By Alicia S. Landry, PhD, RDN, LDN, SNS
Lydia Sartain, MS, RD, LD, CDE
Nina Roofe, PhD, RDN, LDN, FAND, CNWE

College of Health and Behavioral Sciences, University of Central Arkansas

Making the aging process fulfilling and enjoyable should be the goal of healthcare providers working with older adults. While indicators of wellness have been assessed to see how they may interrelate in aging, there is still some work to be done to get the message out that holistic wellness in older adults can positively impact quality of life. For example, in patients diagnosed with Parkinson’s and Alzheimer’s disease, declines in functional status have been related to declines in cognition¹. In frail and cognitively impaired elderly people, strength and balance training showed improvements in functional and cognitive abilities². Finally, older adults who report social isolation, also show delayed recovery of systolic blood pressure in response to stress³. A focus on holistic health and wellness in the senior population is a complex, yet much-needed objective.

In order to approach aging holistically, there are a few key recommendations healthcare providers can encourage older adults to do:

1. Stay active and engaged in social relationships
2. Spend time mentoring others
3. Eat a healthy diet
4. Exercise body and mind
5. Find healthcare providers they trust

With these in mind, faculty at the University of Central Arkansas (UCA) developed an interprofessional learning opportunity for students and local older adults. Through our ongoing partnership with Faulkner County Center on Aging, we were able to enhance our theme meal by involving students from nutrition and dietetics, interior design, and family and consumer sciences (FACS) education. The goal was to provide a service to the elderly participants  while encouraging interprofessional interactions outside of the classroom environment. The theme meal encouraged all the students to assess quickly and think critically during the event, a valuable skill for their future careers.

FACS majors who needed to assess growth and development milestones asked participants to bring in grandchildren. Interior design students observed the building and activities to work with mobility and design issues, then make recommendations. Nutrition students developed and produced a healthy, safe meal with any leftovers going to homebound seniors. The student-produced menu was based on the theme, A Night at the Drive-In, and included grilled hamburgers, oven roasted potatoes, tossed salad, ambrosia salad, and chocolate chip cookies.

The theme meal was successful, and students learned valuable lessons, including planning, organizing, budgeting, and ensuring customer satisfaction. Students also had the opportunity to develop higher level skills, including effective management and decision making. The interprofessional aspect provided students the opportunity to learn textbook concepts while interacting with others to meet numerous objectives for their classes.

Student reflections included quotes like:

“During the theme meal project I learned how to better work with others and share ideas to come up with one main idea. This helped me learn how to come up with the main idea collaboratively and emphasized the importance of communication. This can be applied to learning because it is important to listen to other ideas and consider what is the best one and maybe even putting more than one idea together to find the best outcome. Part of learning is collaborating with others and being willing to put your idea aside if someone has a better one.”

“Accountability is an interesting subject we covered this semester. I honestly thought we would have a problem with someone not doing their part for the theme meal. I was so wrong! I was so proud of how responsible every single person was the day of the theme meal. Everyone arrived on time and did the part they were assigned. There was no withdrawal, aggression, regression, or projection. The reason why I thought back to this topic is that I experience problems with accountability from my staff at work. I guess I assumed that more college students act like this than I thought, and is why I was worried about it from our class. I am so pleased with the maturity of our class’s theme meal. Everyone was accountable for a task and completed it with no complaints”.

“I would have liked to spend more time talking to those who  frequent the center in order to get a better understanding of what a normal day looks like to them.”

“My favorite thing was seeing all of the seniors enjoy the theme of the meal and the meal itself. I think that this theme was great because it was something everyone, despite many differences, could enjoy!”

After evaluating student reflections and surveys from the meal participants, we began to consider other ways in which holistic senior wellness could be addressed. Our search led us to consider a fascinating study done to assess seniors’ wellness using e-health applications⁴. These researchers used technology to ask seniors questions, look at physical and functional health, as well as spend time with them in an assisted living facility. The takeaway message was that this method provided immediate feedback and education opportunities to promote holistic well-being in seniors. In future collaborations, we would like to integrate technology applications to assess cognitive performance, physiological and functional variables, as well as other components of wellness like social and financial aspects. With these added components, healthcare providers in communication and speech, psychology and counseling, health education, physical and occupational therapy, as well as kinesiology could be seamlessly integrated into a community preventative health model that is beneficial and scalable. Using something like a theme meal to get students serving in our community has been a fantastic way to introduce them to interprofessional care as well as teach critical components in our disciplines. Getting students involved in interprofessional discussions and regularly assessing the domains of wellness alongside senior adults could redefine holistic wellness in aging.

