysco staple.  I use about three pounds of rice, some canola oil to coat it, and about three quarts of boiling water in a 4″ deep half hotel pan.  I seal it with foil cover and bake at 325F until the liquid is fully absorbed.  I just shake the pan at the 40 minute mark if there is still liquid, I leave it for another 10 minutes, etc.

I came to realize that the residents were never going to embrace the health department guidelines for inclusion of rice.  I decided to give my plain pilaf a lift.  I started with simple changes like alternating vegetable broth and say, orange juice in the liquid.

Well, that was met with fewer and fewer complaints.

Next, I added some standard herbs one might find in any household such as thyme and bay leaves.  I need to tell you that my kitchen had no spices when I arrived.  So it took a while to work my spice pantry into the budget.

Now, I will add almost anything to the rice.  Turmeric for color,  Star anise for aroma,  Cloves for a kick, or even small diced vegetables for texture.  If I want to add extra nourishment, I will add a small amount of a more expensive mixed grain pilaf (think Uncle Ben’s Seven Grain mix) or a cup of 12 grain hot cereal.  These last two inclusions are never met with favorable response on their own, but by adding them into the rice they add something needed to something familiar.

So after months of evolving the plain white rice pilaf into a variety of more stimulating side dishes, I did something nobody ever thought possible.

Quinoa! And they liked it!

It is relatively expensive, but if I put it on the menu, the board of health is pleased.  So an occasional scoop of a cool quinoa salad or a hot quinoa pilaf is enough to please the county and stimulate the residents.

So, the moral of the story?  Change it up a little! A little ‘shake’ can excite more than you ever thought possible.

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