Before we talk about what is tough to swallow (hint: 21 day standardized menu for seniors in LTC facilities) let me tell you about mustard bean pickle.
My friend Kirsten unleashed an animated facebook exchange when she said she’d spent the weekend making mustard bean pickle. Some of us said mustard bean what?? Others demanded the recipe ASAP!!! We were all fully engaged in the quest for mustard bean pickle.
Mustard bean pickle is a condiment created under extremely trying circumstances—anyone who’s canned anything knows that it’s a hot sticky procedure performed on an unseasonably hot, usually muggy,afternoon. (Apparently there’s no point in canning if you don’t run the risk of succumbing to heat exhaustion.)
Not only does mustard bean pickle taste like nothing you’ve ever tasted before, fresh and sharp on the tongue, but it comes loaded with memories…like Uncle Frank’s root cellar.
My Uncle Frank was a Hungarian immigrant who’d come to Canada before WW2. He owned a produce farm in Saskatchewan. The root cellar was buried in a hillside; a semi-spooky place accessible through a tiny Hobbit* door. It was pitch black inside, cool and earthy. Uncle Frank fiddled with the kerosene lamp while my little sister and I waited in hushed silence for that gauze sock thingy to ignite and flood the space with light, revealing bushels of potatoes, carrots and turnips waiting to be carted back to the house and turned into delicious food. What an adventure!
Mustard bean pickle is much more than food. But then again, for most of us, food is more than fuel to be ingested for the sole purpose of recharging the body for one more day. Food is an excuse to congregate with the family, to catch up with friends or to simply break up the tedium of the day (Starbucks anybody?). Which brings me to the Alberta Health Services 21 day standardized menu.
In 2009, AHS implemented the 21 day standardized menu in 78 hospitals and nursing homes across Alberta. Goodbye fresh food, locally grown and prepared on site. Hello “food” purchased in bulk, pre-cooked, prepackaged and shipped to Alberta from other provinces and the US. That potato nestled in its cubby on the plastic “plate” started life in Idaho, detoured to El Paso for processing and bumped along in the back of a truck for days before it hit the steam tray and found its way to the seniors’ lunch room.
How bad is it? Check out the video Tough to Swallow created by the Alberta Union of Public Employees. The AUPE sent food critic John Gilchrist on a covert mission (complete with hidden camera) to the Stettler Hospital and Care Centre to check out the menu. Mr Gilchrist does not mince words. He described the “food” as appalling, nasty, gluey and, in the case of the lowly potato, obscene.
Are there any redeeming features to the 21 day standardized menu? Apparently not. If the objective was to save money, the experiment is a miserable failure. Food costs rose 6 percent in the two years since the 21 day menu was implemented. And the so-called “ease of preparation” has damaged staff morale rather than improve it as caregivers fret over their inability to change an unpalatable situation.
For 3 years, seniors and their families pursued the government and AHS officials begging for the return of fresh local food. They’ve gotten absolutely nowhere.
The government/AHS say the food is satisfactory—after all that’s what their consultants tell them. We can speculate on whether seniors confined to a long term care facility have the wherewithal or the courage to voice their complaints to a government consultant; but one thing is certain, seniors no longer line up in eager anticipation outside the lunch room and their general health is suffering—AUPE staff have observed an increase in infections and slower healing since the implementation of the standardized menu.
And the government continues on its merry way, ignoring complaints and mouthing platitudes like the recent statement by Doug Horner, President of Treasury & Finance Minister who said (in connection with the 2011-12 budget) “Albertans have been very clear on their priorities—health, education and supporting the vulnerable. We’ve worked hard to meet expectations and we’ll stay focused on providing the programs, services and infrastructure to support them…**
Alberta’s seniors have resigned themselves to the fact that every day represents more and more subtracted from less and less.***Is it too much to ask this government to help Alberta’s seniors enjoy what little time they have left in the company of their friends and families over a delicious home-cooked meal? And please let it include Kirsten’s mustard bean pickle!
*nod to Kirsten for this great description
**NationTalk Online June 28, 2012
***Hitch 22, by Christopher Hitchens, p 4
Susan on the Soapbox 
We appear to have a similar problem in the school systems lunch programs here in BC. It appears that both governments have figured out that seniors and students can’t complain so cutting costs on lunch programs, in these areas, is a good bet because the ability to fight back is minimal.
