Breaking Down Barriers to Food Access for Older Adults

Breaking Down Barriers to Food Access for Older Adults

Too many older adults struggle with hunger and food access. Finances a real issue in this population. In this post, guest writer Gabrielle McPherson, MS, RDN, LD breaks down the issues with food insecurity AND what you can do to help seniors access food.

What is Food Insecurity?

In its simplest form insecurity is not having the money to get the foods you need. No money = No food = Hunger. It effects far too many people for a variety of reasons.

Food Insecurity by Definition

food accessIt is heart-rending to know that for many, there is great difficulty obtaining one of our most basic physiological needs as human beings —food. Food is fundamental to everyday life. When there is trouble accessing it, our livelihoods are negatively impacted in many ways.

The United States Department of Agriculture defines food insecurity as “a household-level economic and social condition of limited or uncertain access to adequate food” (1).

Another definition of food insecurity is when a lack of money and/or other resources causes a disruption in eating patterns or food intake (2).

How Many People Does Food Insecurity Effect?

In 2018, 37.2 million people across the United States were reported to reside in households experiencing food insecurity (3). Fortunately, the prevalence of food insecurity between 2017 and 2018 declined from 11.8 percent to 11.1 percent (3).

What Causes Food Insecurity?

The causes of food insecurity can be a variety of factors. Low socioeconomic status is most commonly associated with food insecurity. Other causes, or triggers, of food insecurity, are income instability, household changes, physical and mental health decline, and job loss (4).

food insecurity in older adults

Food Insecurity and Older Adults

So, food insecurity is a big issue. Now let’s dig deep into how this impacts older adults.

The Older Adult Population is Growing

The older adult population has significantly changed over the years. There are 11 million more older adults in the ages 65-74 category today than there were in 2002 (5). There is an increased prevalence of diabetes, excessive drinking and suicide in this population compared to 15 years ago (5). These are issues that can be impacted by food insecurity.

The older adult population continues to grow. It is expected to increase from 49.2 million in 2016, to 73 million by year 2030 (6).

Food Insecurity and Older Adults

farmers marketCauses of food insecurity specific to older adults are often limited income, disability, medical conditions, and functional limitations (7).

Having limited food access can put older adults at risk for malnutrition, chronic disease, and worsening of chronic disease. Additionally, food insecure older adults have higher chances of emergency room visits, office visits, and inpatient hospital stays compared to food secure older adults (8).

Food insecurity affects 5.5 million older adults in America today and 9.5 million are marginally affected by food insecurity and are at risk for hunger (9).

How do Older Adults Cope with Food Insecurity?

When financial resources are limited and the number of medical bills and prescriptions accrue, older adults make sacrifices to make ends meet. It has been reported that older adult households “made trade-offs” between food and paying for utilities (60%), transportation (58%), medical care (63%) or housing (49%)” (10).

Food insecurity combined with a lack of resources can cause older adults to purchase cheap, highly processed foods that are prone to being high in calories, fat, sugar, and lack nutrients that support bone health, immunity, and overall health.

Feeding America reported 77% of their older adult clients buy the cheapest food even if it isn’t a good nutrition source (11). Their clients also report other coping strategies which include receiving help from loved ones (46%), watering down food and beverages (38%), selling valuables (29%), and growing food at home or in a community garden (24%) (11).

Barriers to Food Access for Older Adults

Let’s dig deeper into what is causing food insecurity in older adults. Breaking down barriers to food access is the key to helping older adults get the foods they need.

empty cupboards

Mobility and Transportation Issues

Access to food can be limited for older adults because of issues with mobility. In older age, it becomes more difficult to move around especially when there is an existing physical condition that may create restricted movement. It can be just too physically taxing to leave home and get to the grocery store. Physical limitations and medical conditions can isolate older adults and limit social exposure.

A lack of reliable transportation or being unable to drive are both real barriers. This can limit access to farmer’s markets and grocery stores that may be far away. Local convenience stores, drug stores, and gas stations nearby can offer a short distance to travel. However, they often do not carry fresh produce or other nutrient rich foods to support good health and manage chronic diseases nutritionally.