1. Stella F, Banzato CEM, Quagliato EMAB, Viana MA, Christofoletti G. Dementia and functional decline in patients with Parkinson’s disease. Dement Neuropsychol. 2008;2(2):96–101. doi:10.1590/S1980-57642009DN20200004
2. Dorner T, Kranz A, Zettl-Wiedner K, Ludwig C, Rieder A, Gisinger C. The effect of structured strength and balance training on cognitive function in frail, cognitive impaired elderly long-term care residents. Aging Clin Exp Res. 2007 Oct;19(5):400-5.PMID: 18007119
3. Xia N, Li H. Loneliness, Social Isolation, and Cardiovascular Health. Antioxid Redox Signal. 2018;28(9):837–851. doi:10.1089/ars.2017.7312
4. Thompson HJ, Demiris G, Rue T, et al. A Holistic approach to assess older adults’ wellness using e-health technologies. Telemed J E Health. 2011;17(10):794–800. doi:10.1089/tmj.2011.0059

By Jacquie Rainey, DrPH, MCHES
College of Health and Behavioral Sciences, University of Central Arkansas

Effective communication with patients is integral to a patient and family-centered approach to care. Effective communication contains elements such as establishing rapport, gaining trust, determining readiness to learn (change), considering the patient’s perspective and asking the right questions. The question is: How we do this in the limited amount of time we have to see a patient? Techniques talked about often involve paying attention to the patient’s concerns, asking them about their motivations, talking about their fears, and listening carefully to their concerns and core beliefs. Two approaches to communication that have gained popularity are motivational interviewing (MI),¹ and  health literacy.

Motivational Interviewing

Motivational interviewing is a communication method that can aid in the development of the patient-provider relationship and thus enhance adherence to medical regimens and behavior change, as well as increase patient satisfaction. Motivational interviewing has been defined as “.. a collaborative, person-centered form of guiding to elicit and strengthen motivation for change.” ²

MI has been described as a complex set of client-centered skills of reflective listening and not a technique that can be learned from a few hours of training. It involves the use of specific communication strategies that are designed to get to the heart of a person’s motivation to change. Miller and Rollnick believe that some clinicians may intuitively practice elements of MI. The use of ‘guiding’ someone to a decision when they are dealing with a problem is a mix of asking, listening and providing information. This type of communication is a common practice among many clinicians. However, MI is true reflective listening in the face of ambivalence from the patient or even irrational and contradictory motives. The purpose of MI is to help the patient recognize their own thoughts and goals and facilitate change. It is a true collaboration between the patient and the provider. The provider uses interviewing to draw out the patient’s ideas and motivations rather than telling them what they should do, and thus empowering the individual to take responsibility for their actions. MI has shown to be effective with older adults in influencing change related to weight loss, medication management and exercise.³ Although MI has a lot to offer in effective patient communication, most healthcare providers are not effectively trained in this technique and do not have enough time with the patient to appropriately employ this method.

Health Literacy

Other suggestions for effectively communicating with patients come from the field of Health Literacy. Health Literacy involves communicating with a patient in a manner that ensures the patient understands and is able to utilize the information provided to make an informed decision. Teach back is one technique that requires the healthcare provider to listen to the patient explain their understanding of the desired action or information. If the patient can’t explain the desired action then the provider attempts to convey the message in another way. The Ask Me 3 approach from Health Literacy requires the patient to ask the healthcare provider three questions: What is my main problem? What do I need to do? Why is it important for me to do this? These are all very important questions but they are clinician-centered rather than patient-centered. The questions may lead to more knowledge and understanding but they do not encourage shared decision making and goal setting and thus patient empowerment. ⁴

