Keeping green in their golden years: vegetarians don't have to give up their lifestyle when entering a nursing home - includes list of resources and a related article on Meals on Wheels

Vegetarian Times, April, 1995 by Billy Ray Boyd

FOR MOST of her 95 years, Valida Davila has been an activist and a vegetarian. She has campaigned for the rights of women, children and animals; she has fought for economic justice, sexual liberation and saving the environment. "She made her mark," says her son, Ralph, 51, who sells Vegetarian Times and other magazines at his news-stand in Los Angeles.

At age 90, Valida could no longer live on her own, and she spent the next three years at Sunset Hall, a non-profit retirement home in Los Angeles for elderly radicals and free thinkers. It was the perfect place for her. Residents share a camaraderie and intellectual stimulation not found in most retirement homes. They hold debates, practice T'ai Chi and organize demonstrations, like the one they coordinated a few years back when Sunset Hall's governing board tried to sell the home to a for-profit developer. Their national campaign saved their home. "It's a great place, and she loved it," says Ralph. His mother especially liked that the staff kept a stash of veggie burgers just for her.

Not all retirement and nursing homes are so supportive of their residents' passions or their diets. "I'm happy if even the non-vegetarians get their basic nutritional needs met," says Carmen Topete, an advocate for nursing home residents in Santa Cruz, Calif. Meals served at many nursing homes are heavy on fat, salt and canned produce, says Topete. "There aren't enough fresh fruits and vegetables," she says. The fact that this is true in Santa Cruz, where awareness and popularity of vegetarian and vegan diets is quite high, makes one imagine the situation in less vegetarian-friendly parts of the country.

Vegetarian-friendly homes for the elderly do exist, and federal law requires that all nursing homes provide for the special needs--including dietary preferences--of residents. Getting some homes to live up to the requirements of the law can be hard work, but not impossible. And as dietitians become more knowledgeable about the health benefits of vegetarian diets, and aging vegetarians create more demand for vegetarian food in nursing homes, requests for meatless meals increasingly should be met with more cooperation.

THE NURSING HOME Reform Law of 1987 requires that all nursing homes care for residents in a manner and environment that "will promote maintenance or enhancement of the quality of life of each resident." The law further mandates that each facility must "provide services and activities to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident in accordance with a written plan of care."

Within the parameters of the law, therefore, is the right to a vegetarian diet. "Particular emphasis is placed on self-determination, choice and dignity for each resident," says Lori Owen, policy specialist at the National Citizens' Coalition for Nursing Home Reform, an advocacy group based in Washington, D.C. "For those who choose not to eat the meal available at a particular time, whether because they dislike the food served or because they are vegetarian, an alternative, acceptable menu must be made available to them."

This law has prompted dramatic improvements in some nursing homes, while others drag their heels along the road to compliance. The same obstacles get in the way: the cost and hassle of making changes, particularly when the changes result in more work, and the lingering bias that a diet without meat is nutritionally deficient. And the law does not apply to retirement or rest homes, technically known as residential care facilities. These facilities, which provide meals, bedding and occasional medical care but not the intensive medical care provided by nursing homes (technically known as skilled nursing facilities), are primarily regulated by state laws, which vary widely in their requirements. "Retirement homes can hire anyone to fix the food," says Topete. "The result can be great home-cooked food, or a nightmare." Nursing homes, on the other hand, must by law hire a dietitian.

If a home fails to provide the meals a resident requests or in any other way violates a resident's rights, the local long-term care ombudsman may be able to help. By federal law, each state must have at least one ombudsman, whose duty is to defend the rights of nursing- and retirement home-residents and Meals-on-Wheels recipients. Most states have more than one ombudsman; California has 35 locations with at least one ombudsman, each assisted by trained volunteers who make unannounced visits to homes. (To locate your local ombudsman, contact the Long-Term Care Ombudsman Resource Center in Washington, D.C.; see "Resources," p. 86.)

The 1987 law and the oversight of ombudsmen seem to be having a positive effect. The American Health Care Association (AHCA), an umbrella group for the large, for-profit nursing home chains, says its members are knowledgeable about vegetarian diets and are able to accommodate residents. "Vegetarian diets don't pose any special challenge to our members," says AHCA spokesperson Dave Kylb. "Dietitians are trained to plan for people with a variety of dietary needs or wants based on personal preference, religion, etc."