Social Isolation and Lack of Information

Transportation challenges can result in social isolation. Social isolation may increase mortality (12) and can have a negative impact on both mental and physical health (13).

Statistics show that 1 in 4 older adults live alone and 1 in 5 older adults feel lonely (9). Social isolation can keep an older adult uninformed or misinformed about their eligibility for and knowledge of food assistance opportunities.

Having social support can not only help older adult’s form meaningful relationships, boost their mental health with activities, it can also encourage a healthy lifestyle and help older adults eat well (13).

Negative Implications of Improper Food Access on Health

Having access to food is a basic human right. It can lead to so many issues that impact overall health and in turn, quality of life.

Malnutrition

Older adults who are food insecure have low intakes of calories, and key nutrients like protein, Vitamins A, C, B-6, and Thiamin, Magnesium, and Iron. Low protein intake and aging can result in loss of muscle and strength (14). Sarcopenia can result from poor protein intake 15 and can further cause falls and hip fractures (16).

Poor nutrient intake can leave older adults at risk for being more susceptible to sickness, and have a reduced ability to get over illness and infections (17). It can also contribute to unintended weight loss in older adults.

food pantry

Chronic diseases

Food insecure older adults are at a 60% more likely to have a heart attack or congestive heart failure, 50% likely to have diabetes, and 30% more likely to have at least one activity of daily living impacted (14).

Improper food access has the potential to deteriorate health status. Consuming nutrient poor foods can lead to all kinds of health issues including abnormal cholesterol, poor control of blood glucose levels, and high blood pressure.

Deterioration of Mental Health

food deliveryMental impacts of food insecurity are unfortunately often overlooked. Older adults facing food insecurity are 2.3 times as likely to have depression compared to other age groups (7).

An ugly cycle of food insecurity, consumption of poor-quality foods, exacerbation of pre-existing health issues, loneliness and other barriers faced by older adults can perpetuate mental health issues.

Quality of Life

As stated previously, improper access to foods for older adults can pose threats to every aspect of life including physical, emotional, mental, social, and economic well-being therefore affecting their quality of life.

And older adults deserve to have the VERY best quality of life!

food programs

Food Assistance Help for Senior Citizens

There are available resources that can enhance the quality of life for older adults suffering from food insecurity. Below, we will discuss the available resources that the older adult in your life may be eligible for.

Congregate Meal Sites

  • What is it?
    • A grant-based program providing s healthy meals, nutrition services, and social engagement opportunities in congregate settings.
  • Who is eligible?
    • Older adults ages 60 and older with a great economic and social need.

Senior Farmers’ Market Nutrition Program

  • What is it?  
    • A program that provides coupons to be exchanged for locally grown produce, herbs, and honey at farmer’s markets and other community stands.
  •  Who is eligible?
    • Older adults ages 60 and older with household incomes no more than 185% of the poverty level

Home-Delivered Meal Services (Meals on Wheels)

  • What is it?  
    • A grant-based program providing home delivered healthy meals, nutrition services, and safety checks.
  •  Who is eligible?
    • Home-bound, frail, and/or isolated older adults ages 60 and older.

Child and Adult Care Food Program

  • What is it?  
    • A federal program that provides nutritious meals and snacks to adult daycares.
  •  Who is eligible?
    • Older adults ages 60 and older who attend adult daycares that participate in this program.

 Supplemental Nutrition Assistance Program (SNAP)

  • What is it?  
    • A federal  program that provides nutrition benefits to low income families, older adults and disabled individuals to be used in grocery stores.
  •  Who is eligible?
    • Older adults ages 60 and older  meeting specific  household income guidelines found here.
    • There is a simplified process for seniors to apply that varies by the state you live in called the Elderly Simplified Application Project (ESAP).

Food Commodities

  • What is it?  
    • A program that provides healthy food packages on a monthly basis.
  •  Who is eligible?
    • Older adults ages 60 and older who are at or below 130% of the poverty level.

