Nutrition Services for Older Americans - Chapter 21

Nutrition Services for Older Americans

Chapter 21

The Role of Nutrition in Healthy Aging

• Important to distinguish between normal changes of aging versus changes due to disease

• Nutrition Challenges of Aging– Calorie needs decrease– Some micronutrient needs increase

• Malnutrition– Older adults eat inadequate diets and are at risk

for malnutrition


• Nutrient Deficiency: Underweight– When the intake of dietary nutrients is less than

that required to sustain health– Common indicators of undernutrition

• Body mass index• Nutrient intakes• Weight loss

– Protein-energy undernutrition (PEU)


• Nutrient Deficiency: Underweight– Sarcopenia and cachexia

• “Wasting” or “The anorexia of aging”

• Nutrient Excess: Obesity– Most common nutrition disorder in older adults– Associated with increased risk of some diseases– Distribution of fat in the abdomen– BMI is not a predictor of mortality or

hospitalization for most individuals aged 75 or older


• Nutritional Concerns of Older Adults– Accessible and available healthy foods

• Psychosocial factors• Physiologic factors• Affected by the aging process, food intolerance,

and medication• Overall food intake is influenced by number of

meals, meal size, and food choices


• Nutritional concerns of Older Adults– Accessible and

available healthy foods• Healthful eating

relies on making the right food selections

• Community factors

© Elena Elisseeva/ShutterStock, Inc.


• Older Adult Nutrition: A Public Health Issue– Many different indicators of deficiency, excess, or

both, in nutritional health• Anthropometric• Clinical• Biochemical• Dietary

– Nutritional health may be influenced by altered absorption, utilization, or excretion as a result of other conditions


• Nutrition as Part of the Health Care Continuum– Primary prevention

• Overall good nutrition helps to promote health, function, and the prevention of nutrition-related disease

– Secondary and tertiary prevention• Nutrition is a major component of the

management of disease conditions and prevention of disability

Nutrition Services to Older Persons

• Public Nutrition Policy– Health care systems

• Individual private health insurance• Health maintenance organizations• Medicare

– Home and community-based long-term care• Public health departments• Aging services providers


• Public Nutrition Policy– White House Conference on Aging

• Social Security Amendments• The Senior Citizen Housing Act• The Community Health Services and Facilities

Act• Medicare• Medicaid• The Older Americans Act (OAA)


• Public Nutrition Policy– White House Conference on Aging

• OAA–Six core service areas–National goal to promote better health

through improved nutrition and to help older adults to remain independent in their own homes

–Services implemented by the Aging Network


Title III and VI Nutrition Program Structure


• Pubic Nutrition Policy– Title IIIC

• Congregate meals–Served at community centers–Provides nutritious meals in a social setting

• Home-delivered meals–Meals on Wheels


• Older Americans Act Nutrition Programs– Must provide at least one-third of RDA– Must use the Dietary Guidelines for Americans as

a framework– Regularly screens their participants for nutritional

risk based on the Nutrition Screening Initiative’s DETERMINE Checklist


• Nutrition Services Incentive Program– Rewards effective performance for delivery of

nutritious meals to older Americans


• Medicaid Waiver Program– A state-federal partnership that pays for health

and long-term care services for low-income individuals who are aged, blind, disabled, or members of families with disabled dependent children, or those who meet certain other criteria for need• Benefits available include meals and/or

nutrition services


• Medicaid Waiver Program– U.S. Department of Agriculture (USDA)

• Federal Supplemental Nutrition Assistance Program

• Food Stamp Nutrition Education• Commodity and Supplemental Foods• The Emergency Food Assistance Program• Child and Adult Care Food Program• Seniors’ Farmers Market Nutrition Program


• Federal Supplemental Nutrition Assistance Program– Provides electronic benefit transfer cards or

coupons to eligible low-income individuals and families

– An entitlement program


• Food stamp Nutrition Education – Improve likelihood that SNAP participants and

applicants will make healthy choices within a limited budget

• Commodity Supplemental Food Program– Supplement diet with nutritious USDA commodity

foods• The Emergency Food Assistance Program

– Commodity-food distribution program


• The Child and Adult Care Food Program– Serves nutritious meals and snacks to eligible

adults in participating adult day centers

• The Senior Farmers’ Market Nutrition Program– Provides coupons that can be exchanged for

eligible foods at farmers’ markets, roadside stands, and community-supported agriculture programs

Conclusion

• Good nutrition is a critical component of healthy aging, and good nutritional health plays a role in maintaining physical and cognitive function.

• OAANP congregate and home-delivered meal programs provide a critical source of nutrition support for many older adults.

Date post:	07-May-2015
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