The purpose of this study was to develop a survey tool for assessing the satisfaction of elderly long-term care (LTC) residents with the meals and food services they receive, as well as to assess quality of life issues related to eating. Food service delivery should be provided in an environment that fosters autonomy, interpersonal relations, and security. The questionnaire was administered as face-to-face interviews with 205 residents (> or = 65 years of age) of 13 LTC facilities in Saskatoon, Saskatchewan, Canada (participation rate = 67%). Residents expressed some concern with food variety, quality, taste, and appearance, and with the posting of menus. Quality of life issues were mostly positive; however, residents were less satisfied with areas related to their autonomy such as food choice and snack availability.

The purpose of this study was to evaluate menus and food service practices provided to elderly in 18 long-term care (LTC) facilities in Saskatoon, Saskatchewan. The study methodology included nutrient analysis of menus and a survey examining food service practices. LTC facility menus did not meet the recommended levels (< 100% Recommended Dietary Allowance [RDA] or Adequate Intake [AI]) of vitamin E, vitamin C, niacin, vitamin B 6 , folate, magnesium, zinc, calcium, and vitamin D. Energy was 88% of recommended for males 50-74 y. Dietary fibre content was low (14 g/day) for both gender groups. LTC facility menus did not provide the recommended number of servings of vegetables and fruit, and grain products compared to Canada's Food Guide to Healthy Eating. Snacks provided by LTC facilities covered the four food groups, but were not consistently offered to all residents. [Article copies available for a fee from The Haworth Document Delivery Service: 1

measured using protocol failure (presentation to ED within 48 hours of appropriate diversion) and patient morbidity rates (hospital admission within 48 hours of diversion). Data was analysed qualitatively and quantitatively using proportions. Results: EMS responded to 695 calls with psychiatric complaints. Of the 650 taken directly to the ED, 18 met diversion criteria; these were missed protocol opportunities (3%). 45 patients were diverted. There was protocol noncompliance in 36 cases (80%), but 34 were due to incomplete recording of vital signs. There were direct protocol violations in only 2 cases (4%). There was protocol failure in 3 cases (33%), and patient morbidity in 8 cases (18%). No patients died within 48 hours of diversion. Conclusion: EMS providers were highly compliant with the protocol when transporting patients directly to the ED. There were high levels of protocol noncompliance in diverting patients to CI, though this is largely attributed to incomplete recording of vital signs; direct protocol violations were low. The protocol provides moderate levels of safety in diverted patients. Broader implementation of a diversion protocol could reduce the volume of mental health patients seen in the ED, and improve quality of care received by this patient population.