Malnutrition is a condition that affects many older adults—but it’s not as simple as whether someone eats enough calories every day. Individuals are also at risk if they don’t eat enough of the right things (such as protein, fiber, fluids, vitamins, and minerals) or aren’t able to prepare or eat adequate meals from the food they already have.
What causes malnutrition?
In reality, malnutrition is complex and has multiple causes. The physical effects of aging certainly play a role. Reduced appetite, poor oral health, and sensory changes all affect older adults’ ability to eat and enjoy food. In addition, while muscle mass and strength gradually reduce with age, the need for vitamins, minerals, and protein does not.
Cognitive, psychological, social, and economic factors also impact whether older people are sufficiently nourished. Individuals with dementia often lose interest in solid food and may forget how to chew or swallow. Depression can cause reduced appetite, while social isolation and a limited support network may change seniors’ eating habits or limit their access to nutritious food. Meanwhile, limited income and lack of transportation significantly impact nutrition and food security.
“You have to be a detective,” says Rose Clifford, a Registered Dietitian Nutritionist (RDN) and Senior Nutrition Program Manager for Iona. “As a community dietitian, when I’m doing an assessment, I have to look at a variety of factors. Where do they live, what are their abilities, what exactly do they need or want, who’s their support system?” she says. “I’m trying to find out the best way to maximize this person’s food and nutrition situation.”
Iona’s Nutrition Team
Clifford and Chris Brentin, a Clinical Nutrition Specialist (CNS) at Iona, support a caseload of approximately 75-105 individuals each year with complex medical nutritional situations who are failing to thrive and need extra support from a licensed health professional. These clients experience unintentional weight loss, physical frailty, food insecurity, or poor appetite and may require multiple interventions to help them become stable.
That’s when Iona’s Nutrition team calls in other Iona staff to action. After receiving referrals from external sources, Iona’s Helpline, and Iona case managers, the Nutrition team works with program staff and volunteers to connect vulnerable individuals to critical services such as nutritional counseling, nutritional supplements, Iona’s Food Pantry Plus, home delivered meals, and case management services. Nutrition clients receive monthly check-ins and home-delivered nutritional supplements, in addition to meals and groceries as needed.
Malnutrition and COVID-19
In a recent emergency referral, a new client, 81, was connected to Iona’s Nutrition team after a COVID-19 contact tracer called Iona’s Helpline. Although the woman was asymptomatic, she was stuck at home in quarantine with only two days of food left. She was employed full-time at a local grocery store but had no money for her January rent because she wasn’t able to leave the house to go to work. In addition, English wasn’t the woman’s first language, so she needed help completing online COVID-19 leave forms that could provide her with financial relief.
Iona’s Nutrition team and staff immediately went to work by:
- Enrolling the client in emergency frozen meals
- Sending an off-hours Food Pantry Plus delivery with groceries, cleaning supplies, and a case of Boost Glucose Control for extra calories (client is diabetic)
- Coordinating touchless delivery of meals and groceries so client wouldn’t have to leave her apartment
- Researching rent assistance to help her with January rent (Iona case manager)
Thanks to their passion and dedication, Iona’s Nutrition team and staff play an essential role in ensuring that at-risk older adults receive the supports and resources they need in order to stay safe.
By Lauren Stephenson