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Cooking skills lead to lessons in and out of kitchen

Thursday, December 19, 2024

For many people, the kitchen is the center of the home and where lessons – cooking and otherwise are learned. It's the same in the Life Skills kitchens used by OSH occupational therapists and other clinicians who turn small group cooking classes into therapeutic opportunities to teach and reinforce skills patients need to be successful in and out of the kitchen.

“When patients return to the community, we ​want them to be able to take care of themselves. We want them to be able to make simple, cost-effective nutritious meals, and we have to prepare patients for that," said Norma Kelleher, an OSH occupational therapist who facilities one of the small group cooking classes. “The classes are also an engagement tool to promote safe behavior and how to get along with their peers and cooperate together."

Clinicians like occupational therapists, recreation therapists, dieticians and treatment services nurses all use the Life Skills kitchens to thoughtfully individualize cooking interventions to support each patient's unique strengths, skills and recovery goals, explained Jacqueline Fullerton, OSH Associate Director of Occupational and Physical Therapy.

“Cooking activities are used both as a means to promote engagement in skill-building therapeutic activities and as an end to promote increased independence in activities of daily living that will provide patients with the ability to take care of their physical health and wellbeing when they leave the hospital," Fullerton said.

The benefits extend to other areas of the patient's experience at OSH, too, she added.

“Many clients report an increased sense of worth or purpose in their lives by engaging in group treatment opportunities that foster both functional living skills as well as self-expression and creativity," Fullerton said.
While patients are learning about food safety and preparation and how to make affordable, nutritious meals, the clinical group leader is also assessing where a patient may need additional support or practice or even how a patient is responding to medications.

Beyond a recipe, the classes also teach a range of skills from planning and community navigation – how to find recipes, how to make a list, how to find the store – to budgeting and identifying ingredients, appliance and tool safety, and the safe handling and storage of food to stretch the budget and reduce waste, said Mia Boessen, an OSH occupational therapist who also teaches small group cooking classes.

“Being able to safely prepare healthy food is a pretty complex process – from planning what to make, recognizing and organizing the ingredients, using kitchen tools to prepare each ingredient together and then combining it all correctly – it's a lot to do!," Boessen said. “Many people don't realize how acclimated they get to having food provided for them (even if they complain about cafeteria food). It can be eye opening how much work it is to prepare food again."

Some classes like those taught by occupational therapists Susan Brandt and Boessen use herbs and vegetables planted and cared for by patients as part of garden therapy groups offered at OSH. The focus in Brandt's “Healthy Harvest" group is tailored for patients who were more recently admitted to the hospital. Brandt cuts or cooks ingredients ahead of time with patients helping to read and follow the recipe to assemble a meal or snack. The class provides a relaxing environment to acclimate to group settings in the hospital, and the opportunity to learn new skills and share interests in cooking and recipes. In the group the focus is on those social skills of building camaraderie and collaboration to help the newly admitted patients be successful as they progress through their programs at the hospital.  

“It helps with those other soft skills like frustration tolerance, patience and respect for each other. They're spending time together in a positive away and sharing their own skills and memories of gardening or cooking. It looks like we're putting together a meal, but those skills translate," Brandt said.

Boessen facilitates a garden therapy group on the Junction City campus, and centers cooking classes on the vegetables, fruits and herbs planted and cared for by patients. There's an added layer of accomplishment for the cooking class participants to witness the changes in the plants, harvesting them and savoring their taste, Boessen said.

“Making pesto is a really simple example that surprised me how much awe it inspired in a few clients. They couldn't believe that the shrubby basil bush could make something so delicious with so few ingredients," Boessen said. “There is a lot of research that shows that having an experience of awe or wonder has positive effects on our mental health, and being able to show that something so simple as pesto can create a positive experience is really special."

During one of Kelleher's more recent classes, patients worked together to cook a pumpkin curry served over rice.  

Kelleher opened the class with a line so familiar to them all that they completed her sentence.

“When you're preparing food for other people," she said, and the group joined her in unison, “you always wear gloves."

As the group washed, dried and then gloved up, Kelleher gave other safety reminders, including allergies, vegetarian preferences and knife safety before handing out the recipe. For safety reasons, the patients use adaptive plastic knives and utensils to prepare the meal. All items are checked out and back in by staff. Some items that aren't easily cut with adaptive knives are prepared by staff ahead of time. As the patients followed the pumpkin curry recipe with some tackling peeling and cutting potatoes, conversation flowed easily about what they'd like to cook next or how coming to the kitchen feels a bit like home.

When one patient said the dish needed more curry, Kelleher suggested, “Shall we ask the others?" The open question was a gentle reminder that the class is not only an effort of collaboration, but when it comes to seasoning, it's also one of compromise.

The group decided to follow the cook's intuition and added more curry and a touch more salt.

There's also a respect for one's dietary choices as the group periodically reminded each other about allergens, preferences for tofu and words of gratitude before a meal.

Kelleher polls the class routinely for feedback on future menus which are also developed with OSH dietician guidelines to ensure the recipes are nutritiously balanced. Curries have been a favorite lately, as well as Tex-Mex dishes.

“This is something they look forward to," Kelleher said after the class. “Being institutionalized is really hard. People are taken away from so much. They're taken away from family and they're also taken away from choice. The kitchen does a good job here, but sometimes people want to be able to make the food that they like. I think patients really appreciate the normalcy of being able to cut up food and put it into a pan and cook it. It's something they look forward to. For some patients, it's the only thing they'll participate in, so it helps to keep people motivated."

That motivation can help them take steps in other parts of their daily life at OSH, said Boessen.

“When a person is motivated by the outcome, I find people are more willing to push themselves to participate – whether their personal challenge is social engagement, initiating an activity, planning steps in a task or trying a new skill," she said. “Motivation is a huge part of what we utilize therapeutically in occupational therapy, and who isn't motivated by a favorite recipe or new eating experience?"