Personal and Social Frameworks for Nutrition and Healthy Aging

Community Nutrition & Aging

As we have noted before, while aging is inevitable, changes experienced with aging do not follow any magic calendar. The nutritional needs of one 80 year old may be the same as those for a person in their 50's.

Using the framework of the social-ecological model, we will examine how different players within the Sectors layer offer support for aging adults. What community programs support aging adults? How is food an opportunity for social engagement in later life? Are there unique nutrition aspects associated with aging adults who access in-home healthcare, assisted living or skilled nursing homes?

As you complete this material, keep in mind this learning objective:

Explore community resources that support older adult wellness in the area of nutrition

Community nutrition services for older adults

In general, programs within communities seek to:

reduce hunger and food insecurity;
promote socialization; and
promote the health and well-being of older individuals by assisting such individuals to gain access to nutrition and other disease prevention and health promotion services to delay the onset of adverse health conditions resulting from poor nutritional health or sedentary behavior.

Many of these Nutrition Programs are funded by federal, state and local governments, volunteer organizations or supported through various foundations. Many services prioritize older adults with the greatest social and economic needs. This module examines community nutrition services for older adults.

Federal Support for Aging Adults- Older Americans Act

Let's begin with the federal government and its role to support its citizens. This section is excerpted from the federal Administration for Community Living website that describes the formation of the Older Americans Act.

Older Americans Act

Congress passed the Older Americans Act (OAA) in 1965 in response to concern by policymakers about a lack of community social services for older persons. The original legislation established authority for grants to states for community planning and social services, research and development projects, and personnel training in the field of aging. The law also established the Administration on Aging (AoA) to administer the newly created grant programs and to serve as the federal focal point on matters concerning older persons. In 2012, the Administration for Community Living was created to oversee the Administration on Aging and other programs to better serve communities. (see next section)

Although older individuals may receive services under many other federal programs, today the OAA is considered to be a major vehicle for the organization and delivery of social and nutrition services to this group and their caregivers. It authorizes a wide array of service programs through a national network of 56 state agencies on aging, 629 area agencies on aging, nearly 20,000 service providers, 244 Tribal organizations, and 2 Native Hawaiian organizations representing 400 Tribes. The OAA also includes community service employment for low-income older Americans; training, research, and demonstration activities in the field of aging; and vulnerable elder rights protection activities.

The most recent re-authorization of the OAA extends through fiscal year 2019.

For a big picture overview of the development of the federal programs for older adults, you can dive a little deeper here: Timeline of programs for Older Americans.

Administration for Community Living

All Americans—including people with disabilities and older adults—should be able to live at home with the supports they need, participating in communities that value their contributions. To help meet these needs, the U.S. Department of Health and Human Services (HHS) created the Administration for Community Living (ACL) in 2012.

ACL brings together the efforts and achievements of the Administration on Aging (AoA), the Administration on Intellectual and Developmental Disabilities (AIDD), and the HHS Office on Disability to serve as the Federal agency responsible for increasing access to community supports, while focusing attention and resources on the unique needs of older Americans and people with disabilities across the lifespan.

Mission: Maximize the independence, well-being, and health of older adults, people with disabilities across the lifespan, and their families and caregivers.

Vision: For all people, regardless of age and disability, to live with dignity, make their own choices, and participate fully in society. Therefore, we will:

Nutrition Services of Administration of Community Living

Nutrition programs are housed under the Administration of Community Living (ACL). The ACL Administration on Aging (AOA) through the Older Americans Act (OAA) provides grants to states to help support nutrition services for older people throughout the country. Nutrition Services Of Administration for Community Living

Open this ACL Nutrition Programs link and read about the following nutrition programs:

The Congregate Nutrition Services authorizes meals and related nutrition services in congregate settings, which help to keep older Americans healthy and prevent the need for more costly medical interventions. In addition to serving healthy meals, the program presents opportunities for social engagement, information on healthy aging, and meaningful volunteer roles, all of which contribute to an older individual’s overall health and well-being.
The Home-Delivered Nutrition Services authorizes meals and related nutrition services for older individuals who are homebound. Home-delivered meals are often the first in-home service that an older adult receives, and the program is a primary access point for other home- and community-based services. The program serves frail, homebound, or isolated individuals who are age 60 and over, and in some cases, their caregivers, spouses, and/or persons with disabilities.This program serves much more than food. It provides a safety check, and sometimes the only opportunity for face-to-face contact or conversation that day.
The Nutrition Services Incentive Program provides grants to states, territories, and eligible Tribal organizations to support the Congregate and Home-Delivered Nutrition Programs by providing an incentive to serve more meals. Grantees can choose to receive their grant as cash, commodities (food), or a combination of cash and commodities.

