<<Disclaimer: Verify this information before applying it to your situation.>>

Replies on skilled nursing facilities:

>>Talk to the facility. Some of the better ones have ways you can check up, even online, to see what is going on. The communication is getting better and better, but at the least you can call the nurses daily.<<

>>One thing to be especially aware of is that many of the "nurses" of these places are those who have just earned their bare minimum degrees to work here.  They are young, and largely inexperienced.  They mean well, but often don't have the full training to really understand what these dietary restrictions mean.  The dietician on staff will, the head of the facility will, but the girls who will take food, change clothes, move people from room to room, they are the ones that your mother will see on a daily basis and they are the ones who don't always understand.  Educate them, and help them learn.  Feel free to speak up when you think something isn't going right.  
 
>>The only advice I have relates to overall patient care. Visit often and get to know the staff. My grandmother was in a premium facility for years. Because we (anywhere from immediate to extended family) were there often and regularly we were always checking on her care. There were mistakes but they were kept to a minimum. 

>>I suggest talking directly with the dietician or head of the dietary department. Ask them how they prepare the gluten free meals, what products they use and how they prevent cross contamination. Start with very generic open ended questions and then get more specific as you get ( or don't get) the information you need. Ask if they can give you a reference from someone they treated with Celiac disease. I doubt they'll give you any names due to privacy issues. Another approach is to ask them to give your contact information to the person or family of the person with Celiac disease and request they contact you. Ask to see the safety inspection reports. They are probably posted somewhere. You could also contact the county health department to see if they are aware of any issues. Talk with the nursing staff and if there is a physician associated with the facility, try talking with him/her. Don't forget to discuss it with your mother's primary care physician and ask for suggestions. 

>>I suggest you contact Ronnie Alicia RD [log in to unmask] <mailto:[log in to unmask]>. she has done work with skilled nursing homes and has good advice?
Also in most states there is an omsbudmen or an agency that oversees nursing homes.  That maybe a valuable resource.<<

>>And while the dietitian can make promises, she (he) likely won't be on site very often.  Kitchen managers and cooks are better allies since they know what's in the pantry and how it's prepared. Ask about staffing on weekends and holidays...

A non-celiac friend with T2 diabetes is in a facility that has an alternate staff on weekend. Nothing from food to healthcare seems to work as it should on those days...They follow the list that's left for them...If it's not specifically on the list, it's not their irresponsibility so she's out of luck--From getting a snack for low blood sugar at bedtime to getting her legs rewrapped.

Mom also need a serious note from doctor on importance of GF diet.  I'd also want  antibody levels tested before she enters facility and then followup in 3 months to make food is safe.   Testing again at regular intervals would be smart, and especially if there are major staff changes--supervisors, kitchen leaders.  Testing G.F. status is just as important as monitoring blood sugar in a diabetic patient!<<



*Please provide references to back up claims of a product being GF or not GF*
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