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Food Security in Older Adults: Community Service Provider Perceptions of Their Roles*

Published online by Cambridge University Press:  31 March 2010

Heather H. Keller ,
John J.M. Dwyer ,
Vicki Edwards ,
Christine Senson  and
H. Gayle Edward
Heather H. Keller*
Affiliation:
Department of Family Relations and Applied Nutrition, University of Guelph
John J.M. Dwyer
Affiliation:
Department of Family Relations and Applied Nutrition, University of Guelph Hamilton Public Health Services
Vicki Edwards
Affiliation:
Hamilton Public Health Services
Christine Senson
Affiliation:
Hamilton Public Health Services
H. Gayle Edward
Affiliation:
Department of Family Relations and Applied Nutrition, University of Guelph
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Dr. Heather H. Keller, Department of Family Relations and Applied Human Nutrition, Macdonald Institute, University of Guelph, Guelph, ON N1G 2W1. ([email protected])
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Abstract

Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food security, and (c) opinions about constraints that influenced these roles. A constant comparison analysis identified key themes. The formal caregivers reported six roles for improving food security: (a) monitoring, (b) coordination, and (c) promoting services, (d) education, (e) advocacy, and (f) providing a social environment. The final theme summarizes these roles as “the need for personalization of service”. Social and community service providers are involved in roles that can promote the health of older adults by addressing their food insecurity. Social service providers need to be acknowledged and supported in this health promotion role.

Résumé

L'insécurité alimentaire chez les adultes plus âgés est influencée par les contraintes financières, l'incapacité fonctionnelle, et l'isolation. Vingt-huit fournisseurs de services sociaux et communautaires ont participé à quatre groupes de discussion ayant porté sur: a) les perceptions et les expériences en matière d'insécurité alimentaire chez leurs clients plus âgés; b) leur perception quant à leur rôle visant à promouvoir la sécurité alimentaire; et c) leur opinion quant aux contraintes ayant eu une influence sur ces rôles. Une analyse par comparaison continue a permis d'identifier les principaux thèmes. Les fournisseurs de soins formels ont fait état de six rôles visant à améliorer la sécurité alimentaire: a) surveillance, b) coordination et c) promotion des services, d) éducation, e) défense des intérêts, et f) fourniture d'un environnement social. Le thème final résume ces rôles comme « le besoin de personnaliser les services ». Les fournisseurs de services sociaux et communautaires jouent un rôle qui peut promouvoir la santé des adultes plus âgés par le truchement de leur insécurité alimentaire. Les fournisseurs de services sociaux doivent être reconnus et soutenus dans leur rôle de promoteurs de la santé.

Keywords

agingfood insecurityolder adultsservice providersvieillissementinsécurité alimentaireadultes plus âgésfournisseurs de services
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue 4 , Winter/Hiver 2007 , pp. 317 - 328
Copyright
Copyright © Canadian Association on Gerontology 2007

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Footnotes

*

This study was funded by the Hamilton Public Health and Community Services.

