With the introduction of the Social (1970’s onwards) and the Ecological (late 1970’s onwards) models of health, the focus has moved from just the biological and physical aspects of an individual’s health towards also studying the social determinants and health-related behaviours in relation to their environment. This has allowed professionals to understand the social impacts on the elderly population (³60 years) in relation to their nutrition. Through studies conducted within the ageing population who are either hospitalised, in assisted-living or who are free-living, it is understandable the impact nutrition plays on their health. “For an individual, nutrition is providing themselves with the food necessary for their health and growth, therefore reducing their risk of morbidity and nutrient deficiencies” (Rust 2018). Studies provided evidence that the elderly have a lower food intake when they eat alone compared to when they eat in a social setting which increases their food intake and therefore reduces their chances of malnutrition, which is “caused by an absence of proper nutrition by either not eating enough, not eating the right foods or the body being unable to use the foods eaten” (Rust 2018). An individual’s health is also impacted upon by social determinants; as explored in Huang et al. 2017, gender plays a vital role in elderly food intake in a social setting, an individual’s eating environment either promotes healthy portions via social support or increases the chances of malnutrition due to loneliness. The social stigma around sharing a meal with others, socio-economic status and social capital also impact an individual’s health. 238 words
In hospitalised and assisted-living arrangements there are often many different cultures. Strategy one is to promote healthy eating in a social setting one dinner and one lunch a week in the communal dining hall, an arrangement of diet appropriate meals from other cultures that nutritionists and professionals have modified for the patients’ health benefit will be available. As the facilities have access to health and dietary requirement records, it allows the patient to eat knowing they are safe and the food is healthy for them as well as trained and professional cooks who can cook modified recipes. Those living in these arrangements can select prior to the meal if they wish to participate or not and every patient is provided with a feedback sheet for the meal. To further support the enjoyment of eating in a social setting, family members can join these cultural meals by providing information if they are going to be joining a meal or not and a small payment as visitors. During meal times, activities will be set up such as cultural trivia, bingo and general social areas for those who wish to participate. This allows for not only an increased food intake due to the social surrounding and new food experience but also an opportunity to participate in mind challenging activities. Developing the participant’s personal skills as they can make their own choices, i.e. if they wish to participate or not, if they participate in an after-meal activity and if so what one.
By introducing the individuals to new cultural food, the program is aiming at bringing back the enjoyment of eating (Winter, Nowson 2016). And although, depending on the living arrangement, the patient may be unable to leave their bedside, they still have the enjoyment factor of eating new food. By having the optional after meal activities, it will prolong the meal times and therefore a higher food intake as well as build social connections. The feedback sheet allows the program to constantly be assessed on what is working and what needs to be modified. The short-term output of this program is that the patients will be eating larger quantities and new types of food and this will result in a long term reduced rate of malnutrition. This is a diverse but complementary approach as it enables anyone and everyone to a well portioned and healthy meal. Workers are needed to run the after-meal actives as well as monitor meal times. Local companies are needed to donate produce and small prizes for the activities as well as raise awareness of the effects of malnutrition to family of the participants by putting up posters giving days and culture of origin that week will be. The hospital or assisted-living food fund needs to be adaptable to buy produce that is needed for other cultural foods as well as the cost of the extra meals of family.
