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Part I Introduction to Nutrition Care in Older Adults

ADMINISTRATION ON AGING PROGRAMS

Older Americans Act Nutrition

Program Administration on Aging’s (AoA) Older Americans Act Nutrition Program (OAANP), also known as the Elderly Nutrition Program, provides grants to support nutrition services for older people throughout the country who may be at risk of losing their indepen- dence. The program is authorized under Title III, Grants for State and Community Pro grams on Aging, and Title VI, Grants for Native Americans, under the Older Americans Act (OAA) (17). AoA awards funds for nutrition and supportive home- and community - based services to the 56 State Units on Aging (SUAs), 629 Area Agencies on Aging, 244 tribal organizations, and 2 Native Hawaiian organizations. Funds also are awarded for disease prevention/health promotion, elder rights (long-term care ombudsman program, legal ser- vices, and elder abuse prevention efforts), the National Family Caregiver Support Program (NFCSP), and the Native American Caregiver Support Program (NACSP) (18).

The purpose of the OAANP (OAA Section 330) is to promote the health and well-being of older adults by:

● ● ● reducing hunger and food insecurity; promoting socialization of older individuals; and

delaying adverse health conditions using access to nutrition and other disease-prevention and health-promotion services (19).

The OAANP provides for congregate and home-delivered meals. These meals and other nutrition services are provided in a variety of group settings such as senior centers, faith-based settings, and schools, or by home delivery to older individuals who are homebound due to illness, disability, or geographic isolation.

The OAANP also provides a range of related ser- vices through the aging network’s estimated 4,000 nutrition service providers. In more traditional senior center settings, participants may be provided access to other services such as nutrition screening and educa- tion, nutrition assessment, and counseling as appropri- ate. These services can include special health assessments for such diseases as hypertension and dia- betes (17,20).

Meals served under the OAANP must provide at least one-third of the daily Dietary Reference Intakes (DRIs) and use the Dietary Guidelines for Amer icans as a basis for menu planning. As well as meeting nutrient requirements, menus need to reflect

the food preferences and needs of participants and must be planned with the advice of an RDN or indi- vidual with comparable expertise (17,21). Approx- imately 3 million elderly participants are receiving an estimated 30% to 50% of the daily required nutri- ents from meals provided by the program (10,17). Eligibility for program participation is not based on income status. Individuals are given the opportunity to make a donation toward the cost of the meals and other services. The OAA authorizes and provides appropriations

to the AoA in three sections of the OAA: ●

● Congregate Nutrition Services (Title III C1)

● Home-Delivered Nutrition Services (Title III C2) Nutrition Services Incentive Program (NSIP)

Grants for Congregate Nutrition Services and Home- Delivered Nutrition Services are allocated to states and territories by a formula based on several factors:

● population factor

● minimum allotment ●

hold-harmless/guaranteed growth amount, or ini- tially by population, then by the greater of the minimum allotment or hold-harmless/guaranteed growth amount (20)

Program participants are screened for nutritional risk based on the Nutrition Screening Initiative’s DETERMINE Checklist (see Chapter 6). Participants must answer 10 weighted statements that focus on food group intake, oral problems, financial resources, social- ization, medication usage, weight patterns, and physi- cal limitations. Involvement in this program is also associated with higher levels of socialization in both ambulatory and homebound elderly adults. This is key because of the relationship between social isolation and poor nutritional status (22).

Congregate Nutrition Services Congregate meals are offered in a variety of settings, such as in senior centers, community and faith-based facilities, schools, and adult daycare facilities. Meals are served five or more days per week, where feasible, and can include breakfast, lunch, dinner, or any combi- nation of these meals that meets the needs of partici- pants. Some communities have even offered congregate meals in local restaurants in the absence of other facilities. The program also allows participants opportunities for social engagement and meaningful volunteer roles, which contribute to overall health and well-being (20). Services are available to individuals age 60 or over and to the spouse of an older individual regardless of