References

Anderson, S.A. (1990). Core indicators of nutritional state for difficult-to-sample populations. Journal of Nutrition, 120, 1559–1600.CrossRefGoogle Scholar
Arcury, T.A., Quandt, S.A., Bell, R.A., McDonald, J., & Vitolins, M.Z. (1998). Barriers to nutritional well-being of rural elders: Community experts' perceptions. Gerontologist, 38, 490–498.CrossRefGoogle ScholarPubMed
Bartali, B., Salvini, S., Turrini, A., Lauretani, F., Russo, C.R., Corsi, A.M., et al. (2003). Age and disability affect dietary intake. Journal of Nutrition, 133, 2868–2873.CrossRefGoogle ScholarPubMed
Brown, I., & Raphael, D. (2002). Improving the quality of life of Canadian seniors. Retrieved 15 Oct. 2005 from http://www.utoronto.ca/seniors/ProjectProposals.pdf.Google Scholar
Brunt, A.R., Schafer, E., & Oakland, M.J. (2000). Ability of social support to predict at-risk dietary intake and anthropometric measures in white, rural, community-dwelling elderly women. Journal of Nutrition for the Elderly, 19, 49–69.CrossRefGoogle Scholar
City of Hamilton. (n.d.). Hamilton's community profile. Retrieved 14 Nov. 2006 from http://www.myhamilton.ca/myhamilton/cityandgovernment/citydepartments/planningecdev/longrangeplanning/informationplanning/factsandfigures.htm.Google Scholar
City of Hamilton (2005). City of Hamilton Public Health and Community Services Department social and health issues report 2005. Retrieved 14 Nov. 2006 from http://www.myhamilton.ca/myhamilton/CityandGovernment/HealthandSocialServices/Research/SHIR.htm.Google Scholar
Coulston, A.M., Craig, L., & Voss, A.C. (1996). Meals-on-wheels applicants are a population at risk for poor nutritional status. Journal of the American Dietetic Association, 96, 570–573.CrossRefGoogle ScholarPubMed
Council on Practice Quality Management Committee (1994). Identifying patients at risk: ADA's definitions for nutrition screening and nutrition assessment. Journal of the American Dietetic Association, 94, 838–839.CrossRefGoogle Scholar
Davidson, J., & Getz, M. (2004). Nutritional risk and body composition in free-living elderly participating in congregate meal-site programs. Journal of Nutrition for the Elderly, 24, 53–68.CrossRefGoogle ScholarPubMed
DeWolfe, J., & Millan, K. (2003). Dietary intake of older adults in the Kingston area. Canadian Journal of Dietetic Practice and Research, 64, 16–24.CrossRefGoogle ScholarPubMed
Dietitians of Canada (2005). Individual and household food insecurity in Canada: Position of Dietitians of Canada. Canadian Journal of Dietetic Practice and Research, 66, 43–46.CrossRefGoogle Scholar
Donkin, A.J., Johnson, A.E., Morgan, K., Neale, R.J., Page, R.M., & Silburn, R.L. (1998). Gender and living alone as determinants of fruit and vegetable consumption among the elderly living at home in urban Nottingham. Appetite, 30, 39–51.CrossRefGoogle ScholarPubMed
Flick, U. (1998). An introduction to qualitative research. Thousand Oaks, CA: Sage Publications Inc.Google Scholar
Frongillo, E.A., & Horan, C.M. (2004). Hunger and aging. Generations: Journal of the American Society on Aging, 28, 28–34.Google Scholar
Hayward, K., & Rootman, I. (2001). People's voices: Poverty and health services in Toronto final report. Retrieved 14 Nov. 2006 from http://www.utoronto.ca/chp/ReportsandPresentations.htm.Google Scholar
Health Canada [Health Policy and Communications Branch] (1986). Achieving health for all: A framework for health promotion. Retrieved 1 Nov. 2007 from http://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/1986-frame-plan-promotion/index_e.html.Google Scholar
Johnson, C.S., & Garcia, A.C. (2003). Dietary and activity profiles of selected immigrant older adults in Canada. Journal of Nutrition for the Elderly, 23, 23–39.CrossRefGoogle ScholarPubMed
Keller, H.H. (2005). Reliance on others for food-related activities of daily living. Journal of Nutrition for the Elderly, 25, 43–59.CrossRefGoogle ScholarPubMed
Keller, H.H., Goy, R., & Kane, S-L (2005). Validity and reliability of SCREEN II (Seniors in the Community: Risk Evaluation for Eating and Nutrition—version II). European Journal of Clinical Nutrition, 51, 1149–1157.CrossRefGoogle Scholar
Keller, H.H., & Hedley, M.R. (2002). Nutritional risk needs assessment of community-living seniors: Prevalence of nutrition problems and priorities for action. Journal of Community Health, 27, 121–132.CrossRefGoogle ScholarPubMed
Keller, H.H., Hedley, M.R., & Wong Brownlee, S. (2000). The development of Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN). Canadian Journal of Dietetic Practice and Research, 61, 67–72.Google ScholarPubMed
Keller, H.H., & McKenzie, J.D. (2003). Nutritional risk in vulnerable community-living seniors. Canadian Journal of Dietetic Practice and Research, 64, 195–201.CrossRefGoogle ScholarPubMed
Keller, H.H., McKenzie, J.D., & Goy, R.E. (2001). Construct validation and test–retest reliability of Seniors in the Community: Risk Evaluation for Eating and Nutrition questionnaire. Journals of Gerontology A: Biological Science and Medical Science, 56, M552–M558.Google ScholarPubMed
Keller, H.H., Østbye, T., Bright-See, E., & Campbell, M.K. (1999). Activity limitation and food intake in community-living seniors. Canadian Journal on Aging, 18, 47–63.CrossRefGoogle Scholar
Kempson, K., Palmer Keenan, D.P., Sadani, P.S., & Adler, A. (2003). Maintaining food sufficiency: Coping strategies identified by limited-resource individuals versus nutrition educators. Journal of Nutrition Education and Behavior, 35, 179–188.CrossRefGoogle ScholarPubMed
