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OBSERVATIONS

Reports that have come in from the various programs being conducted across the country contain valuable information on practical problems and solutions, successful approaches, and recommendations for the improvement of the program. These reports have yielded a series of findings which contravert many commonly held misconceptions regarding nutrition programs for the aged.

Fallacy #1

The aged aren't interested in nutrition programs.

The Fact:

Not only are the aged interested, they come to programs
in rain, snow, and summer heat. They wait patiently for
hours to ensure themselves a place at mealtime.

Fallacy #2

As soon as you initiate a program, participants will come.

The Fact:

While a new program may attract many participants, it
will not attract those in direst need the isolated aged
residing in the community. The very nature of social
isolation is such as to preclude participation in such a
program unless concerted case-finding efforts are made.

Fallacy #3

The aged won't or can't learn about nutrition.

The Fact:

The food and nutrition information and education aspects of the
projects are regarded as successful in terms of providing
the aged with a better understanding of nutrition, food prepara-
tion, budgeting and efficient shopping, and providing a better
orientation toward beneficial eating patterns.

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Fallacy #4

Nutrition education programs need deal only with nutrition education, per se.

The Fact:

The more successful nutrition education programs deal with a variety of problems, not only those relating to food, but also to health care, social security benefits, me dicare and medicaide, housing, transportation, etc.

Fallacy #5

Feeding the aged won't make any difference in their lives.

The Fact:

Many of the aged in the programs are receiving adequate food for the first time in many years. But in addition to the nutritional aspects of the program, virtually all program directors report a startling change in the elderly participants. After a time they begin to dress better, develop friendships, become more conscious of health care, and take a livelier interest in social activities.

Fallacy #6

All the aged need is food; this could be provided through various forms of direct income maintenance, not requiring formal meals.

The Fact:

Program staffs have observed that the nutrition problems of the aged stem from multiple causes, and that no single approach could effectively overcome existing obstacles to adequate food and nutrition. Project personnel agree that the provision of some form of income subsidy alone would not be the solution. The problems of nutrition among the aged are closely related to a complex of social, psychological, and physiological factors.

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Fallacy #7

The facilities in which the programs are conducted makes no difference.

The Fact:

Accessibility to the aged population is the most important criterion for the success of any program. The facility should be near the dwellings of the elderly or near convenient transportation. Moreover, projects appear to get underway more easily and quickly when they are located in facilities such as senior centers, where there is an existing program for the aged and patterns of attendance have already been established.

Fallacy #8

Transportation poses no particular problem to the aged.

The Fact:

The lack of adequate transportation facilities poses a tremendous barrier to the aged, not only to participation in nutrition programs but to many other activities that are vita. to their well-being.

Fallacy #9

The aged are too disinterested or too infirm to help in the maintenance of nutrition programs.

The Fact:

Indigenous aides are extremely helpful, both as paid workers and as unpaid volunteers. Many of the aged are quite eager to participate in some meaningful activity an opportunity which has been denied many of them for years. In addition to assisting with the preparation and serving of meals and in counseling members of their peer groups, these aides have often become an important part of the "outreach" program in several projects. Experience suggests that older people who live in the neighborhood, know its inhabitants and are aware of those in need of service, can be particularly effective and persuasive in promoting program enrollment.

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Fallacy #10

The aged just want to be left alone.

The Fact:

The aged generally respond to given social situations in ways that are characteristic of younger people. When rejected by others, they will learn to be alone, albeit unhappily, and will assume the attitudes of the isolated. Brought into a social context and reoriented toward social interaction, they show quick and marked change. Moreover, this process of resocialization appears crucial to the success of nutrition programs. Again and again program participants have told staff members that when they are alone, without family or friends, there is just no reason to cook. The nutrition programs are specifically directed toward overcoming this lack of motivation.

Fallacy #11

To conduct a nutrition program it is necessary to have extensive kitchen facilities with health department approval.

The Fact:

While there are advantages to on-site preparation of meals, a number of programs rely on the purchase of meals in bulk or in individual packages. It would appear that the cost of commercially prepared meals in some areas is not substantially greater than that of meals prepared on-site, particularly if it obviates the cost of additional staff and extensive building alterations.

CONCLUSION:

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The nutrition problems of the aged stem from multiple causes and the experience of the Administration on Aging's nutrition program would indicate that no single approach could be effective in overcoming obstacles to adequate food and nutrition.

Certainly many of the aged cannot afford to buy those foods which are essential to meeting nutritional needs. At the same time, it has become apparent that the mere provision of an income subsidy would not produce solutions for all the social, psychological and healthrelated factors that contribute to malnutrition and undernutrition of the aged. Raising the income level would not motivate the aged person to cook for himself alone; it would not help the invalid to shop; it would not alleviate the feelings of loneliness, rejection, and apathy; it would not help the aged person to understand the need for a nutritionally adequate diet, or how to achieve it. Nor would it produce solutions to such everyday problems as housing and transportation which are inseparable from the problem of nutrition.

Experience to date demonstrates that the most effective program to combat the food and nutrition problems of the aged needs to be a comprehensive program designed to meet all these related needs. The provision of meals in a group setting is a highly desirable approach because it fosters social interaction, facilitates the delivery of other services, and meets emotional needs of the aged while improving their nutrition.