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Abstract: The opinions of both national aging and health experts and practicing registered dietitians (RDs) were surveyed on which key quality indicators from the Food And Nutrition Care Indicators checklist should be regulated in assisted-living facilities (ALFs) for older adults. The extent to which the practices on which the indicators were based should be regulated, and which were in fact included in the current regulations of the 50 states was also studied. One hundred fifty-three national aging and health experts were surveyed in 2005 and 882 practicing RDs who were members of two American Dietetic Association dietetic practice groups employed in ALFs were surveyed in 2006. Both the experts and the RDs believed that the need for regulations in ALF food and nutrition services was vital for about a third of the indicators, (eg, 18 items on the 57 item checklist), particularly those involving facilities and staffing. For seven out of the 18 indicators, there was substantial consensus between experts and RDs. Only three of the seven indicators were addressed by regulations in more than half of the states. Consensus exists among experts and RDs that a small but significant number of food and nutrition service indicators need to be regulated. [Copyright &y& Elsevier]

Abstract: Objectives: There has been no consensus on best practices in food and nutrition services in assisted living facilities for older adults. We documented experts'' views on optimal food and nutrition services emphases in assisted living facilities, and factors affecting their views. Methods: One hundred thirty-five national experts specializing in health, aging, nutrition and assisted living facilities completed a survey consisting four scenarios (ie, home-style, restaurant/hotel, and health/medical, and a combination of these three) in six food and nutrition services areas: dining room environment, meal services, meal quality, nutrition services, employees'' qualifications, and therapeutic nutrition services. Results: Sixty-three percent of experts favored the combination scenario. Dietetics education and experts'' beliefs that assisted living facilities should be health promotion and maintenance facilities were significant predictors of emphases, including wellness considerations. Experts'' personal views exerted a powerful influence. Conclusions: Experts chose food and nutrition service quality indicators that emphasized a focus on both wellness and amenities as their ideal scenarios for optimal food and nutrition services in assisted living facilities. [Copyright &y& Elsevier]

This study assessed the utility of the 57-indicator Food and Nutrition Care Indicators Checklist for assessing food and nutrition services in assisted-living facilities for older adults among registered dietitians (RDs). They were members of two American Dietetic Association practice groups focusing on aging and long-term care and were also employed in assisted-living facilities. The 1,281 respondents rated the importance of each checklist item and provided their views on the role of assisted-living facilities and their level of agreement with statements regarding the importance of residents' autonomy for making food choices and their ability to make wise dietary choices. Registered dietitians practicing in assisted-living facilities considered all of the domains on food and nutrition quality indicators on the Food and Nutrition Care Indicators Checklist to be highly important (92% of dining room environment items, 83% of foodservice operations, 92% of general nutrition, and 89% of therapeutic nutrition items). They preferred a service style that included both health and amenities, as did national health and aging experts. Registered dietitians should work with other professionals to further validate the checklist, promote its use, and establish optimal service models for food and nutrition services in assisted-living facilities for older adults. [ABSTRACT FROM AUTHOR]

Abstract: This study assessed the views of 153 national experts in nutrition, health, and aging services in assisted-living facilities; including gerontological nutrition (39%), foodservice (14%), aging and disability (22%), geriatric medicine (9%), and assisted living (16%); on the practices that serve as indicators of the quality of food and nutrition services provided in assisted-living facilities and ascertained the most favored style of service delivery: health, amenities, or both. An 88-item Food and Nutrition Care Indicators survey was developed from assisted-living facility regulations in 50 states and other quality indicators of nutrition services. Respondents rated each item on a scale from 1 (not important) to 5 (extremely important). Results show that at least 80% of experts rated the majority of indicators in each domain as highly important (57% of dining room, 67% of foodservice indicators, 65% of general nutrition, and 70% of therapeutic nutrition indicators). Most experts (89%) rated a combination of indicators that included both health (general and therapeutic) and amenities service styles as being highly important. The 57 items rated most important were consolidated into a checklist. A service model that incorporates all of these elements appears to be most appropriate. [Copyright &y& Elsevier]