Elder Advocates Take Aggressive, Proactive Stance Against Malnutrition

Nearly one in two older Americans is at risk for malnutrition, at an estimated cost of $51.3 billion annually to treat diseases related to the condition. Elder advocates have taken an aggressive stance on eradicating this public health threat. 
The 2017 International Association of Gerontology and Geriatrics World Congress in San Fran­cisco, together with the American Society on Aging, hosted a July 25, 2017, 90-minute symposium: “Nutrition for Healthy Aging: Policy and Practice.” Presenters were ASA Board Chair Bob Blan­cato, president of Matz, Blancato & Associates, Meredith Ponder Whitmire, senior associate,  Matz, Blancato & Associates, and ASA Board member Paul Downey, president/CEO of Serving Seniors. 
“Of all the things that beset older adults as they age, the most insidious of them all is malnutri­tion,” said Blancato in his opening remarks. Distinct from hunger and food insecurity, malnutrition is a serious health threat to elders’ physical and mental health; it is prevalent in 20 percent to 50 percent of older patients admitted to hospitals, but is only diagnosed in 7 percent of patients. 
Blancato, who also serves as executive director of the National Association of Nutrition and Aging Services Programs, introduced Ponder Whitmire, who spoke about a “comprehensive, coordinated solution” in the form of DefeatMalnutrition.Today, a multi-disci­plinary coalition of 60 organizations working to combat older adult malnutrition by increasing aware­ness about the problem, creating and proposing policy solutions and acting to change policy. 
The coalition has united groups with a broad range of foci on nutrition, wellness, faith, aging, health, business and more. The coalition’s push for clinical quality measures on efforts made to treat and eliminate malnutrition is key, says Ponder Whitmire, and “quality measures are so impor­tant to supporting Medicare reimbursement.” 
The coalition created the National Blueprint: Achieving Quality Malnutrition Care for Older Adults, released this past March, which details mal­nutrition care across acute, post-acute and community settings and suggests strategies for policy makers, organizations, healthcare providers, patients and caregivers to address malnutrition. Stressing the importance of cooperation, Ponder Whitmire added, “Without collaboration, we cannot implement all of the Blueprint’s solutions.” 
Blancato then overviewed current policy issues and challenges related to eldercare advocacy 
in Washington, D.C., and emphasized influential legislation that would affect eldercare and 
health, including the effort to stanch malnutrition. One important bill up for renewal in 2018 is 
the Farm Bill, he noted, which funds food assistance programs such as SNAP and the Senior 
Farmers Market Nutrition program. 
Although the federal Administration for Community Living (ACL) supports senior nutrition programs and services, helping to fund, under the Community Development Block Grant program, services like Meals on Wheels, this assistance also faces cuts under the proposed FY 2018 budget. October 1, 2017, is the countdown to the new fiscal year, so while the recourse is to “wait things out and when the time comes, to weigh in—your voice matters,” Blancato said. 
Research on the negative effects of malnutrition and on positive effects of nutritious food as medicine, Blancato emphasized, is crucial: “It’s more than just a meal we’re talking about. There also is value in the socialization aspect.” Home-delivered meals, he says, help combat the growing problem of social isolation among older adults. 
Paul Downey, who heads San Diego, Calif.-based Serving Seniors, continued the discussion on current fiscal constraints, outlining a practical, proven plan to help social services organizations continue offering their programs and services to elders. 
Since beginning his role with Serving Seniors in 1995 (and prior, serving as a volunteer), Downey says he has learned much about poverty—and the stigma and myths surrounding it. The current Federal Poverty Level (FPL) stands at $12,060 per year, or $1,005 per month. In California, 11 per­cent of elders ages 65 and older live below the FPL, and one in two of the state’s elders do not have enough income to cover their basic needs—food, housing, transportation and healthcare. 
Getting to know Serving Seniors clients, especially a woman named Stella, Downey was able to prove false one pervasive poverty myth—that people in poverty don’t work hard or achieve some­thing meaningful in their lives. A single mother, Stella lived 83 years in poverty, but successfully raised her five children. “This is what success looks like,” said Downey, “and [Stella’s] story taught me much about people who live in poverty.” 
So that Serving Seniors can continue providing its core services, the organization relies par­tially on supports from the Older Americans Act, as well as small contributions from its clientele. Though his organization is “driven by mission,” Downey says a primary strategy is to manage costs: “A dollar saved is a dollar raised.” 
Community-based organizations (CBO) need to quantify not just fiscal ROI, but also social ROI, e.g., “we provided someone with a meal, or we kept people out of the hospital.” Having program data to show funders is crucial, but Downey emphasized social ROI, saying organizations need to have “a compelling story for funders.” Any stories that relate positive results in keeping elders healthy and independent (and ER visits and costs down)—and able to give back to community—are the most effective. 
Downey’s final strategy for CBOs is to “leverage collaborations.” For example, Serving Seniors acquires building space, and offers “free” rent to collaborators who can provide needed services to clientele. And there is an added advantage to collaborations of data-sharing and coordinated care. Seeking collaborators is a strategic part of advocacy, Downey says, “[CBOs] need to be in the game: make friends at even the lowest level of elected officials—invite them out to your orga­nization. 
“You have the power,” he added. 

Editor’s Note: This article appears in the September/October, 2017, issue of Aging Today, ASA’s bi-monthly newspaper covering issues in aging research, practice and policy nationwide. ASA members receive Aging Today as a member benefit; non-members may purchase subscriptions at our online store.