Long-term support referrals to enhance food security and well-being in older adults: Texas physicians and nurses on what works

Aim

Senior participation in the congregate meal programs (CMPs) has alarmingly declined over the past decade in Texas as elsewhere in the nation. The purpose of this survey study was to identify the possible reasons for this decline from the viewpoint of the Texas physicians and nurses who are key in coordinating care and ensuring food security for the vulnerable older Texans by referring them to community-based long-term support services (LTSS).

Subject and methods

The methodology adopted was an online panel survey of physicians and nurses from rural and urban Texas counties. Structured multiple-choice and open-ended questions primarily focused on provider referral processes, reasons for connecting older clients to CMPs, perceptions about various aspects of these programs, possible reasons for the decline in participation, suggestions to make the programs an integral part of the community-based LTSS referral system, and how to address the COVID-19 pandemic constraints on the programs.

Results

As a majority of the healthcare providers surveyed were unaware of the CMPs in their communities, the study spotlighted an urgent need for a better-coordinated referral process centered on strategic marketing and awareness-building about the CMPs, including an extensive healthcare provider education component as well as an overall improvement in meal quality and variety.

Conclusion

The study highlights a need for additional research so decision-makers better understand how to best disseminate information to healthcare providers to improve the referral mechanisms, increase the referrals, and enhance the overall CMP program quality to benefit the vulnerable food-insecure older adults.

A State-Level Review of Diversity Initiatives in Congregate Meal Programs Established Under the Older Americans Act

The Older Americans Act (OAA) congregate meal program (CMP) targets those most at risk for nutritional deficiencies, social isolation, and institutionalization. Social minorities (racial, ethnic, cultural, and sexual minorities) are at high risk for all three. This study explores state-level diversity initiatives to welcome these social minorities in CMPs. A national survey was distributed to each State Unit on Aging, all but three states participated. The majority of states (64.6%) target CMPs to a specific racial, ethnic, or cultural minority; five states target sexual minorities (lesbian, gay, bisexual, and transgender [LGBT]). Negative binomial regression results find state minority population percentage is a significant predictor of the number of diversity initiatives at CMPs. States with LGBT CMPs reported the highest levels of racial/ethnic/cultural diversity initiatives and high levels of statewide LGBT protective policies. Recommendations are suggested that build upon the diversification success of states to further the mission of OAA in reaching high-risk older adults.

Dietary and activity profiles of selected immigrant older adults in Canada

In Canada, the population of older adults is becoming ethnically diverse. However, our understanding of the health behaviors including diet and physical activity among this group is limited. The purpose of this study is to examine the dietary and physical activity profiles, and the factors that influence these behaviors, among older immigrants. The sample included 54 participants (mean age = 68 +/- 6 years) from Cambodian, Latin-American, Vietnamese and Polish groups. Measures included background questionnaire, nutrition screening tool, 24-hour dietary recall, and physical activity assessment. Results showed that 72.5% were at moderate to high risk for poor nutrition. Identified dietary issues were related to food preparation, nutrition management for diseases, and nutritional needs of the elderly. Although 83.3% reported to be physically active, the level was less than optimal, and barriers to physical activity were identified. The results are further discussed in light of health promotion and nutrition education among immigrant older adults.