Effective Listening

Effective listening is often described as a lost art in medicine. In one study, family practice and internal medicine residents spent an average of 12 seconds letting the patient speak before interrupting them during primary care visits, often interrupting before the patient had finished explaining an issue.⁵

To be an effective advocate for the patient and partner in their healthcare the provider needs to find out who the patient really is, where they are in their healthcare, and how they want to proceed. Ronald Epstein M.D. discusses healthcare providers being present in the moment when communicating with patients in his book Attending: Medicine, Mindfulness and Humanity. He describes being present as listening deeply, without interruption, judgement or preconceptions.^.6 The provider needs to learn whether the patient understands the diagnosis and also the patient’s perspective of her health status and options.

Suneel Dhand believes the one question doctors utilize the least is asking the patient, “What are your goals?” This question gets at what the patient would like to see as an outcome of the encounter. It is particularly important to ask this of older adults who may be dealing with multiple health challenges. It elicits the patient’s expectations for their care and shows that the provider cares about them and their health. It engages the patient in their own healthcare and fosters the patient-provider relationship.⁷

The core element of MI, health literacy and effective patient education/communication is listening. By exploring the patient’s goals and values and determining what they want from their care, the provider can determine if the desired behavior or treatment fits in with the person’s values. Does the behavior change or healthcare plan help to accomplish an important goal or does it interfere with the goal?

Questions that could be used to help elicit goals are:

What specifically would you like to work on to manage your condition?

How important do you think it is to manage/treat your condition?

What is the most important thing for you to accomplish with your care?

Then just listen………

Markides states, “We don’t have to talk all of the time. When someone tell us her problem we healthcare professionals tend to want to give her a solution or say something to cheer her up because we feel uncomfortable watching her suffering. That’s not always the right thing to do. There are times that we need to learn to say nothing and just listen to the other person.”⁸

1. Martin, L. Communicating with patients. Medline Plus, US. National Library of Medicine. https://medlineplus.gov/ency/patientinstructions/000456.htm review date 11/20/17. Accessed March 1, 2019.
2. Miller WR, Rollnick S. Ten things that motivational interviewing is not. Behavioural and Cognitive Psychotherapy, 2009; 37, 129-140.
3. Beagley D, Bonifas R. Motivational interviewing with older adults. Eder care: a resource for interprofessional providers. University of Arizona College of Medicine Tucson; 2016.
4. Beyond AskMe3. http://www.ihi.org/education/Documents/ProgramMaterials/CDCMillionHeartsBloodPressureProject/BeyondAskMe3.pdf. Accessed March 1, 2019.
5. Rhoades DR, McFarland KF, Finch WH, Johnson AO. Speaking and interruptions during primary care office visits. Family Medicine.2001;33(7,) 528-32.
6. Mindful Practice. http://www.ronaldepstein.com/mindful-practice. Accessed March 1, 2019.
7. The simple powerful question doctors should ask their patients. https://www.kevinmd.com/blog/2018/07/the-simple-powerful-question-doctors-should-ask-their-patients.html. Accessed March 1, 2019.
8. Markides M. The importance of good communication between patient and health professionals. Journal of Pediatric Hematology Oncology. 2011;33, S123-S125.

By Kevin Rowell, Ph.D.
Department of Psychology and Counseling, University of Central Arkansas

It seemed to Karen that her 78 year-old mother was having more trouble remembering people’s names, recalling the right words to use in a conversation, and driving with some confusion about which routes to take. Karen noted that her mother’s difficulties began occurring gradually over the past two years, and now she wondered if this is a part of normal aging or if it could be signs of Alzheimer’s disease. On two different occasions, Karen addressed her concern with her mother but was met both times with her mother’s refusal to discuss the matter.

Such a scenario is quite common in families, and with the Baby Boomer generation now in their 60’s and 70’s, it is becoming a reality to millions of Americans. When an elderly person begins to experience noticeable decline in memory, sense of direction, and other cognitive abilities, the concern is whether these are due to normal, age-related changes or due to a disease process like Alzheimer’s, the most common type of dementia. Receiving a diagnosis of dementia is certainly troubling and disconcerting, much like a cancer diagnosis, because some forms have no cure and are fatal within a few years of onset. As with most diseases, early detection leads to early intervention which even if not curable, can at least slow down the progression or assist in preserving cognitive function for a longer period of time.

