By Mary-Justine Lanyon

The staff and patients at Mountains Community Hospital and the residents of the Skilled Nursing Facility are now enjoying an expanded menu, thanks to Delacey Foster, the nutritional services manager who assumed that position in January.

Foster, who hails originally from Missouri, had found her way to California after meeting her husband, Antonio Ortega, who was working in Missouri but had grown up in and lived in Southern California.

Prior to coming to Lake Arrowhead, Foster had volunteered at San Antonio Regional Hospital in the nutrition department to see what goes on there. “I did menu selections with the patients,” she said.

What she discovered was that she really enjoyed working with older adults.

She also volunteered at Mt. San Antonio Gardens. “I fell in love with working with the nutrition of older adults,” Foster said.

She received her bachelor of science degree in nutrition and food sciences from Cal State San Bernardino. As part of her studies, she did a dietetic internship with Sodexo, a company that manages food services for hospitals, skilled nursing facilities and colleges. They sent her to sites they manage. She also did clinical rotations at Riverside Community Hospital and Mt. San Antonio Gardens, doing nutrition assessments of the patients and residents. Those assessments, she noted, were very complex.

“They determine how their nutritional needs are met,” Foster said.

During her volunteer work, Foster worked in the kitchen, helping prepare the meals. “That was invaluable experience,” she said. “I was doing exactly what our kitchen staff does. I can’t imagine managing the staff without have done their jobs already. I have heard of a lot of dietitians coming in without that experience. How can they be successful without having had boots on the ground.”

While doing her internships, Foster received her master’s degree in dietetics from the University of Rhode Island and then managed kitchens at two different continuing care retirement communities. While there, she did a lot of diabetes education, education on unintentional weight loss and consulted with memory care unit residents.

“I did presentations once a month which was super fun,” she said. Other topics she covered were nutrition for brain health and immune health – a big topic during the pandemic – getting adequate protein, healthy snacks and bone health.

Foster would like to start doing similar presentations here on the mountain, both for the residents and the community as a whole.

As for how she found her way to Mountains Community Hospital, Foster said a former boss of hers had worked with Cindy Beeman, the former dietitian at MCH, and knew she was retiring.

“She asked me if I’d be interested in a position in Lake Arrowhead. I had never been here so I looked into the area. It’s beautiful – I’m an outdoorsy person, love camping and mountain biking. I thought this might be the place for me.

“I immediately fell in love with it up here.”

Foster did have some concerns about taking over for Beeman, who had been at MCH for 37 years. “That was a clue it must be a great place to work,” she said.

“Change is hard for everyone,” she said. However, she noted, “everyone has been very receptive and willing to adapt to changes. They are excited for it. Not that anything was wrong – I just want to put my own touch on it.”

Foster added pork chops to the menu and they have been a big hit. “I went to the Skilled Nursing Facility today and they were talking about them,” she said, adding she visits with the residents every day to talk about menu items.

“I want it fluid – based on their feedback. Whatever they want, we can adapt to it.”

Foster is introducing themed meals for holidays and special events. She wants the cooks involved, giving them the opportunity to plan a dinner menu, be creative.

She agreed she could ask the residents for some of their favorite recipes and make that night that resident’s themed dinner.

All these ideas, Foster said, “keeps it fun for everyone.”

When a patient is admitted to the hospital, she meets with them to find out their dietary preferences. “I want to make sure we give them foods they’re going to eat – things they like, things they can handle.”

Foster is part of the team that meets with the SNF residents and their families quarterly. She does new assessments as part of those meetings to make sure the menus are meeting their nutritional needs.

The menus include a strict amount of protein and a certain amount of grains. “Every micronutrient is accounted for,” Foster said.

Her role is to provide education to the residents on their nutrition needs and meet those needs. But, she noted, “in long-term care it’s their choice, their right. We have to honor their requests.

“That’s one of my favorite parts. It’s resident-centered care, not us telling them what they have to have. This is their home.”

Foster will visit the residents during mealtime to see what they like, what they’re eating and what they’re not.

“This is the best environment to work in as a dietitian,” she said. “You can see your nutritional interventions work out. I want to help the SNF residents live their highest quality life.”

She is not alone in that desire. Foster points to Karen Dobson, the weekend cook at MCH, who talks with the residents about their menu selections and knows their preferences, like just how one resident likes her broccoli cooked.

“This is one of the most amazing things I’ve seen in long-term care,” Foster said. At other long-term care facilities, the cook has no connection with the residents. “The residents here love Karen. They know all about her kids and grandkids.

“It’s a special place here.”