In free-living arrangements, it is important to create a community support network. By creating a dinner hosting program, it allows those in free living to share a meal with others once a fortnight. It will be a community run program, therefore within the group of twelve participants, everyone will host twice throughout the duration and the community soup kitchen/ Oz harvest or volunteered restaurant will cook the first and last meal. The program has little cost as it the individual hosts twice and they are given a budget of a maximum of $70 per meal in order to spend less. Their first meal which is provided by the hosting company (community soup kitchen/ Oz harvest or volunteered restaurant), will give tips for low cost meals and any allergies or dietary requirements are swapped at the beginning to maximise food intake potential. At the final meal, participants are provided with a feedback sheet asking questions such as: did you find you ate larger quantities of food when you ate with others as opposed to when you ate alone? Did you find it hard to cook for 12 people? Were the meals satisfactory? Did you ever go over budget/ did you find it hard to stick to the budget? Should the group be smaller? Etc. to assess the program and find any flaws. This developed personal skills as it built practical skills such as buying enough food to feed 12 people on a budget and cooking healthy and correct portions for 12 people. It also builds their interpersonal skills through communication with others throughout the meal and allowing them to verbalise their opinion on the program. The program creates a supportive environment that provides healthy eating behaviours and health in the age context. It develops flexible systems for strengthening public participation and direction of health matters. The first night which is provided by the host company will explain essential aspects meals need for the elderly to reduce now nutrition other health problems. The program reorientates health services by supplying a group within the community the opportunity to decrease their risk of malnutrition rather than having to treat them for that disease later in life. With the identification of obstacles that affect the health of the elderly, action can be applied to non-health sectors of health public policies. Understanding that ill-health processes can either be stopped or slowed down by those in communities living/working in a non-health sector is expressed in this program as the community is wanted to supply healthy recipes from their cultural origin. The short term output is the bit disappearance up eating a social meal once a fortnight and are able to Cook healthy food as per the guidelines resulting in a higher food intake. The long-term output is the reduced risk of malnutrition due to increased food intake and the education of foods beneficial for their health and the budgeting skills that they can adapt into their everyday lives and therefore reduce their risk of nutrient deficiencies. With the feedback sheets, the program can be assessed and adapted into ways that are better suited the targeted demographic. As this is a community program, the community can fundraise prior to the beginning of the program to subsidise some for the participants. A local GP can provide medical check-up at the beginning of the end to supply statistical evidence of the social impact of eating has on their Health. A nutrition is can supply information to aid in the benefit derive from the type of food that will be cooked. By educating them, it provides them the everyday die. A member from a local soup kitchen, large family or bank who can assist in budgeting tips means this program is provided not only those who can ‘afford it’ but is available to anyone who is willing to learn how to better their health.
As explored in Huang et al. 2017, gender plays a major role in elderly nutrition. It’s stated that those who ate with others ate more than those who didn’t, however of those who ate alone, males had a higher mortality rate. This is due to lack of knowledge when it comes to cooking and they increased takeaway rates. In order to reduce this, a practical education is needed. By creating a program aimed at the males of a community, that teaches them the basic structure of the healthy diet and cooking techniques, a reduced rate of malnutrition will occur. Cooking class will run twice A month in a community commercial kitchen where a nutritionist will give information and tips on how to maximise the benefit of a healthy diet. A cook/chef Will teach basic cooking techniques that are easily adaptable to different meals that they can create. Every lesson each member can bring an ingredient of choice to learn how to either prepare a meal based on that ingredient or how to incorporate it into everyday meals. Local companies donate produce to the lessons as well as the public health system subsidising $ 50–$ 100 per month of lessons. It is a preventative strategy that will reduce the costs of treatment later in life. This builds practical cooking skills that they can adapt into their everyday cooking as well as educating them on what is right and wrong for their diet. This program also promotes an environment that supports healthy eating behaviours and promote health in their age context. By enhancing self-help and the community action/ social support, people from the community get involved and help those in need while also being educated in how to better their own health. It allows the Health care system to move from a majority treatment focus to health promotion and disease prevention by giving the participants the skills to reduce their risk of disease later in life. Local fruit and veg/Grocery stores can donate produce to subsidise the cost. A local cook/chef Will volunteer to teach the classes in a commercial/ communal kitchen supplied by either the local council or a local business. A nutritionist is needed to provide diet cherry guidelines to maximise healthy food intake. This program provides a social support network that allows not only the participant but if applicable their partner peace of mind knowing they will be able to Cook healthy food for themselves reducing takeaway rates and therefore malnutrition.
By identifying the obstacles that effect the health of our elderly, non-health sectors of health public policies can begin to apply to a larger demographic. To maintain maximum nutrition and reduce the risk of malnutrition programs need to support the social environment, physical environment, health services and structural and societal factors. Nutrition is vital to maintain bone density, muscle mass/strength, brain function and to reduce malnutrition. It can be affected by many different factors; surrounding environment, food available, Health status and dietary needs. Without adequate nutrition, the effects of malnutrition begin to diminish the health of the elderly population reducing their quality of life. Strategy one provides those hospitalised or in assisted living the chance to enjoy a new food surrounded by friends and family which has proved to increase their food intake and therefore reduce malnutrition. Strategy two provides a similar experience for those in free-living arrangement. As these participants have more movement freedom to eat out-of-home while still learning beneficial skills adaptable to the everyday life. This results in a higher food intake and a decreased risk of malnutrition. Strategy three provides a program that is supported by evidence found in Huang et al. 2017, as it targets the ³60 years Male demographic who are at a greater risk of mortality due to malnourishment. By teaching them the skills they need to better their Health they are able to provide for themselves and teach others valuable techniques to increase food intake and reduce takeaway rates therefore reducing the risk of malnutrition.