Some of the physical factors mentioned last week that influence older adult nutrition included oral hygiene, medical conditions affecting swallowing, mobility, potential side effects of medications, and dementia. There are social factors as well which play important roles in the ability and desire of seniors to prepare and consume meals which will help them maintain adequate nutritional health.
Finances are one social factor which can affect a senior’s nutritional choices. For seniors with lower income levels and assets, processed foods are often less expensive than fresh foods. This can be problematic when processed foods may not be the best choices if the senior should be following a special diet. The Commonwealth of Pennsylvania provides financial assistance for groceries for those who qualify through the Supplemental Nutrition Assistance Program (formerly known as food stamps). This program is administered by the Department of Human Services, and additional information can be obtained by visiting www.dhs.state.pa.us. Information about healthy eating on a low budget and stretching your food dollars is also available on this site. Other local programs include food banks and senior centers. The Cumberland County Aging & Community Services office can provide contact information for these programs. The low cost hot meals available at senior centers have the added benefits of socialization and someone else to do the cooking. Sometimes, local churches may offer hot meals which are open to the public, either on a routine basis or for special occasions.
Another consideration is the senior’s lifelong habits related to meals, including food preferences and mealtime patterns (such as staying at home versus going out to eat, eating alone or with others, and timing of meals). The ability to eat preferred foods may be hampered by some of the factors that we have already discussed, such as oral health and medical conditions. Seniors may feel less inclined to eat if their routine has changed or their day lacks other activities to give it structure. If someone is accustomed to dining out on a regular basis, changes in the ability to drive or in the health of dining companions will impact nutritional status. The loss of a spouse can be nutritionally devastating for a senior for a number of reasons. Perhaps the spouse took primary responsibility for meal planning and preparation, and the senior doesn’t enjoy cooking or even know how to cook. Some seniors don’t want to take time to cook a full meal for just one person. The loss of companionship during meal time can be an even bigger hurdle to overcome. In a study of 600 seniors who live alone, Home Instead Senior Care found that the majority reported that they eat more nutritiously and that the food actually tastes better when they eat with others instead of eating alone, and 85% reported that having someone to share their meals with makes mealtimes more satisfying for them. In the same study, men were twice as likely as women to desire more assistance with activities related to meals, such as shopping and preparation.
Seniors who live in care facilities or with family members can be regularly monitored for nutritional risks and support to initiate interventions is readily available when needed. For seniors who live alone in the community, identifying those at risk for nutritional deficiencies and finding strategies to combat those risks can be more complicated. Living alone (and thus probably eating alone) is a significant risk by itself, but living alone can also amplify some of the other risk factors that we’ve mentioned. The potential magnitude of this issue is overwhelming to consider, since the US Department of Health and Human Services reports that as of 2012, 11.8 million older Americans live alone. The likelihood of living alone also increases as seniors age (46% of women age 75+ live alone, as reported by the Administration on Aging – A Profile of Older Americans 2012).
While an awareness of risk factors is an important start to address the issue of seniors and nutrition, awareness without action is useless. How can you help? The Academy of Nutrition and Dietetics has declared March as National Nutrition Month. Sometime this month, challenge yourself to find an opportunity to promote healthy nutrition for a senior who may be at risk. Invite the senior to share a meal, take them grocery shopping, or assist them to start some “spring cleaning” in the kitchen (when was the last time the refrigerator received a good review of contents and a scrubbing?) Healthy eating for seniors involves a lot more than just food choices, and the time spent with others may be even more valuable than the food itself.
Karen Kaslow, RN