Academic journal article Generations

Food and Nutrition Services in Assisted Living Facilities: Boon or Big Disappointment for Elder Nutrition?

Academic journal article Generations

Food and Nutrition Services in Assisted Living Facilities: Boon or Big Disappointment for Elder Nutrition?

Article excerpt

Assisted living facilities represent a relatively new and rapidly growing housing and life-care option for elders that has the potential to provide exciting new opportunities for improved quality of life in numerous areas, including food and nutrition. On the other hand, if food and nutrition services in diese facilities arc neglected or ignored, nutritional quality of life and even physical health may be impaired for large numbers of elders who are increasingly choosing this model. This article addresses the question of whether assisted living facilities represent a boon or a big disappointment for provision of the best nutrition for elders. We also present practical tips for assisting elders and their families in choosing good facilities, along with the principles that should drive advocacy efforts to improve food and nutrition services in these living situations.

Assisted living facilities (ALFS) are residential settings for older people that provide or coordinate die following services: personal care, twenty-four-hour supervision, scheduled or oncall assistance, social activities, and some healthrelated care. The popularity of and necessity for ALFS is rising. More than 33,000 licensed ALFS are in operation in the United States today, housing more than one million persons 75 years of age or older (Mollica, 2000a).

It is especially important to look after nutrition in ALFS as these facilities are becoming the homes of an unprecedented number of elderly residents who may reside in them for years or even decades. Also, today ALFS are increasingly providing care for economically and medically disadvantaged elders, who are the most likely to be at nutritional risk and in need of nutrition services (Mollica, zooob; Nolan, 2000).

The old notions that ALPS were only temporary "way stations" enroute to the grave and that nutrition during later life stages had no purpose are outdated and inaccurate. Today, it is widely recognized that attending to the nutritional needs of older adults is a crucial investment that pays dividends in both physical and mental health and quality of life. Regardless of whether an elder lives in a private residence, an ALF, or another institution such as a nursing home or hospital, provisions for food and nutrition must address both the quality and safety of the food and die environment in which meals are consumed. There should also be some provision for comprehensive nutrition monitoring, which starts with screening of elders to identify present risks or potential problems. Such screening should then be followed by a needs assessment for those at risk, and healthcare or social services interventions, necessary changes in food and nutrition, as well as actions by care providers should be recommended, as appropriate (Dwyer, 2001a, 2001b; ADA, 1996,1999; Amarantes, Martincz, and Dwyer, 2001). This basic framework of attending to an elder's nutrition status should be followed, regardless of whether the individual is living at home or in another type of residential setting.

However, a number of problems mitigate against the potential in ALFs to improve nutrition for better quality of life and health among elders. Compared to nutrition services in nursing homes and hospitals, provisions for these services in ALFs often seem to be an afterthought, and there remains little consensus on what codified and uniform standards for nutrition services are necessary and appropriate in these settings. National surveys reveal a lack of common vision among working professionals in this field; ALF operators seem to implement practices based on their individual philosophies about the purpose and role of ALFs (Hawcs, Phillips, and Rose, 2000; MoIlica, 2000a). Some ALF managers give top priority to dining-room amenities, while others emphasize the provision of nutrition therapy, which they deem essential to maintaining nutritional health.

One way to describe food and nutrition services in an ALFs is by the facility's dominant "theme" or philosophy: restaurant, resort; medical, health; or home style. …

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