Over the last couple of weeks, this column has covered various aspects of the relationship between nutrition and aging, including nutritional recommendations for older adults https://keystoneelderlaw.com/aging-gracefully-with-good-nutrition/ and some of the physical factors which can influence an older adult’s ability to obtain, prepare, and consume foods which contribute to good nutrition https://keystoneelderlaw.com/nutrition-and-aging-part-i/. Social elements also exist which influence nutritional health and the likelihood of maintaining independence while aging.
Finances are a social element which has an obvious impact on food choices. For older adults who have limited income and resources, processed foods are often less expensive than fresh foods. This situation can be problematic when processed foods might not be the best choice if a special diet has been recommended for the older adult. The Commonwealth of Pennsylvania provides financial assistance to pay for groceries through the Supplemental Nutrition Assistance Program (formerly known as food stamps) for those who qualify. This program is administered by the Department of Human Services (DHS). Additional information about SNAP can be obtained by visiting https://www.dhs.pa.gov/Services/Assistance/Pages/SNAP.aspx .
Educational resources about healthy eating on a low budget and stretching your food dollars is also available on the DHS website. Additional programs which provide nutritional assistance include food banks and senior centers. Your local office of aging can provide contact information for specific programs near you. The meals available at senior centers have multiple benefits including a lower cost, opportunities for socialization, and someone else to do the cooking. Local churches may also offer hot meals which are open to the public, either on a routine basis or for special occasions.
An older adult’s lifelong habits related to meals will also influence nutrition in the later years. Food preferences and mealtime patterns such as staying at home versus going out to eat, eating alone or with others, and the timing of meals are important to consider when evaluating an older adult’s nutrition. The ability to eat preferred foods may be hampered by some of the physical factors that have already been discussed, such as oral health and medical conditions. Older adults may feel less inclined to eat if their routine has changed or their days lack other activities to provide 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 affect nutritional status.
The loss of a spouse can be nutritionally devastating for an older adult for a number of reasons. Perhaps the deceased spouse took primary responsibility for meal planning and preparation, and the surviving partner doesn’t enjoy cooking or even know how to cook. Some older adults don’t want to take the time to cook a full meal for just one person and snacking may be viewed as easier.
The loss of companionship during meal time can be an even larger hurdle to overcome. In a study of 600 older adults who live alone, the home care agency Home Instead 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. 85% reported that having someone to share 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.
Older adults who live in care communities or with family members can be routinely monitored for nutritional risks. When necessary, support to initiate interventions is more readily available. For older adults who live alone in the community, identifying those at risk for nutritional deficiencies and determining 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 have been mentioned. The potential magnitude of this issue is overwhelming to consider with the Administration for Community Living’s 2020 Profile of Older Americans reporting that 14.7 million adults age 65+ live alone. The likelihood of living alone increases as adults continue to age, at a time when they may also benefit from additional assistance with the tasks of daily living.
We can all contribute to promoting healthier aging for the older adults in our lives. An understanding of the risk factors for impaired nutrition is a beginning, but awareness without action is useless. Find an opportunity to invest in healthy nutrition for an older adult who may be at risk. Invite the older adult to share a meal, offer them a ride to the grocery store, or assist them to start some “spring cleaning” in the kitchen (when was the last time the refrigerator received a thorough review of its contents and a good cleaning?)
Healthy eating for older adults involves a lot more than just food choices. The impacts of nutrition can reach far beyond mealtime to both quality and quantity of life.
Karen Kaslow, RN, BSN