Notes from Iona’s Dietitian Nutritionist: Setting the Table for Seniors

October 11, 2016

Rose Clifford, Iona’s licensed dietitian nutritionist, is a senior hunger advocate – a warrior in the tireless fight against senior food insecurity and malnutrition.

I’m often asked what I do in my role as Iona’s licensed dietitian nutritionist. Many think I spend my days telling people to eat this, but not that. “Not quite,” I say. Though I am Iona’s Nutrition Program Manager, I primarily work as a senior hunger advocate – a warrior in the tireless fight against senior food insecurity and malnutrition.

While no one should go hungry or lack access to sufficient healthy food, all older adults are particularly vulnerable to the effects of food insecurity, hunger, and sub-optimal nutrition. The National Foundation to End Senior Hunger’s June 1, 2016 release of the State of Senior Hunger in America 2014 Annual Report found that 1 in 5, or 20% of DC seniors overall face the threat of hunger. DC is ranked #7 in terms of the worst states/communities in the United States for the threat of senior hunger. Imagine that.

I know what you’re thinking: “But, what about Ward 3? There can’t possibly be hungry seniors even in our tidy, mostly well-off Ward 3 neighborhoods?!?!”My response? This is a problem that affects all of DC. In fact, my team and I spend our days tirelessly fighting on the front lines of senior hunger right here in Ward 3.

An Iona Client

Take for example, a current client who is a 77 year old male. In June of this year, he was referred to me by his social worker because he had lost 63 pounds in 6 months. He looked haggard, weak, and underweight. He’d had all kinds of sophisticated, invasive, and costly medical tests and procedures to rule out everything from an undiagnosed malignancy to gastrointestinal disease. All of the testing was inconclusive and provided no cause for his unintentional weight loss.

Imagine his anxiety level and distress, just trying to survive each day in this weakened state. I wish this was an unusual situation or referral, but in Iona’s work, it’s common.

Did anyone think to investigate his nutritional situation or ask this man if he had enough food to eat before thousands of dollars were spent on medical tests? Such a simple, basic human need and right – to have sufficient good-quality food to eat in order to maintain health and a good quality of functioning and life.

Yet, here is an older adult who recently had only $7.00 left of his monthly income to last him the 10 days before he would get another social security check deposit in his bank account. In fact, he was so low on funds that he literally did not have enough money to buy food after the middle of the month.

And while Iona does offer a free lunch for older adults every weekday (and a Farmer’s Market on Mondays) through our Active Wellness Program at St. Alban’s, he didn’t even have the bus fare to regularly get to and from our program. For this client and many others like him, senior hunger is a health issue with very high personal and economic costs.

A Hidden Secret

Senior malnutrition is often a “hidden secret” with devastating individual suffering and societal consequences. The estimated annual cost of disease-associated malnutrition in older adults in the US is $51.3 Billion.

Astoundingly, marginal food insecurity in older adults is functionally equivalent to being 14 years older. Food and nutrition issues are so important to good health and life quality for older adults, but are often poorly understood or go unrecognized. According to the DefeatMalnutrition.Today Coalition, up to 1 out of 2 older adults are at risk for malnutrition and up to 60% of hospitalized older adults may already be malnourished. Malnutrition increases the length of hospital stays, and leads to more complications such as falls and readmissions. Eighty-seven percent of older adults have one or more chronic diseases with nutritional implications, and based on the Healthy Eating Index, 83% of older adults do not consume a good quality diet.

But, back to my client.

Today, he has a steady weight, normal blood sugars (he has diabetes), a better sense of well-being, a community of friends, and a good level of energy and functioning. How did Iona step up to the plate to help him?

First, he was enrolled in our home delivered meals program, and receives 10 fresh Mom’s Meals delivered every two weeks. He also participates in our Weekend Meals program, receiving one hot and one cold meal delivered by our wonderful volunteers every Saturday. He receives several cases of a high calorie/high protein Boost Glucose Control liquid nutrition supplements per month, courtesy of the DC Office on Aging nutrition supplement program and donations from the community. He also receives a monthly donated food package valued at $45 through the Blessed Sacrament SHARE bulk grocery program. His amazing social worker restored his $18.00 per month SNAP (food stamp) benefit, got him new dentures, and also takes him regular deliveries from Iona’s food pantry.

Senior Hunger: A Complex Phenomenon

It’s also important to understand that senior hunger and malnutrition is not limited to low income seniors but is a complex phenomenon that cuts across all income spectrums and is often an access issue. Factors such as poor appetite, unintentional weight loss and frailty, isolation, decreased mobility, cognitive decline, psychosocial and mental health issues, nutrient deficiencies, poor oral health, and lack of transportation are common contributing factors to senior food insecurity and malnutrition. For these and other reasons, older adults or their caregivers are often unable to plan, procure, and prepare adequate, fresh, and nutritionally-balanced meals.

Putting an end to senior hunger and food insecurity in Washington, DC requires a coordinated effort by multiple stakeholders – please help us in our tireless efforts to set the table for our seniors.

Sources: Food and Nutrition for Older Adults: Promoting Health and Wellness

Food and Nutrition Programs for Community-Residing Older Adults

By Rose Clifford, RDN, MBA

Rose Clifford, RDN, MBA has practiced as a registered dietitian nutritionist in the Washington, DC area for over 30 years. Her current primary work as the Nutrition Program Manager for Iona Senior Services focuses on helping older adults maximize their nutritional health so they can live active, full lives in their own homes. Rose is an active member of the DC Office on Aging Nutrition Task Force and is FY17 co-chair of the Food & Nutrition sub-committee of the DC Senior Advisory Coalition.