Food Waste at Long-Term Care Facilities, a Moral Dilemma?

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Last summer we conducted a study on food waste at two long-term care facilities located in southwestern Ontario. While interest in food waste has increased greatly in recent years, very little research has been done studying these unique operations.   Our research team had two objectives; determine what percentage of food was wasted in these operations; establish what factors were the drivers of food waste.  We spent two weeks at each facility measuring food being served to residents in their respective dining halls.  Measurements were taken for all foods pre and post service for breakfast, lunch, and dinner.  Any food waste incurred in the kitchen was measured separately.  All food waste produced in the facility measured at the end of each day.  Interviews with food-service management and employees of the facilities were conducted and observations of residents eating behaviors made during meal periods.  Results of our study estimate that 213 kg. of food per resident, per year is wasted at the facilities. While we put forth the need for discussion about the findings regarding food waste we have produced, we must emphasize that the quality of care provided at these facilities was nothing short of impressive.

We used a template we created called the “Restaurant Food Delivery System Framework” (RFDSF)  as a guideline for our management interviews and observations.  Categories of the RFDSF are listed below:

  1. Planning:  Menu Development, Recipes, Choice of Supplier
  2. Pre-Service:  Inventory Management, Forecasting, Ordering, Storage
  3. Service:  Preparation, Production, Quality Assurance

Some of our initial findings were straightforward and predictable. Compared to most commercial kitchens, minimal food waste is generated in preparation and production because almost all food is frozen, pre portioned, and often pre-prepared.  In addition, the amount of meals needed for each service period is known ahead of time unlike many other food-service establishments.  Only 5.6% of all food was wasted in the kitchen.

What took us by surprise was the significant waste that occurred once the food was delivered to the dining halls for service.  Mandated by the Ontario governments Long-Term Home Care Act (LTHCA), ON Long Term Care Home Act

residents are offered a choice of two proteins, two vegetables and two desserts.  Since orders are taken at the time of dining, management must guess at the preference each of these items will garner when determining their food production levels for each meal period.  Managers make educated guesses but also apply ‘buffers’ to ensure that all residents get their first preference.  Managers are also required to make food of various textures such as pureed, and minced.  Depending on how the resident feels that day, they (or their PSW) will order what texture they think they can handle. This results once again in ‘extra’ food being made to accommodate ‘choice’.  This combination of factors leads to an incredibly high level of waste in food that is sent to the dining halls but never even served (45.7%).

Forecasting is made challenging by the fact that menus are constantly changing to provide variety for residents. The facilities we studied worked on a three-week meal calendar.  Residents are offered choice to improve their quality of life. Not only are they served food they will more likely consume and enjoy, this ‘choice’ provides them some ‘control’ over their meals. This offering of ‘choice’ is the single biggest driver of food waste in long-term care facilities and brings into play the moral underpinnings of the policies mandated in the LTHCA.

The second driver of waste is again policy driven by the LTHCA.  Food-service providers are mandated to give ‘full portions’ to all residents whether they want them or not.  Residents meals are determined by dietitians to ensure required levels of caloric and nutritional intake.  We often observed full portions of meals going to residents that could not possibly consume them. We watched one 98-year-old man receive a full lunch every day when all the workers knew he would not eat more than 2 bites of anything.  Food that is served to residents but not eaten is considered ‘plate waste’ and accounted for a significantly lower amount of overall food waste than we thought (10%).  This number is somewhat misleading because roughly half the food prepared never makes it to the resident.  Based on our data we can estimate that approximately 20% of food served to residents comes back untouched.

Food Waste Source % of food used
Kitchen waste (prep & production) 5.6
Over produced food to garbage 45.7
Resident Plate Waste 10.0
Total Food Waste 61.3

Table 1.  Breakdown of Food Waste

The findings of our study are exploratory in nature and highlight the need for more research of the topic.  We also put forth that these results could lead to discussion and debate in regard to the LTHCA food-service policies.  Lastly, we hope our findings act as ‘wake up call’ to the extent of food waste created in this every growing sector of the food-service industry.

Having studied food-service in many different food-service venues we have never come across any operation that produces as much food waste as these two facilities did.  Consulting other food-service workers who work in these setting we conclude that these findings are not an anomaly and are indicative of what may be an industry wide issue.

In addition to the quantifiable results of our study we noticed what we termed a ‘throw away’ culture at these facilities.  We associate this finding with this being a healthcare facility where patient health in the primary focus and waste in general is an acceptable outcome of this.  Again, this is not a critique of the system but an observation that hopefully will lead to further review.  While we have provided evidence of high levels of food waste that are and accepted negative outcome as a result of patient care, we must once again reiterate how impressed we were at the level of care that was provided residents at these facilities.