Area Agencies on Aging

Area Agencies on Aging (AAAs) were added to the Older Americans Act in 1973 to be the “on-the-ground’ organizations charged with helping vulnerable older adults live with independence and dignity in their homes and communities. The OAA mandates that AAAs use the flexibility provided in the law to ensure that local needs and preferences are taken into consideration and that the resulting local service delivery system is tailored to the community. source: https://www.n4a.org/olderamericansact

To learn more about the AAAs, check out this publication from the National Association of Area Agencies on Aging (n4a.org) Local Leaders AAA

Federal Programs through US Department of Agriculture

In addition to the department of Health and Human Services (HHS), there are many programs operated by the US Department of Agriculture (USDA).

It can be difficult to keep track of where a program originates and where it resides. Who do you go to for support? A national nonprofit called the Food, Research and Action Center (FRAC) has created a chart that divides federally funded programs for older adults by lead agency- USDA Food and Nutrition Service and the US Health and Human Services Administration on Aging. After reading this module, take some time to review the chart ( 7.2 Federal Nutrition Programs for Older Adults ) and learn about many important programs helping older adults.

Senior Farmers' Market Nutrition Program (SFMNP)

The Senior Farmers' Market Nutrition Program (SFMNP) awards grants to States, U.S. Territories, and federally recognized Indian tribal governments to provide low-income seniors with coupons that can be exchanged for eligible foods (fruits, vegetables, honey, and fresh-cut herbs) at farmers' markets, roadside stands, and community-supported agriculture programs.

The SFMNP is administered by State agencies like State Department of Agriculture or Agency on Aging.

Attribution: "Person holding farm fresh label next to bell peppers" by raw pixel is in the Public Domain, CC0

Attribution: "Older Adults at Commodity Supplemental Food Distribution" is in the Public Domain

Commodity Supplemental Food Program (CSFP)

The Commodity Supplemental Food Program (CSFP) works to improve the health of low-income elderly persons at least 60 years of age by supplementing their diets with nutritious USDA Foods. Women, infants, and children who were certified and receiving CSFP benefits as of February 6, 2014 can continue to receive assistance until they are no longer eligible under the program rules in effect on February 6, 2014. Through CSFP, USDA distributes both food and administrative funds to participating States and Indian Tribal Organizations.

SNAP- Supplemental Nutrition Assistance Program

Older adults are eligible for food stamps, now known as SNAP. The following blogpost is from the National Council on Aging.

7 Facts about Older Adults and SNAP

By Erin Kee McGovern | 7.6.2018

The Supplemental Nutrition Assistance Program (SNAP) is the largest domestic hunger safety net program. SNAP is especially important in helping low-income older adults to achieve food security. But many myths abound–here we set the record straight with seven facts about seniors and SNAP.

1. Older adults’ participation in SNAP is staggeringly low.

Nationally, about 4.7 million older adults (aged 60+) are enrolled in SNAP. Yet this figure represents less than half of the eligible population; approximately 3 out of 5 seniors who qualify to receive SNAP are missing out on benefits—an estimated 5.2 million people in all.

2. The average SNAP benefit for older adults is $106/month.

While there is a pervasive myth that older adults who qualify for SNAP only receive $16/month in benefits, this is largely untrue. The $16 figure is the minimum monthly benefit a senior can receive—80% of elderly SNAP participants receive more than the minimum. The average monthly benefit for a senior living alone in FY16 (the most recent year that data are available) was $106/month. Yet many older adults may be able to take advantage of deductions for other expenses that can increase their monthly SNAP allotment.

3. Many older adults who qualify for the excess medical expense deduction don’t use it.

Seniors who spend more than $35 a month on out-of-pocket medical costs may be able to deduct that from their gross income when applying for SNAP, thus increasing their monthly benefit amount. Currently only 16% of older adults utilize the medical expense deduction, but it is estimated that many more SNAP-eligible seniors would qualify to use it. To learn more about the deduction, see our fact sheet SNAPshots: Maximizing the SNAP Medical Expense Deduction for Older Adults.

4. Isolation is a key factor in the lives of many older adult SNAP participants.

Roughly 80% of older adults who receive SNAP benefits live alone. More than half of these isolated seniors have little to no income—depending entirely on general assistance, Supplemental Security Income (SSI), or other benefits for their subsistence. For these individuals, the $1,272 in average annual SNAP benefits can mean the difference between having food and going without.

5. SNAP is good for the local economy.

SNAP benefits are spent at community grocery stores and markets, thereby infusing money into the local economy. An analysis of the fiscal stimulus measures from USDA’s Economic Research Service found that additional SNAP benefits created the best return on investment, with every $1 in additional SNAP benefits generating $1.79 in local economic activity. On a larger scale, it is estimated that an additional $1 billion in SNAP benefits would generate 8,900 full-time equivalent jobs.