I can not figure out how a potato that has traveled the world can be cheaper than one out of a BC or Alberta farmer’s field.
Good comparison Rose. I think both governments also know that the seniors and the students are such a marginalized sector of the voting population (this includes their families as well) that even if they DO complain, nothing will come of it. All you have to do is look at who has the government’s ear. Here in Alberta it’s the resource industry first and everybody else second. So notwithstanding Doug Horner’s statement that Albertans’ priority is health, education and the vulnerable (seniors get 2 out of 3 there), it’s business and the economy that has the government’s full attention.
PS. that must be a very special potato!
Thanks, Susan, for this article and the link to the video.
If people are not getting proper nutrition, their overall health will decline. This will lead to higher health care costs. Good nutrition is a cost-effective kind of preventive medicine.
There are three factual questions I would like to know (this is not to put you on the spot, Mrs. Soapbox, I’m just throwing these out):
1. Does anyone have credible data on the nutritional value of the food from before and after the 21-day menu, and if so, is there a significant difference?
2. The same question, does anyone have credible data, this time on the palatability of the food. If people won’t eat it, it doesn’t matter how good the nutritional content may be. I don’t think seniors are asking for cordon bleu cookery, but like anyone else, they probably want something that isn’t off-putting to eat.
3. Does anyone have credible data on the health status of the people eating the 21-day menu, and the related health care costs from before and after the menu was introduced? Can the reported increase in urinary tract infections, slow healing, and so on, be proven, and can it be attributed to diet?
Only a cold-hearted person would say it is OK to let a person get sick more often if it reduces the cost of feeding them. However, if that is one of the unintended consequences of this 21-day diet, it should be taken seriously. First on compassionate, humane grounds, and second on economic grounds. It costs more to treat an infection than to prevent it.
What is the government’s rationale for continuing with a food program that has met with such criticism? I would like to know their side of the story. If they say they are saving taxpayers’ dollars, let’s see the specifics, including any associated increases (or decreases) in wellness and treatment costs at the institutions with the 21-day menu and the hospitals that receive and treat ill patients from those institutions. .
The answer to your last question is the answer to them all. You asked: what is the government’s rationale for continuing with the 21 day menu program? The response of AHS is: the seniors are “generally satisfied”. Nine months after the implementation of the program and periodically since then (as part of a broader satisfaction survey) the residents are asked to fill out a multiple choice survey. The residents pick the “generally satisfied” box for food. End of story. Family and staff don’t place much value in these surveys and continue to complain on behalf of the seniors, but their complaints are brushed aside.
AHS could put this matter to bed once and for all by simply providing the data you’ve requested and proving that the food is just as nutritious and the residents are just as healthy as they were before the implementation of the 21 day menu plan. If this data doesn’t exist (something I’d find shocking), then AHS can ask the Health Quality Council to look into it. But AHS hasn’t done so and I don’t think they ever will. Meanwhile the residents continue to be fed food that John Gilchrist rates as less that 0 out of 10.
Morale of the story, don’t join the ranks of “the vulnerable” in Alberta unless you’ve got enough money to live comfortably outside the government funded “safety net”.
Thanks for your comments Jill. Good discussion.
Great column! While I have always been a champion for keeping as much as possible ‘local’ in such services as laundry,housekeeping, plant maintenance and food services …. I wonder if the loss of market when airlines stopped providing meals prompted the introduction of airline cuisine into public sector health facilities. Sort of like the closing of local incinerators and subsequent trucking of hospital waste from all over the province to Swan Hills … helping the viability of that plant and giving trucking business to a prominent supporter of the government.
Back to the issue of hospital and nursing home meals, nutrition and taste are two of a vast number of sad ‘losses’ experienced with this change. It’s nothing to be proud of, for sure!
Jane, good point. You always have to wonder about the rationale for a decision which is so unpopular with the people at the receiving end (ie. the seniors and their families), especially when costs go up, not down.
I too was thinking about this from the “local movement” perspective. There are so many ways in which going “local” could be of benefit: it would support local food growers, support the local economy in general, provide real food services training for new young cooks, support the sustainability equation by reducing emissions from trucking semi-cooked food all across the countryside thereby reducing the externalities that should be factored into the cost of this program but are not.