While most of us are familiar with the terms Alzheimer’s disease and dementia, there is some confusion about their meaning. Dementia is a class of disorders that usually occurs after age 60 with abnormal decline in memory being the first symptom to be noticed. Other cognitive deficits include difficulty recalling names of people or objects, carrying out multiple step tasks, solving complex problems, and maintaining visual-spatial accuracy. Alzheimer’s disease is by far the most common type of dementia and represents approximately 60-70% of cases. Other common types include vascular dementia, dementia due to Parkinson’s disease, and Lewy Body dementia (American Psychiatric Association, 2013).

Determining whether or not an elderly family member has dementia usually involves some type of cognitive exam to measure the degree of function that is lost and may also include a brain scan such as a CT scan or MRI to evaluate the brain’s structural changes that have occurred. In both types of examination, the results from the current patient are compared to a large sample of people his or her age to determine if the changes are significantly below average, that is, if these changes are much greater than expected for the patient’s age group.

Cognitive examinations vary in terms of complexity and time: very brief scales have only a few items and take less than five minutes, intermediate tests require 30 minutes to an hour, and more comprehensive neuropsychological assessments involve several hours of testing. The kind of test administered depends upon the health care provider who is seen. Their choice of assessment will be based upon how much time they can allocate for the testing and the kind of assessment training that they have received.

Most people will make an initial appointment with their primary care provider (PCP) rather than with a psychiatrist, neurologist, or psychologist. PCP’s typically have very limited time to conduct an assessment, and they usually receive training on administering brief screening tests instead of more complex scales. If results of the screening test indicate a problem with memory or other kinds of cognitive functioning, the PCP may give a tentative dementia diagnosis but will typically refer the patient for more in-depth assessment by a psychiatrist, neurologist, or psychologist in order to confirm the diagnosis (Yokomizo, Simon, & de Campos Bottino, 2014).

Because of their common medical education and training, psychiatrists and neurologists often provide similar kinds of assessments. These tests usually require approximately 30 minutes to complete and involve several cognitive tasks such as memory, attention span, naming common objects, copying geometric figures, verbal ability, and orientation to time/date, place, and person. Each task is assigned a very limited number of points, usually ranging 0-3, and a total score is derived by summing all of the points. This total score is then compared to a normal range of scores expected for someone with the same age, and in some cases, with similar education. Psychiatrists and neurologists very often refer the patient for a CT scan or MRI which will help determine the specific type of dementia given that the cognitive testing indicates a significant level of impairment and warrants a diagnosis of dementia (Del Sole, Malaspina, & Biasina, 2016; Tsoi, Chan, Hirai, Wong, & Kwok, 2015).

Psychologists who specialize in geriatric assessment, typically receive the greatest amount of training in test administration. Whereas they often utilize the kinds of intermediate tests used by psychiatrists and neurologists, neuropsychologists may want to use more in-depth, more complex tests to precisely evaluate a person’s memory, attention span, and the other cognitive abilities measured in the intermediate tests. Similar to the other tests mentioned, the results are compared to a normative sample to determine the severity of impairment (Fields, Ferman, Boeve, & Smith, 2011).

If a family member begins to experience noticeable memory loss or problems in other kinds of cognitive tasks, it is advisable to seek a cognitive examination because it is critical to have this kind of information in determining whether or not the individual has dementia. These results can then be used to track changes in their cognitive abilities as they age which will be highly useful in determining the optimal type of intervention for them.

References.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5^th ed.). Washington, DC: Author.

Del Sole, A., Malaspina, S., & Biasina, A. (2016). Magnetic resonance imaging and positron emission tomography in the diagnosis of neurodegenerative dementias. Functional Neurology, 31, 205-215.

Fields, J. A., Ferman, T. J., Boeve, B. F., & Smith, G. E. (2011). Neuropsychological assessment of patients with dementing illness. Nature Reviews. Neurology, 7, 677-687. doi: 10.1038/nrneurol.2011.173.