Emergency Food Assistance Program

  • What is it?  
    • A federal program that provides emergency food assistance to help supplement diets of low-income individuals.
  •  Who is eligible?
    • Elderly individuals who meet state specific income guidelines.

Programs of All-Inclusive Care for the Elderly (PACE)

  • What is it?  
    • A Medicare and Medicaid program that provides medical and social needs including nutrition counseling and meals.
  •  Who is eligible?
    • Older adults age 55 and older who live in the service area of a PACE organization. They must have need for a nursing home-level of care (as certified by your state) and be able to live safely in the community with help from PACE.

Humana Well Dine Prepared Meals Food Assistance Program

  • What is it?  
    • A home meal delivery service for older adults recovering from a hospital or nursing home stay.
  •  Who is eligible?
    • Humana insurance carriers. Hopefully more insurance carriers will begin offering such services- be sure to check out your policy to see if this is covered!

Community Food Assistance

soup kitchen

Food assistance can be found locally through food banks, food pantries, mobile markets, churches, community centers, and non-profit organizations. Local grocery stores may offer a small discount for older adults. Restaurants may also offer specials for older adults.

Do some research in your community to see what is available! Ask your health care team, a dietitian, social worker, community worker, or even just some friends.

Eldercare Locator

This amazing resource helps connect people to the resources available for older adults in YOUR community.  Check out their website or call 1-800-677-1116 to learn more!

How Caregivers can Help Loved Ones Eat Well

Most of you reading are caregivers to an older adult in some capacity. Thank you. Now, I’m sure you want to know how YOU can help. This information can be confusing. You can help the older adult in your life connect the dots to the resources available in their community.

There are other things you can do to help.

Do the grocery shopping/take grocery orders

grocery cartYou can help your loved one obtain access to food in many ways that were not possible a decade ago. Going grocery shopping for your loved one can be a great help, especially if you’re coupon savvy.

This may not always be feasible so another option could be arranging for a personal shopper to deliver groceries to your loved one’s home through Instacart or Shipt. More and more grocery stores are also starting to offer delivery services, but the cost can be a barrier.

Assist with applications and gathering of important documents

As mentioned, this information can be confusing. An older adult may get lost in the tediousness of food assistance applications. They may also be uncomfortable with using certain modes of technology.

Help him or her gather all of the necessary documents needed while assisting with submitting the completed paperwork. According to the National Council on Aging, 3 out of 5 older adults are eligible for SNAP but are not participating (18).

Also provide support in reassuring them that they DO deserve these benefits and we want to help them get the food they need to stay healthy and at home. Sometimes there are barriers to accepting help and stigma associated with getting assistance.grocery and delivery

 

Assist with meal preparation or food delivery for seniors

grocery bagHelp your loved one by doing some cooking for them and keeping meals frozen so they are easy to reheat. If you are looking for a great gift for an older adult, consider giving them a meal delivery service. This can easily be set up online.

HelloFresh is a meal delivery service where ingredients are delivered to the door to be quickly prepared with the help of an easy-to follow recipe. An even better option would be Magic Kitchen where you can select  senior specific  meals to be delivered to their door. These meals were designed by a Dietitian and can be customized by chronic disease such as Diabetes or kidney disease.

Wrapping it Up

This was a lot of good information! Hopefully you now see how many resources there actually are for older adults. No older adult should go hungry. Ever. We can help them bridge the gap in getting the resources they need to get food in their pantries.