 

 

15 thoughts on “Food Waste at Long-Term Care Facilities, a Moral Dilemma?

  1. If in the morning each resident was to indicate which protein, vegetables and desserts they want at supper time, if they are able, otherwise someone else needs to choose, would cut down significantly on waste?

    1. Yes! We had thought taking the orders the day before. This would add more steps and complicate the ordering process a bit. It takes away the ability for the resident to ‘order what they feel like at that moment’, but they still have control of their food decisions. We estimate this could cut the waste almost in half.
      Thank you for your contribution to this topic of discussion.
      Bruce

    2. If a resident will only eat 2 bites tjen it is a real turn off for them to be sent a full tray. Dieticians should know that. The solution is small snacks more often

  2. To: therovingprofessor
    I am not sure who to address this to but I have worked in the hospitality industry for 20years and in the last year I have gotten out of restaurants and worked in a nursing/retirement home. I want speak with someone about the food waste article and get more information. I am disgusted that food wasted and nothing much has been done. I am looking into ways that this can be eliminated and a law.

  3. I started as a cook in the kitchen at a hospital. Food service as well. It was awful how much food is wasted. You can’t take orders ahead of time because more then half the residents don’t understand, will forget, decide at time they want the other option. As well as if something needs to change last minute on menu. As workers you are not allowed to even have lunch off of the leftovers unless you pay for it. We did manage to save some waste from specific meals. We packaged them up as single meals and froze them. Meals on wheels. Customer would just come pick up a month or so worth and toss one in the oven when needed.
    I then ventured in ltc as a hca. It was great. You get to know the residents alot better. You have to think these people are old, many have severe health issues a few might be diabetes, over weight, dementia among many others. Residents sometimes will refuse to eat. Others might want to eat to much. Some you can’t put to much on their plate, they feel overwhelmed and then won’t eat. More communication between hca’s and kitchen staff is needed. Not just the manager. Most of the time they have no idea whats going on as it is.

  4. I have been to several long care homes, and the food does not look very appealing to me,so I understand why so much food is wasted. I know this problem I is not the kitchen staff.It is because most of it is processed food!

  5. I too work in a nursing home. I am appaulled at the quality of food given. Cold, hard Grilled cheese, fries, canned soup, high high sodium content in egg casseroles. Powdered eggs, high fructose drinks, more cheese more powdered eggs, no fresh veggies, rather frozen. Little protein from hotdogs.
    Improve the quality, better healing, empty plates. Simple

  6. I worked in long g term care for 10 years as a PSW. the food waste was a disgrace and the homes I worked in refused to allow staff to buy it for their meal breaks. They preferred to throw it in the garbage claiming liability issues if staff consumed food. I’m sure there is a way to allow staff to buy the food and it also would raise extra funds for entertainment for the residents.

  7. There are a few errors in this article. PSWs are not allowed to change a residents food texture. This can only be done by the nurse and can only be downgraded. For example regular to minced or puree. Smaller or larger portions can be given if it is properly documented in the care plan. Although preorders sound good, residents are required to be shown sample plates ahead of time and those with dementia can forget their choice in the time it takes to deliver the order to the servery. There are other MOHLTC rules like all mashed potatoes must be instant (to ensure smooth texture for those with swallowing concerns), milk must be served at each meal along with water and juice. LTC is the most regulated care, moreso than hospital.

  8. After witnessing what our seniors are eating in LTC facilities, I wouldn’t feed the SLOP to an animal! Virtually everything is premade, hight sodium, no flavor,,DISGUSTING! these seniors have lived on all kinds of food! They love comfort food,,,not a CHINESE STIR FRY! even worse PUREED! they are at most, at the end of their lives…there isn’t a whole lot of enjoyment left! Let them damn well eat what they please!!

  9. I have worked in LTC in Ontario and now New Brunswick. The food is very different in N.B where I work…..no pre-packaged meals, powdered potatoes or eggs. The residents receive fresh vegetables, fruit and eggs. Meals are created on the basis of using up leftovers through the week. The residents only have one choice and if they dont like it the have the option to have soup and/or sandwich. Unfortunately, we do have the same problem of the quantity placed on plates. Our staff have the option to purchase the meals for approximately $3.00. Ontario definitely needs to follow the lead of the Maritimes where food is concerned.

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