Serving holiday traditions it's not just about the food.

A member of a facility's food committee, Mrs. Walters was the self-appointed facility food critic.

In a recent meeting of the committee, she surprised the facility nutritionist by knowing the meal combinations of the four-week menu cycle at least as well as the nutritionist did. The problem was Mrs. Walter had become bored of it.

She was tired of the tough roast beef dinner every fourth Sunday and the not-quite-sweet-enough harvard beets for lunch every fourth Tuesday. Her negativity began to permeate the room.

The nutritionist gently guided the topic from a complaint session to planning holiday meals, and it brought about a dramatic turnaround in Mrs. Waiter's attitude. She offered abundant ideas for holiday meals and events.

Do you downplay the importance of mealtimes and special events in the lives of your residents? Your residents likely enjoy holiday traditions as much as you do. Most of us spent the holiday seasons of our youth building traditions and memories that will be special to us for a lifetime. It is a wonderful time of year and all of those warm holiday thoughts, feelings and events should continue into old age.

In our day-to-day rush we barely give passing thought to the importance of foods and traditions in our own lives, much less those of our residents. When the holiday time nears, thoughts turn to decorating, shopping, cooking and baking. Many of our residents still think in those terms as well.

Many female residents will reminisce about all of the holiday dinners and baking, while many male residents will recollect their attempts to find the perfect Christmas tree. Allowing them to share those stories and assist in planning holiday events at the facility is one way to bring the twinkle back into their eyes and lives.

More and more facilities are seeing the benefits of the hard work that goes into planning these special events. The nutritional benefits are clear: appetites increase, weight gains occur in residents whose weight has declined throughout the year, and nutritional parameters improve. But, more importantly, the change in meals--along with the decorations, extra visitors and the joy of the season--help them relive past roles and rejuvenate identities that may have been forgotten.

"Holiday traditions are a huge quality of life issue. Cultural foods and a family atmosphere really enhance the holiday spirit," said Rhone M. Levin, clinical dietitian of oncology services at the York Cancer Center in York, Pa. Quality of life is of utmost importance to residents and their families.

Holiday meals and events don't have to be costly. Involve the residents in the menu planning process. Decades before now the residents made rather extravagant meals on a shoe-string budget and can offer practical meal suggestions. It is important to involve all other staff as well, from housekeeping to recreational therapy. Care should be taken to convey the ambiance of the season.

The holiday preparations were in full swing at the Mountain View Care Center in Scranton, Pa., according to Paulette Mordente, director of clinical services. The facility highlights the importance of involving the residents from the beginning stages as much as possible to rekindle past roles in their own holiday traditions, she said. "Each holiday is celebrated in a traditional manner," Mordente said. "We usually have the residents decide what type of celebration they want, and they do most of the planning."

For example, "On Christmas Eve the residents will gather around the fireplace to listen to the 'Night Before Christmas' and then share their own Christmas stories among the group, while sipping hot chocolate and snacking on Christmas cookies," as they have in the past.

Bringing holiday meals, entertainment and decorations together takes an interdisciplinary effort. Take advantage of the holiday season goodwill that people possess and enlist their efforts to make the holiday season a memorable one for your residents. Nancy Brooks, director of dietary service for Cortland Care Center, Cortland, N.Y., said, "It takes everyone--it's not just the food."

The role of culture and ethnicity is of growing attention and importance in nursing homes. While most facilities pay closer attention to these precious details during peak religious and holiday seasons, some facilities are making strides to attend to them all year long.

Kevin Kavanaugh, a spokesman for the Illinois Council on Long Term Care noted that many facilities in the Chicago area have begun to cater to certain nationalities and religions. Chicago has the third largest number of foreign born residents in the Unites States, and the specialization that the facilities are employing has become more common and formalized.

For example, Mid America Convalescent Center has assembled residents by ethnicity. Asians live on one floor, Hispanics on another. Each cultural unit has its own traditional food, staff that speaks the language, and holidays that are celebrated in the traditional style. Other facilities are doing similar things for their Polish, German, Russian, Korean and Italian populations.

Rhone said, "In Central-PA there is a very strong German culture. Families remain in the area forever, and newer families, like mine, assimilate into that regional culture." As a result of that strong cultural tie, traditional foods are being assimilated into hospital and nursing home menus--many of which are "comfort foods" for the patients and residents.

We all need foods that we can identify with, and many of those foods have cultural origins. It likely won't be long before other states catch on to this concept as a way of bringing cultural change into facilities and improving the quality of life for the residents of particular ethnicities.

Consider this the next time your food committee meeting turns into a complaint session: Put yourself in your residents' shoes. While it is more work for all to bring the special events such as theme meal days and holiday celebrations to life, to residents it could be the most precious gift of the season.

Christina Hasemann, Ph.D., R.D., L/C.D.N, a registered dietitian, is the President/CEO of NY-Penn Nutrition Services, Inc. a healthcare consulting firm In Binghamton, N. Y., and an adjunct instructor at Broome Community College and Morrisville State College (Norwich Campus). She can be reached at [e-mail].