Nutrition Services for Older Americans - Chapter 21
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Transcript of Nutrition Services for Older Americans - Chapter 21
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Nutrition Services for Older Americans
Chapter 21
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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
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The Role of Nutrition in Healthy Aging
• 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)
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The Role of Nutrition in Healthy Aging
• 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
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The Role of Nutrition in Healthy Aging
• 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
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The Role of Nutrition in Healthy Aging
• Nutritional concerns of Older Adults– Accessible and
available healthy foods• Healthful eating
relies on making the right food selections
• Community factors
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The Role of Nutrition in Healthy Aging
• 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
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The Role of Nutrition in Healthy Aging
• 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
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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
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Nutrition Services to Older Persons
• 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)
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Nutrition Services to Older Persons
• 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
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Nutrition Services to Older Persons
Title III and VI Nutrition Program Structure
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Nutrition Services to Older Persons
• Pubic Nutrition Policy– Title IIIC
• Congregate meals–Served at community centers–Provides nutritious meals in a social setting
• Home-delivered meals–Meals on Wheels
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Nutrition Services to Older Persons
• 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
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Nutrition Services to Older Persons
• Nutrition Services Incentive Program– Rewards effective performance for delivery of
nutritious meals to older Americans
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Nutrition Services to Older Persons
• 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
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Nutrition Services to Older Persons
• 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
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Nutrition Services to Older Persons
• Federal Supplemental Nutrition Assistance Program– Provides electronic benefit transfer cards or
coupons to eligible low-income individuals and families
– An entitlement program
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Nutrition Services to Older Persons
• 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
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Nutrition Services to Older Persons
• 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
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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.