The most important element is the one you highlighted at the end–the loss of nutrition and the sheer enjoyment of sitting down to a nice meal. Many seniors need to a reason to leave their rooms, presenting them with a plate of mystery meat and an “obscene” potato, isn’t going to cut it.
I do not believe there is even a question of what is richer, a potato from Alberta or a potato that comes from wherever and flies half the planet to be feeding our seniors. This is another case of our sick new perceptions of what makes sense. A friend of mine that works in the food industry told me that we export tomatoes to the US and they export tomatoes to us! Interestingly enough neither gets the best quality tomatoes because they are picked too early to be able to make it through the time they are in transition. No wonder the trade numbers are so high. It is just ridiculous and the amount of gas and pollution to just do this useless trade everyday. I am personally making sure I buy locally as much as I can. Hopefully soon we will be able to stop this crazyness.
We now live our lives based on trade numbers and short term gain without any concern for anything else. Gosh do we have work to do.
What is more interesting is that it has been known for decades that in most of the Asian countries there are serious diseases due to the use of Human excreta as manure. This is well documented and has been for a long time. Now suddenly, because food is cheaper, no one seems to be concerned anymore. We now import food from China despite the fact this is not a secret at all. Just try the net and search for China and human excreta and you will have enough to make you sick in a second.
Canadian tomatoes exported to the US while US tomatoes are imported into Canada…Carlos that was a perfect example of the lengths to which our countries will go in order to ensure that the wheels of commerce and free trade keep on turning. As you correctly point out, there is a hidden cost to this trade balance equation which is driven by unaccounted-for “externalities”. While I’m not fully conversant with the externalities argument I am aware that today’s trade practices fail to account for the impact of pollution in the exporting country, the waste of fossil fuels in unnecessary transportation and the social and economic impacts on the underpaid local labour pool.
The local food movement is slowly gaining traction, however it would get a big boost if the government were to set an example by eliminating the 21 day menu and bringing the local produce growers back into the picture.
PS I googled the use of human excreta and found out way more than I ever hoped to learn about this practice. Suffice it to say that one needs to prepare all one’s food with great care being mindful of good hygienic practices, because as our mothers used to say “You don’t know where that [whatever it is] has been or who touched it!”
Thanks Carlos!
Yes the ‘externalities’. I missed that great word. The fact of the matter is that these ‘externalities’ are what is killing us. If we were to know the extent of these we would all be horrified. Many years ago, I was way more into knowing about them and it changed my life in many ways forever. It just so happened that I had heard about our meat industry and we were doing to animals in order to have more and more cheap meat. What I saw was appaling and shocking. Not only the treatment of most of the animals we use for food but the concentration of urine and feces that are dumped into the environment without any concerns. The concentration of thousands of animals is so great that one has to use masks to be able to breath. In the slaughter houses the picture is as sick. I became a vegetarian as I could not live with the guilt of what I saw. Yes there are many animals that are not treated that way but in general it is quite sad that we can no longer see any value in decent treatment of these beings that feed us. All in the name of more and more, cheaper and cjheaper.
You are absolutely right about the local food movement and of course it does make sense for the government to bring the local producers back into the picture. The issue is that what matters is not the quality of food, the seniors or the local producers. What matters is how much it costs and if someone, somewhere in the world living like rats and making 20 cents a day can provide us with whatever looks like food we are in line to buy it. Whether these people producing the food are chained to the ground, have no place to live, belong to a country that does not respect human rights…..etc, that is all just details that do not matter really. The answer is always who cares? Well it may be that one day we will be the ones providing them whatever they want in the same conditions. One never knows.
As much as I everyday try to understand what is it that is happening to us, I cannot for the life of me reach any sense in our present decisons and choices. I am even thinking that maybe we have some global disease that is affecting us all the same way. We just do not know how to appreciate life anymore. The consequences that are slowly evolving could overwhelm us just like other civilizations have been before us.
Time for the Externalities Party.
Jill, if the Externalities Party were able to convey the message as clearly as The Story of Stuff video, I’d vote for them!