Thank you for caring for older adults. Thank you for helping them get access to food.

caregivers

Infographic

Food Assistance for Seniors Infographic

 

 

 

References:

  1. Coleman-Jensen, Alicia, and Christian A Gregory. “Definitions of Food Security.” USDA ERS – Definitions of Food Security, 4 Sept. 2019, www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security.aspx#ranges.
  2. Nord, Mark, et al. Household Food Security in the United States, 2005. 2005, Household Food Security in the United States, 2005, www.ers.usda.gov/webdocs/publications/45655/29206_err29_002.pdf?v=41334.
  3. Coleman-Jensen, Alicia, and Christian Gregory. “Key Statistics & Graphics.” USDA ERS – Key Statistics & Graphics, 4 Sept. 2019, www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/key-statistics-graphics.aspx#trends.
  4. Gundersen, Craig, and Steven Ziliak. “Childhood Food Insecurity in the US: Trends, Causes, and Policy Options.” Aspen Institute, 2014, assets.aspeninstitute.org/content/uploads/files/content/docs/ee/N.Childhood_Food_Insecurity_in_the_U.S..pdf.
  5. “Senior Report 2019.” America’s Health Rankings, 2019, assets.americashealthrankings.org/app/uploads/ahr-senior-report_2019_final.pdf.
  6. US Census Bureau. “2017 National Population Projections Tables.” The United States Census Bureau, 6 Sept. 2018, www.census.gov/data/tables/2017/demo/popproj/2017-summary-tables.html.
  7. Klakotskaia , Diana. Senior Food Insecurity Report 2018. Missouri Department of Health and Senior Services, 2018, pp. 1–60, Senior Food Insecurity Report 2018.
  8. Bhargava, Vibha, and Jung Sun Lee. “Food Insecurity and Health Care Utilization Among Older Adults in the United States.” Journal of Nutrition in Gerontology and Geriatrics, vol. 35, no. 3, 2016, pp. 177–192., doi:10.1080/21551197.2016.1200334.
  9. “The Escalating Problem of Senior Hunger and Isolation.” Meals On Wheels of America, Sept. 2019, www.mealsonwheelsamerica.org/docs/default-source/fact-sheets/2019/2019-national/mowa2019factsheets_issue_final.pdf?sfvrsn=b92bb93b_2.
  10. “Baby Boomers and Beyond: Facing Hunger after Fifty.” Feeding America, 2019, www.feedingamerica.org/research/senior-hunger-research/facing-hunger-after-fifty.
  11. DelVicchio Dys, Theresa, et al. “Baby Boomers and Beyond: Facing Hunger after Fifty w.” Feeding America, 2015, www.feedingamerica.org/sites/default/files/research/senior-hunger-research/baby-boomers-executive-summary.pdf.
  12. Steptoe, A., et al. “Social Isolation, Loneliness, and All-Cause Mortality in Older Men and Women.” Proceedings of the National Academy of Sciences, vol. 110, no. 15, 2013, pp. 5797–5801., doi:10.1073/pnas.1219686110.
  13. Stevenson, Sarah. “20 Facts about Senior Isolation That Will Stun You.” Senior Assisted Living Guides: Find Senior Care A Place for Mom, 15 Nov. 2019, www.aplaceformom.com/blog/10-17-14-facts-about-senior-isolation/.
  14. Lloyd, Jean. “Hunger in Older Adults.” Meals On Wheels America, Feb. 2017, www.mealsonwheelsamerica.org/docs/default-source/research/hungerinolderadults-fullreport-feb2017.pdf.
  15. Yanai, Hidekatsu. “Nutrition for Sarcopenia.” Journal of Clinical Medicine Research, vol. 7, no. 12, 2015, pp. 926–931., doi:10.14740/jocmr2361w.
  16. Santilli, V. “Clinical Definition of Sarcopenia.” Clinical Cases in Mineral and Bone Metabolism, 2014, doi:10.11138/ccmbm/2014.11.3.177.
  17. Pae, Munkyong, et al. “The Role of Nutrition in Enhancing Immunity in Aging.” Aging and Disease, vol. 3, no. 1, 2012, pp. 91–129., www.ncbi.nlm.nih.gov/pmc/articles/PMC3320807/pdf/ad-3-1-91.pdf.
  18. “Facts About Senior Hunger.” National Council on Aging , 3 Sept. 2019, www.ncoa.org/news/resources-for-reporters/get-the-facts/senior-hunger-facts/.

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