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Eating Well
UI Northern Idaho Program Wins National Acclaim Helping Seniors Avoid High Nutritional Risk
By Bill Loftus
Across Idaho and the United States, senior citizen numbers are growing. In Kootenai County alone, enticing beautiful scenery and an aging population combined to boost senior numbers by nearly 43 percent during the 1990s.
Alarmed by statistics indicating that malnutrition and hunger confronted several hundred of northern Idaho's senior population, the University of Idaho Extension Nutrition Pro-gram pursued a unique partnership. Two years ago, an assessment by Coeur d'Alene's Aging and Adult Services (AAS), a non-profit agency funded through federal, state, and private sources, showed nearly half of 750 service recipients in five northern Idaho counties were at high nutritional risk.
"That is a really big number," says Shelly Johnson, head of the UI Senior Extension Nutrition Program out of Coeur d'Alene. "Research shows seniors at high nutritional risk spend more on health care, make more visits to the doctor, and they have longer hospital stays."
So Johnson and AAS Director Pearl Bouchard teamed up. Johnson hires and trains three nutrition advisors for northern Idaho. Bouchard picks up the bill when they visit her at-risk clients. The team effort scores dramatic results and has won national attention.
For senior citizen Fern Clark of Coeur d'Alene, working with Pam Schilling Dlouhy, one UI nutrition advisor, means "my menu expanded." She now incorporates a greater variety of vegetables in her cooking, shifting from canned to frozen and fresh products.
Nutrition-independence connection
Most important for seniors, perhaps, is that their independence relies on good nutrition and good health. Sen-iors who leave the hospital after ex-tended stays often don't return home, going instead to nursing homes.
The Senior Extension Nutrition Program emphasizes the basics-the importance of a healthy diet to long-term health, meal planning, quick and low-cost meal preparation, and the benefits of eating fruits, vegetables, and whole-grains. It also offers advice specifically tailored to seniors-how medications or health conditions can affect appetite, implications of sudden weight gain or loss, and ways to make eating by yourself a pleasant experience. (See box.)
Advisors provide six in-home lessons and help seniors connect to food-related services ranging from senior centers to community food banks and food stamps. The Idaho Department of Health and Welfare trains advisors to help seniors apply for food stamps without leaving home.
Bouchard's interest in a team approach grew after working eight years with seniors. "We were re-quired to do nutrition screenings. We entered all of the information into our files and gave them nutrition information. That was the end of it. It was frustrating to me that we would determine that someone was at risk, and there was no way to get them the help they needed."
Then she met the UI's Johnson, who already was running a food stamp nutrition education program that required nutrition specialists to visit homes of seniors. "The more we talked," Bouchard said, "the more we got excited."
At first, case managers seemed reluctant to refer clients for nutritional advice because they "tended to think that older people already have their eating habits set, and they aren't interested in new things," recalls Bouchard." Advisor experience quickly found the opposite.
Home visits make a difference
The three UI Extension nutrition advisors make home visits to at-risk seniors in Benewah, Bonner, Boundary, Kootenai, and Shoshone counties. Re-ferrals keep advisors busy, averaging 50 home visits a month. The program helped 160 seniors in its first two years.
Surveys show how well the program works. The number of seniors eating calcium-rich foods jumped from 57 to 88 percent; the number of participants who increased their consumption of water and prepared foods in ways that made them easier to chew and swallow doubled. None ran out of food before the end of the month, compared to one in 10 before the advisors began to visit. All seniors also report eating three to five times a day, the recommended frequency.
"I'm not a spring chicken, either"
More men having to cook, as wives die or find their health compromised, is one trend advisors find. At 81, Norm Sheard took over cooking duties early this year. Pam Dlouhy works with the Post Falls couple. "Since [my wife] Carol has diabetes and all that goes with it, Pam's just been teaching us how to eat a better planned meal for the both of us, because I'm not a spring chicken anymore either, you know," says Sheard.
A retired farmer and excavating contractor, Norm said during most of their marriage, "I was gone in the field or somewhere all day long and usually just came home to eat, so I didn't get in on the cooking. But I've had to learn."
Program receives national recognition
The Idaho program is one of seven nationally recognized "for innovation and quality in healthcare and aging" during the April 2004 joint conference of the American Society on Aging and the National Council on Aging in San Francisco.
It is seen as a model that other regions in Idaho and elsewhere may adopt. Bouchard and Johnson are responding to requests for information as they come in. Meanwhile, fewer Idaho seniors are at nutritional risk.
Contact Shelly Johnson, sjohnson@uidaho.edu.
Box
Tips for Eating Alone
1. Buy foods that are high in nutrition and easy to prepare:
Peanut butter and whole-grain crackers
Tuna or canned salmon and whole-grain crackers
Cheese and crackers
Cottage cheese and canned fruit
Yogurt, graham crackers, and applesauce
Cold cereal and low-fat milk
Fresh fruit such as bananas or berries
Prunes, raisins, or dried apricots
2. Make eating a habit. Eat meals or snacks at about the same time each day. Eat smaller amounts four to six times daily.
3. If you live alone, listen to the radio or watch television when eating.
4. Set the table for yourself. Make eating a special occasion.
5. Invite family members or friends over to a potluck.
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