So long, sunny side up: preventing food-borne illness in nursing homes - includes related articles

FDA Consumer, Dec, 1991 by Rebecca D. Williams

According to the October JAMA study, as of March 1989, 40 states had no institutional food service inspectors trained in FDA food and hygiene standards, while only three states lacked FDA-trained officials to inspect commercial food services.

And in 34 states, there were no state-level standardized training courses for nursing home food inspectors to follow, leaving the responsibility to local jurisdictions, according to the study.

No matter what training workers receive, or how often nursing homes are inspected, the ultimate responsibility for food safety in nursing homes depends on the kitchen staff on a day-to-day basis, says Luten. Kitchen workers may pass inspection with flying colors one day, but if they undercook the hamburger the next day, residents may still get sick.

"Training does not always mean you're going to get what you pay for," says Luten. "You've got to have dedicated people who understand the importance of what they're doing and the importance of doing it right."

Steven James, an FDA official who teaches food safety to HCFA inspectors, agrees.

It's just like walking into a restaurant," he says. "How would you know it's safe? All we can do is try to reduce the odds of food-borne illness from happening. No program is a guarantee--there are no guarantees. But we can take some preventive steps."

And as the elderly population grows, those steps will become even more necessary. The U.S. Bureau of Census projects that by the year 2000, the nursing home population will increase by 40 percent to more than 2.2 million people.

Careful food handling will be especially important to the health of this population, even if that means nursing home residents forgo their favorite foods.

In Janet Tulloch's case, that means no fresh eggs for breakfast, at least while she is in the nursing home.

"I know the reasons," she says, "but I don't think most residents understand why we can't have fresh eggs. When I visit home," she adds, "I'm dying for them."

Rebecca D. Williams is a staff writer for FDA Consumer.

A Glance at Nursing Home Food Handling

* Between 1975 and 1987, nursing homes accounted for 2.4 percent of all food-borne illnesses, but nearly 20 percent of the deaths. The rate of deaths from food-borne illnesses is 10 times higher in a nursing home than in any other setting.

* People choosing a nursing home should try to examine the food service facilities for cleanliness and attention to food safety.

* FDA and the Health Care Financing Administration have developed two instructional videotapes on nursing home food safety techniques, one geared for medical directors and nursing home administrators, the other for food service workers. FDA plans to distribute the tapes in early 1992. For information on receiving them, contact FDA's Center for Food Safety and Applied Nutrition, HFF-11,200 C St., S.W., Washington, D.C. 20204; telephone (202) 485-0325.

Choosing a Food-Safe Facility

A conscientious nursing home kitchen staff offers the first line of defense against food-borne illnesses. When choosing a nursing home, the best way to check the kitchen is by visiting it and watching how the food handlers prepare meals.