Q: What is the best approach to take in regard to the gluten-free diet in considering a move to an assisted living facility? Many offer a meal plan and that can be a problem for a person with celiac disease. So many will respond "oh our chef is really great and he/she can handle this request.”
It can be very daunting moving to an assisted living facility and trusting someone else to provide you with gluten-free (GF) food. It is important that you find a place where they understand the complexity of the GF diet, as well as are willing to train their staff on the GF diet and appropriate preparation procedures.
If you have celiac disease and a meal plan or food is included in the price of the assisted living facility, then they are required to accommodate a GF diet per the Americans with Disabilities Act (ADA), which is a federal law. Although celiac disease is not directly stated, the ADA recognizes a disability when it affects a major life activity such as eating and digestion. This already has legal precedence in other cases such as the Lesley University and Rider University settlements.
I would recommend researching facilities carefully and extensively interview staff before deciding on a place. Ask friends and family for recommendations and also check reviews online.
Helpful tips when vetting facilities:
- Ask to meet with the foodservice director and the registered dietitian on staff to discuss meal accommodations. These staff members would have the most insight to how the kitchen and foodservice department work. Just speaking with a general director or other representative might not be as helpful because they often do not have adequate knowledge of what goes on in the kitchen.
- Questions to ask:
- Do they have experience with serving GF food?
- Do they have a separate GF menu and how many choices are on the menu each day?
- How do they vet ingredients for GF status? Label reading can be very complex, do they have training on what to look for on a label?
- Are GF foods prepared separately from other foods?
- Do they have dedicated equipment for GF meal preparation? (i.e. toaster needs to be completely dedicated)
- How are GF foods stored, prepared, held and served?
- Do they bake with regular flour in the kitchen? This is a high risk for cross-contact because flour gets everywhere including in the air.
- Are all staff members trained on preparing GF foods?
- How are foods vetted for GF status?
- Will you have to pre-order GF meals?
- It can also be helpful to visit the dining hall/kitchen to see how everything works. I would talk to the chef/kitchen manager directly as well.
- Also, if possible, ask to speak with someone who eats GF at the facility to hear directly from them how everything is working.
- Check if a kitchen/kitchenette is available in the room and what your options for cooking and storing your own food are.
Training for Foodservice:
We recently did a training for the National Resource Center on Nutrition & Aging on celiac disease and how to prepare gluten-free meals. The aim was to increase awareness and knowledge for foodservice staff serving seniors in various environments. This two part training webinar can be accessed for free at: https://nutritionandagingresourcehub.org/toolkit-preparing-gluten-free-senior-meals-parts-1-2/
There are also official training and certification options available through the Gluten-Free Food Program’s Hospitality Program: https://gf-finder.com/hospitality-program/
To read more about Americans with Disabilities Act: https://www.ada.gov/
Rider University Settlement: https://www.justice.gov/usao-nj/pr/us-attorney-s-office-reaches-agreement-rider-university-resolve-allegations-under
If you are having problems with an assisted living facility not providing GF foods even though you are paying for a meal plan and have tried to communicate this need to them, then you should contact your State Attorney General’s Office for legal advice: https://www.usa.gov/state-attorney-general
Note: This information is provided by NCA and Katarina Mollo MEd, RDN, LDN, NCA's Director of Education. This information is meant for educational purposes only and is not intended to substitute for personalized medical advice or replace any medical advice provided directly to you by your health care provider. No liability is assumed by the NCA or Katarina Mollo, MEd, RDN, LDN by providing this information.