Kempson, K.M., Palmer Keenan, D., Sadani, P.S., Ridlen, S., & Scotto Rosato, N. (2002). Food management practices used by people with limited resources to maintain food sufficiency as reported by nutrition educators. Journal of the American Dietetic Association, 102, 1795–1799.CrossRefGoogle ScholarPubMed
Krueger, R.A., & Casey, M.A. (2000). Focus groups: A practical guide for applied research. (3rd ed.). Thousand Oaks, CA: Sage.Google Scholar
Lee, J.S., Frongillo, E.A., & Olson, C.M. Jr (2005). Conceptualizing and assessing nutrition needs: Perspectives of local program providers. Journal of Nutrition for the Elderly, 25, 61–81.CrossRefGoogle ScholarPubMed
Madriz, E. (2000). Focus groups in feminist research. In Denzin, N.K., & Lincoln, Y.S. (Eds.), Handbook of qualitative research (pp. 835–850). Thousands Oaks, CA: Sage.Google Scholar
Margetts, B.M., Thompson, R.L., Elia, M., & Jackson, A.A. (2003). Prevalence of risk of undernutrition is associated with poor health status in older people in the U.K. European Journal of Clinical Nutrition, 57, 69–74.CrossRefGoogle Scholar
McDonald, J., Quandt, S.A., Arcury, T.A., Bell, R.A., & Vitolins, M.Z. (2000). On their own: Nutritional self-management strategies of rural widowers. Gerontologist, 40, 480–491.CrossRefGoogle ScholarPubMed
Morgan, D.L. (1988). The focus group guidebook. Thousand Oaks, CA: Sage.Google Scholar
Morse, J.M., & Richards, L. (1998). Read me first for a user's guide to qualitative methods. Thousand Oaks, CA: Sage.Google Scholar
National Advisory Council on Aging. (n.d.) Seniors and disabilities: Overview and trends. Expression Newsletter 11(1). Retrieved 14 Oct. 2006 from http://www.naca-ccnta.ca/expression/11-1/exp11-1_3_e.htm.Google Scholar
National Advisory Council on Aging (1990). The NACA position: On community services in health care for seniors. Retrieved 23 Aug. 2006 from http://www.naca.ca/publications_e.htm#position.Google Scholar
Nelson, K., Cunningham, W., Andersen, R., Harrison, G., & Gelberg, L. (2001). Is food insufficiency associated with health status and health care utilization among adults with diabetes? Journal of General Internal Medicine, 16(6), 404–411.CrossRefGoogle ScholarPubMed
Nord, M., Andrews, M., & Carlson, S. (2003). Household food security in the United States, 2002 ( Food Assistance and Nutrition Research Report No. 35). Washington, DC: Department of Agriculture, Economic Research Service.Google Scholar
Payette, H., & Gray-Donald, K. (1994). Risk of malnutrition in an elderly population receiving homecare services. Facts and Research in Gerontology Suppl. 271–85.Google Scholar
Public Health Agency of Canada (2005). The Canadian Population is aging … Canada's Seniors at a Glance. Retrieved 14 Oct. 2006 from http://www.phac-aspc.gc.ca/seniors-aines/pubs/seniors_at_glance/poster2_e.html#a.Google Scholar
Raphael, D. (2004). Social determinants of health: Canadian perspectives. Toronto, ON: Canadian Scholars' Press.Google Scholar
Rainville, B., & Brink, S. (2001). Food insecurity in Canada, 1998–1999. Ottawa: Human Resources Development Canada, Applied Research Branch of Strategic Policy.Google Scholar
Reuben, D.B., Greendale, G.A., & Harrison, G.G. (1995). Nutrition screening in older persons. Journal of the American Geriatrics Society, 43, 415–425.CrossRefGoogle ScholarPubMed
Sharkey, J.R. (2002). The interrelationship of nutritional risk factors, indicators of nutritional risk, and severity of disability among home-delivered meal participants. Gerontologist, 42, 373–380.CrossRefGoogle ScholarPubMed
Sharkey, J.R. (2003). Risk and presence of food insufficiency are associated with low nutrient intakes and multi-morbidity among homebound older women who receive home-delivered meals. Journal of Nutrition, 133, 3485–3491.CrossRefGoogle Scholar
Torres-Gil, F.M. (1996). Malnutrition and hunger in the elderly. Nutrition Reviews, 54, S7–S8.CrossRefGoogle ScholarPubMed
Townsend, M.S., Peerson, J., Love, B., Achterberg, C., & Murphy, S.P. (2001). Food insecurity is positively related to overweight in women. Journal of Nutrition, 131(6), 1738–1745.CrossRefGoogle ScholarPubMed
Vitolins, M.Z., Quandt, S.A., Case, L.D., Bell, R.A., Arcury, T.A., & McDonald, J. (2000). Ethnic and gender variation in the dietary intake of rural elders. Journal of Nutrition for the Elderly, 19, 15–29.CrossRefGoogle Scholar
Vozoris, N.T., & Tarasuk, V.S. (2003). Household food insufficiency is associated with poorer health. Journal of Nutrition, 133, 120–126.CrossRefGoogle ScholarPubMed
White, J.V., Ham, R.J., Lipschitz, D.A., Dwyer, J.T., & Wellman, N.S. (1991). Consensus of the Nutrition Screening Initiative: Risk factors and indicators of poor nutritional status in older Americans. Journal of the American Dietetic Association, 91, 783–787.CrossRefGoogle ScholarPubMed
Wolfe, W.S., Frongillo, E.A. Jr, & Valois, P. (2003). Understanding the experience of food insecurity by elders suggests ways to improve its measurement. Journal of Nutrition, 133, 2762–2769.CrossRefGoogle ScholarPubMed
Wolfe, W.S., Olson, C.M., Kendall, A., & Frongillo, E.A. Jr (1996). Understanding food insecurity in the elderly: A conceptual framework. Journal of Nutrition Education, 28, 92–100.CrossRefGoogle Scholar
World Health Organisation. (n.d.). Ottawa charter for health promotion, 1986. Retrieved 31 Oct. 2006 from http://www.euro.who.int/AboutWHO/Policy/20010827_2.Google Scholar