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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #231076

Title: The Food and Nutrition Care Indicators (FANCI): Experts’ views on quality indicators for food and nutrition services in assisted living facilities for elders

Author
item Chao, Shirley
item Houser, Robert
item Tennstedt, Sharon
item Jacques, Paul
item Dwyer, Johanna

Submitted to: Journal Of The American Dietetic Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/8/2007
Publication Date: 9/1/2007
Citation: Chao, S.Y., Houser, R.F., Tennstedt, S., Jacques, P., Dwyer, J.T. 2007. The Food and Nutrition Care Indicators (FANCI): Experts’ views on quality indicators for food and nutrition services in assisted living facilities for elders. Journal Of The American Dietetic Association. 107(9)1590-1598.

Interpretive Summary: Assisted living facilities (ALFs) are residential settings that provide or coordinate personal care services and a higher level of assistance than is usual at home, with 24-hour supervision, scheduled or unscheduled assistance, social activities, and some health–related services. The service priorities of ALFs vary. Some stress their role as housing alternatives. Others focus on either a hotel-like atmosphere with many amenities, or offer many medical and health related assistive and supportive services. Still others emphasize a combination of these. The type and quality of food and nutrition services currently provided to elders residing in ALFs are largely unknown. In most states, only the most basic aspects of food safety, such as the prevention of food-borne illness, are regulated and inspected on a regular basis. The broader aspects of food and nutrition services relating to residents’ health status (general and therapeutic nutrition) and quality of life have rarely been included in regulations. The goal of this study was to identify the best practices that might serve as key food and nutrition care indicators in ALFs. We obtained the views of 153 national experts on nutrition, health and aging services on the food and nutrition services in ALFs that they deemed most important. We also probed the style of delivery (e.g. emphasis on health issues, amenities or both styles) for food and nutrition services that they favored the most. An 88-item Food and Nutrition Care Indicators (FANCI) survey was developed from ALF 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). The results show that at least 80% of experts rated the majority of the indicators in each domain as highly important (57% of dining room, 67% of food services 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.

Technical Abstract: This study assessed the views of 153 national experts in nutrition, health and aging services in ALFs, including gerontological nutrition (39%), food services (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 (ALFs) and ascertained the most favored style of service delivery: health, amenities, or both. An 88-item Food and Nutrition Care Indicators (FANCI) survey was developed from ALF 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). The results show that at least 80% of experts rated the majority of the indicators in each domain as highly important (57% of dining room, 67% of food services 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.