6. Access to SNAP is associated with reduced health care costs.

NCOA’s previous research on senior debt found that many older adults with debt make trade-offs that are potentially dangerous to their health, such as skipping meals and cutting pills in half. Access to benefits that help pay for food and health care reduces food insecurity and increase medication adherence—but the effects may be even bigger than that.

A recent study of 60,000 low-income Maryland seniors found that SNAP participants are 23% less likely to enter a nursing home and 4% less likely to be hospitalized in the year after receiving SNAP than non-participants. SNAP participation was also linked to lower overall health care expenditures and Medicaid/Medicare costs.

7. You can get all the information needed to help older adults apply for SNAP in one place.

NCOA’s SNAP map makes it easy to find your state’s SNAP program website, application forms (in multiple languages, where available), and eligibility criteria. Users can take a simple, quick screening to see if they potentially qualify. Because 44 states also allow individuals to apply online for SNAP, there are also links to the online applications.

Are you a counselor looking for more information about SNAP application assistance? Be sure to visit our Senior Hunger & SNAP page for links to more facts, outreach and enrollment tools, and your state’s SNAP application.

Tags: SNAP, benefits for seniors, senior hunger

Professional Associations

National Association of Nutrition and Aging Services Programs

Professional membership non-profit organization of persons working in or interested in the field of aging, community-based services, and nutrition and the elderly. The organization conducted a survey in 2016. For more information, visit their website: National Association of Nutrition and Aging Services Programs.

Socialization:

The following findings from a study conducted in 2018 stress the value of socialization in the lives of the older adult program participants.

Those who answered that “socialization is encouraged” at the Congregate site were also four times as likely to say they had a knowledge of good nutrition, had a knowledge of healthy eating habits and had experienced improved physical health since coming to the site
Those who answered that they have “more friends now” than before they started at the site were also two times as likely to say that their physical health has improved since starting to visit the site

Meals on Wheels Association of America

Meals on Wheels America is the leadership organization supporting the more than 5,000 community-based programs across the country that are dedicated to addressing senior isolation and hunger. This network serves virtually every community in America and, along with more than two million staff and volunteers, delivers the nutritious meals, friendly visits and safety checks that enable America’s seniors to live nourished lives with independence and dignity. By providing funding, leadership, education, research and advocacy support, Meals on Wheels America empowers its local member programs to strengthen their communities, one senior at a time. For more information, see the website:Meals on Wheels of America.

Food Safety of Meals Delivered to Seniors

Many people receive home delivered meals from churches, social organizations, senior assistance groups, or healthcare organizations. Hot or cold ready-prepared meals are perishable and can cause illness when mishandled. Proper handling is essential to ensure the food is safe to eat. Food Safety of meals delivered to older adults

References

Administration for Community Living. (n.d.). Older Americans Act. Retrieved from https://acl.gov/about-acl/authorizing-statutes/older-americans-act#
Administration for Community Living. (2018, January 10). About ACL. Retrieved from https://acl.gov/about-acl
Administration for Community Living. (2019, April 24). Nutrition Services. Retrieved from https://acl.gov/programs/health-wellness/nutrition-services
National Association of Area Agencies on Aging. (2019). Older Americans Act. Retrieved from https://www.n4a.org/olderamericansact
National Association of Area Agencies on Aging. (2017). Area Agencies on Aging- Local Leaders in Aging and Community Living. Washington, DC: National Association of Area Agencies on Aging. Retrieved fromhttps://www.n4a.org/Files/LocalLeadersAAA2017.pdf
Food Research & Action Center. (2018, May). Federal Nutrition Programs and Emergency Food Referral Chart for Older Adults. Retrieved fromhttp://frac.org/research/resource-library/federal-nutrition-programs-emergency-food-referral-chart-older-adults
USDA Food and Nutrition Service. (2018, July). Seniors Farmers’ Market Nutrition Program. Retrieved from https://fns-prod.azureedge.net/sites/default/files/sfmnp/SFMNPFactSheet.pdf
USDA Commodity Supplement Food Program. (2019, March 5). Serving Seniors with a Monthly Food Package. Retrieved fromhttps://www.fns.usda.gov/csfp/commodity-supplemental-food-program
National Council on Aging, E. K. M. (2018, July 6). Serving Seniors with a Monthly Food Package. Retrieved fromhttps://www.fns.usda.gov/csfp/commodity-supplemental-food-program
National Association of Nutrition and Aging Services Programs. (2019). NANASP. Retrieved from http://www.nanasp.org/
Meals on Wheels America. (2019). Meals On Wheels America. Retrieved from https://www.mealsonwheelsamerica.org/
Food Safety.gov. (2019). Food Safety for Home Delivered Meals. Retrieved from https://www.foodsafety.gov/risk/deliveries/index.html

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