Institutional Dining: Memory-Care Facilities
Executive chef Kai Phanthavong shows off two of his creations for Smith & Porter Restaurant + Bar at Abitan Mill City.
In the 2014 documentary, "I’ll Be Me," starring country music superstar Glen Campbell, the musician appears unable to recognize his son or the mother of his children in a family video as he and his fourth wife Kimberly Woolen watch from the sofa.
“Who’s that?” He squints. “And who’s that?”
Campbell (known as the “Rhinestone Cowboy” for his hit record by the same name) was diagnosed with Alzheimer’s in 2011, and passed away of the disease in 2017. But in the intermittent years, in spite of having difficulty with everyday interactions, Campbell was able to go on a farewell tour after his diagnosis, playing beautifully to enormous crowds.
The portrayal of that tour offers a glimpse into new ways that memory care is being perceived and treated in the U.S. and beyond. Minnesota-based Ecumen is one of the United States’ largest and oldest nonprofit senior housing and services companies. The company’s “Awakenings” initiative aims to reduce the use of antipsychotic drugs for memory-care patients, by redirecting care towards holistic touchstones such as increased human contact, walks, games, exercising, pets, music, and reminiscence therapy.
Unsurprisingly, food is also a central focus.
“Food surrounds every good and bad part of your life,” says John Gleason, food and beverage director of Abitan Mill City, a cutting-edge downtown Minneapolis Ecumen facility.
Clearly, in conjunction with reminiscences like music and play, food plays a fundamental role in everyone’s existence, and memory-care patients are no different.
Smith & Porter Restaurant + Bar at Abitan Mill City
Wander into the restaurant at the ground level off the handsome condo building on handsome South 2nd Street in the heart of downtown Minneapolis’ Mill City, and aside from the concierge desk in the lobby there’s little to indicate you’ve arrived anywhere but a chic urban bar and restaurant.
Inside, a gas fireplace crackles along with flickering table candles. A lone gentleman sips bourbon at the bar and chats with the bartender who is vigorously shaking a cocktail. The menu is New American with a few global touches like salmon tataki and Moroccan chicken curry. Serving happy hour, dinner and brunch on weekends, the space feels like a peaceful oasis from the sometimes overwrought surrounding downtown eateries. In the adjacent space, Porter Cafe serves Izzy’s ice cream by the scoop, espresso, soups, sandwiches and typical grab-and-go fare.
Menu selections from either restaurant are available in the assisted living units room-service style any time a resident calls for them, and the proximity of both establishments to living quarters are an obvious boon to both the resident and the family. And, having them open to the general public incorporates an important energy and community synergy to the experience of dining out.
Chances are you wouldn’t realize that a few floors up, a group of memory-care residents are dining around a common table of baked chicken thighs, house-made creamed corn, dinner rolls and a cinnamon cake for dessert that only one resident complains to me is “very heavy.”
While the latter may or may not be true, thousand-layer French croissants crowd in a basket on a modern center island in the “Play Kitchen.” Residents and staff alike crow that they’re the best croissants in the city.
The Play Kitchen is an important element of the space, allowing residents access to sinks, stoves, ovens and other appliances (all retrofitted for safety) for cooking classes, easy access to snacks and beverages, or for family members to come in and prepare food of their own choosing. All obvious holistic touchstones extending into the thrice-daily need for nourishment.
Tonight’s chicken dinner came out of the very same kitchen as the one putting out poutine and house-made crab ravioli for paying customers on the ground floor at Smith & Porter. While many of the daytime meals are prepared by a dedicated chef, the restaurant staff is also cross-trained on meal preparation for the assisted-living and memory-care residents occupying the projected 92 residents upstairs (Abitan is still in the course of filling its available units).
This cross-training goes beyond baked chicken thighs and cakes, to specialized preparations such as dysphagia diets (pureed for those who have difficulty swallowing). In many facilities, it’s a perfectly acceptable industry protocol to blend every element of a meal into one shake for patients to consume, with the emphasis being on nutrition, rather than flavor. (So think burger, potato, and vegetable all mixed into one.) But at Ecumen, the emphasis is on both. Gleason says that the kitchen team will conduct experiments on each element of the meal, creating “mini-shakes” so that, for instance, that baked chicken tastes as much like a baked chicken should taste as possible, as well as the dinner roll and the cake. Instead of using water to thin out a food, what about using chicken stock or milk? Ecumen takes the time for the discovery, so “everything tastes as it should taste.”
The team also empowers patients to feed themselves if they so choose, “and if they end up dirty, they end up dirty.” Retrofitted utensils are available for patients with motor difficulties.
Real chefs, real food, real people
At The Moments facility in Lakeville, chef Michelle Jensen has recently on-boarded as a chef, after many years spent in the traditional restaurant world. In the most forward-thinking facilities, it’s not unusual to find staff with impressive culinary resumes, as these companies are seeking to employ the best of the industry. Jensen says she’s been floored at the attention to detail at The Moments, from lighting, to considerations about the size and color of flatware and the food itself.
Since dementia patients are easily overwhelmed, Jensen serves her meals in courses, just as she would in a high-end restaurant, even if it’s just a couple of carrots on a plate or some steamed zucchini strips. So, for instance, a vegetable course comes first, a fancy charcuterie and fruit plate second, a main course third, and so on.
“It couldn’t be scoopers and steam tables ... Instead, this is a totally different vision—culinary and chef-driven,” she says. Her kitchen also takes special pains to accommodate individual residents. One of Jensen’s diners has lost her sense of smell, so the chef takes care to serve her foods that are higher in salt like summer sausage, pretzels and popcorn that compensate.
The Moments also serves meals family style, and places an emphasis on empowerment. She calls the food “bright, simple, and unique,” and is pleased to be able to forge relationships with individual patients, a paradigm that a restaurant chef rarely has the opportunity to realize. She dines together with residents—establishing these relationships is imperative, says Jensen, because in many cases, her diners are unable to directly tell her what they want or need. So, it’s up to her to make intimate, one-on-one connections to glean that information, by all the tools she has at her disposal.
These amenities come at a price. Abitan is among the higher-tier of cost for assisted living and memory care, and The Moments is “competitive” in the local market. But there is a potential boon for all facilities once a few begin best practices. They can become a model, and give the entire industry a benchmark to examine.