Wednesday, February 23, 2011


It is not a good idea to leave choice of an Assisted Living Facility (ALF), Residential Board-and-Care Home, or a nursing home to the last minute. If you plan ahead for yourself or your aging parent, it is better to have time to check several alternatives out and compare. There are good blogs and articles on line to help you make the decision (for Assisted Living, see for example:, and, for Nursing Homes: Such guidance will help you assess amenities, level of care, cost, and those more intangible factors such as people-centeredness.

One issue that many people will not immediately think of when choosing one of these, is whether the facility is likely to serve safe food. But this is important. The unfortunate truth - as statistics show - is that you are much more likely to get a food borne illness in a place like this than you are when living in your own home. There are two reasons: greater vulnerability and less safe food.

After all, people in residential facilities and nursing homes are older adults. Once we get to that stage, the chances are that we will be more susceptible to bacteria and other microbes. Unfortunately, aging usually brings with it a weaker immune systems, serious illnesses and conditions such as poorly operating digestive system, kidneys and liver. This means even small numbers of microbes are more likely to make you ill, and, any illness you do get is more likely to be serious and land you in the hospital.

There is also another factor: the mass preparation of food always creates extra risk in any institutional facility - and, in restaurants. Efforts to keep costs under control may also lead to compromises (such as hiring less well trained staff, keeping utility bills down by setting the refrigerator temperature too high, purchase of cheaper food products, and serving food past its expiry date).

Yes, nursing homes have to meet federal quality standards, and be regularly inspected. ALFs have looser standards, but are also inspected in many states. In fact, common citations by such inspections tend to be related to nutrition and safety of food. But occasional inspections will not catch every problem, especially when advance notice is given and the facility has time to clean up its act. I have watched this happen.

But when checking out ALFs or nursing homes, do try to get hold of that inspection report and see what it found. Also take a look yourself when touring the facility and try to do it just before lunch or dinner is served so you can get a good view of what is going on in the kitchen and dining room. Food safety matters, particularly when you are older and more vulnerable.



Anonymous said...

Hate to say it, but I don't think one inspection is enough. I tried to visit the kitchen every time I went to see my mother when she was in a nursing home and the management allowed me to do so. If they won't permit such visits, time to check Grandma out of there!

Anonymous said...

Finding somewhere that will treat an aged parent with respect and dignity is tough enough, now food safety? Maybe the old fashioned approach of the extended family is the best approach after all. At least at home they are respected and the food is safe.