Battling senior malnutrition with finger food

Lunch at Watermark starts with warm, lavender-scented hand towels, proceeds with scoops of citrus sorbet, and finishes with elegant, bite-sized hors d’oeuvres that range from French toast and sausage casserole, to beef Wellington with mashed potatoes.

Watermark isn’t Philadelphia’s newest swanky restaurant — it’s a chain of retirement communities that recently rolled out a new program called Thrive Dining. Designed by chefs, it aims to battle malnutrition among residents with physical and cognitive disabilities.

“This is a company-wide initiative, and Thrive is specifically for our memory care residents at the moment,” says April MacDonald, the dining services director at Watermark’s Philadelphia location. “It is used to enhance their dining experience, assist with weight gain and ensure that they’re getting a complete nutritional meal.”

Malnutrition can be a major problem among the elderly, especially those with conditions like dementia and Alzheimers. In addition to physical challenges that make using utensils difficult, some people become disoriented at mealtime. That confusion can manifest itself in the form of different anxieties.

“When they see a plate of food, it’s like, I can’t eat all this food,” says Jennifer Smith, who helps oversee care of residents with memory disorders.

Others, she says, believe that they’ll have to pay for the meal, or fear wasting food.

For many, that means that they don’t eat, or don’t eat enough, which can lead to health problems like dehydration and lowered immunity.

Thrive aims to take on these problems by transforming the way meals are served. Instead of dauntingly large plates of food, meals are made up of hors d’oeuvres that combine the different parts of a meal into bite-sized packages.

The smaller portions aren’t only easier to eat, their composition ensures that even picky eaters get the nutrients they need.

“Some residents may just skip the meat or something else on their plate,” says Watermark’s nutritionist, Wing Lau. “But with Thrive Dining, al the ingredients are mixed together. So I think each bite, they’re getting a more balanced diet.”

Watermark says the program uses a patented grinding process that allows ingredients to be broken down without losing their texture. The result is a meal that’s more appealing to residents on several levels.

“It’s not overwhelming to them, and it’s colorful,” says MacDonald. “Residents who are on the Thrive Dining program enjoy eating more than they ever did before.”  Making the dining experience pleasurable also has a practical purpose — it helps keep residents focused on what they’re doing.

MacDonald says that’s why every meal begins with scented hand towels and sorbet.

“Sometimes they get confused and may not know why they’re in the dining room,” she says.

The sensory-based ritual provides a cue that they’re about to eat.

“So by the time their entrée comes, they’re already prepared,” she says. “They’re not having to think about it.”

Staff at the Philadelphia location say the program has been so successful, they’re considering offering it as an option to the rest of their residents.

“It could help with residents with limited dexterity or people that just struggle feeding themselves,” says the location’s executive director, Jennifer Tapner.

“It definitely improves their ability to be independent. And it’s a fun alternative to a regular menu. As you can see that the items are very attractive how they’re presented. So it’s not just stimulating the palate, it’s also stimulating the senses.”