It’s time to start thinking outside the box so we can develop programs to reduce food insecurity among older adults.
A few years back, a friend’s mother was living happily in a suburban New York senior housing property when she began to show signs of physical decline.
Fainting episodes led to multiple falls, eventually prompting family members to encourage their mother’s move to a nearby assisted living community.
After the move, the fainting and falling abruptly ceased.
It turns out that lack of nourishment, not age-related physical decline, had been the cause of their mother’s ills.
TALKING ABOUT FOOD SECURITY IN MICHIGAN
My friend’s story came to mind during a recent brainstorming session about food insecurity that took place on a wintry day in Michigan.
Representatives of aging services organizations, many of them LeadingAge members, were around the table.
We had been invited to that table by Gordon Food Service, which distributes food products that long-term care providers, health care entities, schools, and restaurants use to prepare meals for their residents, patients, students, and customers.
The group spent an entire day thinking aloud about what could be done — and what the organizations we represent could do — to ensure that older adults like my friend’s mother have access to nutritional foods that could help them:
- Stay healthy.
- Remain in their homes and communities.
- Avoid unnecessary transfers to higher and more expensive levels of care.
- Save health care dollars.
PREVALENCE OF FOOD INSECURITY
Poor nutrition among older adults has many and varied causes.
The very early stages of dementia, skillfully hidden from out-of-town children, had made shopping and cooking increasingly difficult for my friend’s mother. On most days, she found it easier to pick at snack foods that had little nutritional value. On other days, she did not eat at all.
Other older adults may not eat well because they can’t afford to buy afford healthy food, can’t get to the grocery store, or live in “food deserts” where healthy food is simply not available.
Behavioral health issues can stand between an older adult and a nutritious meal. The loss of a spouse – and the difficulty of suddenly cooking for one — can also contribute to dangerously poor nutrition.
Whatever the cause, food insecurity is all too common among older people. The AARP Foundation’s 2015 update to Food Insecurity Among Older Adults reports that 1 in 10 over-40 American households — or about 14 million people — experience serious food insecurity issues.
That’s a number we can’t afford to ignore, especially when you consider 2 facts also included in the AARP Foundation report:
- Food insecurity is a “strong predictor” of health problems like heart disease, cancer, stroke, pulmonary disease, or diabetes.
- The highest rates of food insecurity in the 40+ age group are found among low-income individuals, women, African Americans, Latinos, and people who live alone.
These are exactly the people that LeadingAge members serve in our affordable senior housing properties and through our home and community-based services (HCBS) programs.
NO ANSWERS, BUT SOME HOPE
My friend and her siblings remain convinced that their mother would still be living in her apartment if the building’s staff had been trained to recognize her need — and if nutritious meals had been available in her home when she most needed them.
Our brainstorming session didn’t yield any definitive strategies for bringing those kinds of services to more older adults living in community. But we were able to think creatively about a problem that, heretofore, has seemed too overwhelming to tackle head-on.
I left the Michigan meeting with a hopeful vision of what might be possible — and with 4 steps that I believe would help us get started:
- Ask questions. Providers of aging services need to work harder to understand the role that food and nutrition play in the health of the older adults they serve. Every time you engage with a resident or client — no matter what the reason — ask questions about that person’s diet and sources of healthy foods. Then do what you can to connect that person with the food-related services and supports he or she may need to stay healthy.
- Get creative with existing services. As you define the extent of food insecurity in your communities, start thinking about how you might address this issue through your existing service lines. I’ve talked with rehabilitation programs that offer affordable packaged meals to community-dwelling adults who use their services. Could home health agencies also think creatively about how they might facilitate the delivery of affordable meals to their clients?
- Develop and evaluate new strategies. I’d love to see us collaborate on some pilot projects that explore the food-related needs of different groups of community-dwelling older adults, identify the most effective food delivery options, document the outcomes of those programs, and disseminate best practices.
- Find new partners. Our nation has a bustling food infrastructure, composed of a host of potential partners. Let’s put some thought into how we can approach these partners, identify mutual benefits to collaboration, and work together to tackle food insecurity. Think about how food distributors and dietary professionals could help you implement a food security program. And don’t overlook health entities, schools, and restaurants that could contribute their expertise and their kitchens to these endeavors.
Clearly, it’s time to start thinking outside the box so we can develop programs to reduce food insecurity, evaluate those programs to identify which ones actually improve health status among older adults, and then take definitive steps to help vulnerable older adults enjoy a better quality of life.
Robyn I. Stone, DrPH, is senior vice president of research at LeadingAge, and co-director of the LeadingAge LTSS Center @UMass Boston. Her widely published work addresses long-term care policy and quality, chronic care for people with disabilities, the aging services workforce, affordable senior housing, and family caregiving.