Carlos, a good friend of mine pointed me in the direction of a great little video which has been circulating for quite some time called The Story of Stuff. I’ve attached the link (hopefully it comes through). It provides a simple (but in my view helpful) way of looking at processes of extraction, production, distribution, consumption and disposal and their impacts on the environment and on humankind. It also provides an answer to the intriguing comment you made at the very end of your post: “We just do not know how to appreciate life anymore”. I hope you like it. http://www.storyofstuff.org/movies-all/story-of-stuff/
I’m glad you have taken up this issue, Susan. I just saw this on CBC, and there’s even a recipe! Though, not for the Mustard Bean Pickle. Some of the first “comments” following the article reveal the common sense that has been missing from health authorities’ (apparently out-dated and misguided) decisions to “farm out” food preparation for the people in hospitals and nursing homes. With costs escalating, it is evident that someone is benefiting from the contracting out of food services even if clearly, the sick and elderly are not. http://www.cbc.ca/news/canada/ottawa/story/2012/07/03/f-hospital-food.html
Elaine, thanks for the link to the CBC story. The Guelph St Joseph’s hospital was a great case study demonstrating how switching from a pre-made outsourced food plan to a locally grown, locally made food plan makes good sense. It resulted in healthier food, increased morale, reduced waste, contributed to the local economy and was more cost efficient. St Joseph’s made the switch in 2005. I was sitting here wondering why AHS got into the 21 day menu in 2009, a good 4 years after St Joseph’s and other hospitals abandoned this ineffective and downright damaging food plan, then I re-read your last sentence. You’re right –someone is indeed benefiting from the contracting out of food services. I think it’s time for another FOIP request. I’ll fire one out this weekend and let you know how it goes. (Likely as well as my last 2 FOIP requests…which unfortunately got nowhere, but hey, I might get lucky!).
Great video Susan. Thank you for letting me know. I had not heard of it. I truly believe that there is a lot of stuff going on like the video suggests and I want to believe that we will turn this insanity around, but I am not sure that is possible. The damage we have caused to this gorgeous planet is quite large. It is not hard to notice that I am not as positive as you are about the future but one thing I know for sure and that is that we can do it if we manage to stop this insane version of reality we have created. The most important step on this process is to get our governments back to where they should be instead of being lackeys of corporations.
Carlos
Talking about mustard, has anyone seen the government? Do we actually have one? All I have seen so far is these beautiful messages to make us all feel so cozy. Just like those affirmations one uses in front of the mirror and repeat 50 times. 🙂
Here is an example
___________________________________________________________________________
Premier sets priorities for government
Premier Redford has outlined her expectations for government including ensuring we work together as a team to provide the best services for Albertans.
___________________________________________________________________________
I for one would like to know what are we doing to resolve the Hospital Emergency problems. The last time I was there, despite the fact that there were myself and someone else, it still took 2 hours to talk to someone, never mind seeing the doctor.
Carlos, a friend and I were asking ourselves the very same question…just where exactly is our government these days. The results of the public inquiry into queue jumping will be delayed until 2013, contract negotiations between Health Minister Horne and the Alberta Medical Association broke down completely leaving the doctors without a contract since Mar 2011, the provincial auditor says that no one has adequately tracked the success (or lack thereof) of Primary Care Networks but we’re launching 140 family care clinics without any evaluation whatsoever. I’d say the health portfolio is a bit of a mess. But news releases like the one you mentioned are issued daily to bolster our spirits…Ms Redford attended the Bilderberg conference and met with business and government leaders in China. I’m afraid it will take more than that for the PCs to provide decent social services to Albertans.
Susan I am not one to be making quick judgements as I have worked for many years and I fully understand the difficulties of real life problems, but there comes a time when something needs to be done, people have to be competent enough to make changes and try new ways of resolving old problems. All I see is people flying all over the world spending millions of dollars to avoid the real issues at home. I have seen enough of all the Chinese officials and I almost know them by their first names. I wish the best to China but honestly I am way more concerned with decisions that have to be made here in Alberta where I live. I want to know what kind of royalties my government is going to set , how they think health care can be better managed, the cost of University education……etc.
Unfortunately the concerns I had about the PCs before the election are coming to fruition. Once again they won and are going to sit back and gather years for their gold plated pensions. They have a majority and they do not have to worry about it for another 4 years. They do not even have to bother with the Legislature because as far as they are concerned it is useless. Klein started this atittude and it is now endemic. Just go there and you get sick with the arrogance some of these people display every time they have an opportunity.
Yes Susan I am sure the Bilderber conference was the highlight of Alison Redford next 4 years. She has already been where the world economic decisions are made so what else is more exciting!!!
Well maybe an Alberta Spring is also necessary to resolve this moron atittude from our politicians. It is not that hard really.