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A tour with Meals on Wheels in Washington Heights


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At Mary Manning Walsh Nursing Home, food is therapy


By CAROLINE SHIN

On a recent Friday afternoon at the Mary Manning Walsh Nursing Home, a petite Arlaine Bruce cut up slices of homemade apple, sweet potato and pumpkin pies for the Harvest Moon Ball. There were also sugar-free oatmeal and chocolate chip cookies for the diabetic patients and cups of ginger ale for all. Guests kept rolling in. Many needed help with their wheelchairs; a few wheeled themselves in. Even fewer walked.

At Mary Manning Walsh, food plays multiple roles in the lives of its residents—the more than 350 patients are 80 years old on average (and a lot are waiting to get in). The Upper East Side nursing home organizes special events such as the harvest ball, where food is used for socialization and normalization among its patients. Generally though—whether special events or regular meals—it is about “trying to get them to be happy with what they’re eating,” said Joanne Gaffney, 61, clinical nutrition manager. “Trying to feed them what their mother made them.”

Food and nutrition make up just one part of the nursing home’s comprehensive services, which also include 24-hour nursing, physician, laboratory and even, religious services. Arlaine Bruce said most of the residents are covered by Medicaid and Medicare and a few pay out of pocket.

Bruce, 46, director of recreational therapy, organized the harvest ball: a show with two lithe dancers, a keyboardist and a singer. She often uses food to get her patients to socialize. At the start of the show, one elderly lady, smartly dressed in an autumn leaves pattern, waved to a friend and wheeled herself over to the table where they chatted amid bites of pie and sips of ginger ale. Most of the 120 patients, however, stayed quiet, eating and responding to the show with occasional applause. They could not be identified nor interviewed, according to the nursing home’s policy.

Music therapist Sue Dennis, 40, says the food also normalizes things for the residents. “It might orient them a little,” she said. “It’s fall. We’ve got pie.” For Christmas, there are cookies, eggnog and hot chocolate, and the Passover seder presents its usual menu. The food reminds the patients of “what they would normally be doing.”

Bruce has also organized Saturday morning Doughnut Hours in which she and her patients talk about the news and play trivia around doughnuts and coffee. At monthly birthday celebrations, Bruce hands out cake and ice cream. The nursing home also hosts Travel Club meetings, in which a country and a typical regional food would be presented. Those who had visited that country would start reliving how good the food was there. Both Bruce and Dennis mentioned the apple strudel and sweet plantain, which have been featured in past meetings.

“They get together, eat and talk,” said Dennis. “It’s stimulating. They start reminiscing.”

For regular meals, Gaffney said the nursing home’s food service is not that much different from a restaurant’s. “We do cater to the needs and preferences of the residents.” The nursing home provides balanced meals that contain all food groups, adjusting the dishes or giving alternate sustenance for the patients with liquid restrictions, tube feedings or controlled carbohydrate diets. But she emphasized that, unlike a hospital, the nursing home does not adhere to a specific therapeutic diet. “You want to strike a balance,” she said.

Patients have individualized menus that adhere to their taste preferences and dietary needs. The menu, which varies daily, is planned weekly at the dietitians’ office. Breakfast usually comprises orange juice, oatmeal and a hard-boiled egg. Lunch and dinner include an entrée, starch and vegetable sides and dessert. All three meals come with bread and butter and coffee or tea with milk or creamer. The dinner menu that included beefaroni or tuna salad, mashed potatoes, creamed spinach and apple cobbler. There are additional off-the-menu dishes such as honey soup. Crab cakes, goulash and Philly cheese steak appear on the menu for upcoming weeks.

Gaffney added that food provides oral stimulation for some patients who are not tube feeding, and “for people that are seriously, terminally ill, we are more liberal with their diet because it’s one of the few things they can enjoy.”

Every day, it’s up to Andrea Reid, 58, assistant director of food and nutrition, to supervise the kitchen’s tray line: One person calls out the resident’s dinner selection — “two scoops, no mash” — and places a dish on a heat conductor plate, alerting the next two people on the hot or cold foods sides to place food and beverages on the dish. One person then adds coffee or tea, and the final person checks for accuracy. Beefaroni, mashed potatoes and creamed spinach lay steaming in baking pans. Tuna salad lay cold and yellow digital thermometers stuck out from roasted chicken.

After stacking up the trays of food, the staff members cart the meals to the nurses, who then deliver the food to the residents’ rooms. Some patients elect to eat at the dining room, where they have assigned seating. “They’re territorial,” said Bruce.

At the monthly Food Committee meetings, the nursing home allows its patients to issue complaints — most concerned cold food and a desire for new food.

Gaffney said the staff tries to remedy the issues the best they can. “You want to keep people happy here. This is their home.”

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