Tsoi, K. F., Chan, J. C., Hirai, H. W., Wong, S. S. & Kwok, T. Y. (2015). Cognitive tests to detect dementia. A systematic review and meta-analysis. JAMA Internal Medicine, 175, 1450-1458. doi: 10.1001/jamainternmed.2015.2152.

Yokomizo, J. E., Simon, S. S., & de Campos Bottino, C. M. (2014). Cognitive screening for dementia in primary care: A systematic review. International Psychogeriatrics, 26, 1783-1804. doi: 10.1017/S1041610214001082.

By Stephanie Rose, MSW
Department of Health Sciences, University of Central Arkansas

With the increase among the aging Baby-Boomer population, there has been an overall increase of prescription drug use. Many older adults struggle with co-morbid diagnoses, contributing to multiple prescriptions being consumed at one time (Dowell, 2016). Older adults are also more likely to be victims of medication theft (Collins, 2018). With the rising amounts of opioid overdoses, the use of opioids for pain-management among older adults is a growing concern (Dowell, 2016). Historically, there has been more of a focus on younger adults and opioid misuse; however, the average age (50 or older) of treatment admissions for opioid abuse is rising. One in four older adults have used a prescription drug that has the potential for addiction (Carew, 2018). The U.S. Department of Health and Human Services found that while 500,000 older adults were prescribed higher than recommended amounts of opioids, 90,000 of these individuals were identified as high risk for abuse and/or overdose (Collins, 2018).

It is projected that the amount of older adults who abuse illicit substances will double by 2020 (Carew, 2018). Misuse and abuse of prescription opioids in older adults is associated with higher levels of pain, depression and low-level physical disabilities. In 2012, 2.9 million adults, age 50 or older reported using their prescription medications for reasons other than prescribed. Pain-medication accounted for almost half of drug-toxicity related visits to the emergency room for those ages 50 or older (Chang, 2018). This highlights the need for increased attention on older adults and opioid misuse/abuse.

There are a number of initiatives being developed and implemented in order to address these concerns. The CDC has developed guidelines regarding better management of chronic pain (Loreck, 2016). These guidelines address pain management strategies including the oversight of prescription and opioid use, appropriate opioid selection, patient education, when to cease opioid prescriptions, as well as appropriate follow-up (Dowell, 2016). Additional risks and concerns are associated with ceasing opioid prescription-management too quickly, particularly if the person is not provided adequate follow-up and resources for pain-management (Collins, 2018). This is especially concerning due to the rise of heroin use among older adults, as well as, an increase in those who are ages 50-70 receiving methadone treatment (Carew, 2018).

Interventions

Knowing the warning signs of substance abuse can assist with intervention that may save lives. It is important to increase awareness of what interventions are available and what to do should there be a concern. Some helpful tips include:

• Knowing what resources exist to assist older adults is important. Proper treatment is essential, particularly since higher rates of depression and anxiety were reported among those ages 50 and older and who misused/abused their opioid prescriptions. Factors that can affect the rates of abuse may include use of opioids as an attempt to cope with the multiple changes that occur in this life-stage, as well as perceived greater pain (Chang, 2018).
• Look for warning signs of substance abuse. Several warning signs include slurred speech, hostile and/or depressed mood, memory loss, confusion, and increased isolation. (Hazelden, 2018).
• Increasing social engagement can be helpful, particularly since increased opioid use is associated with increased isolation (Chang, 2018).
• Identifying supportive resources, including housing and food assistance, as well as addiction education that addresses issues of empowerment, decreasing stressors and enhancing coping skills. (Hazelden, 2018).

It is of further importance to select the right treatment. Due to the complex needs of an individual struggling with addiction, it is important for treatment to seek appropriate practitioners with expertise. Addiction is influenced by a variety of issues, including genetics, mental health, environmental and health factors. An array of practitioners with special skills and training who can appropriately address substance use disorders are available. Some examples of special certifications in Arkansas include Licensed Alcoholism and Drug Abuse Counselor (LADAC), Licensed Associate Alcoholism and Drug Abuse Counselor (LAADAC), Advanced Alcohol and Drug Counselor (AADC) and Certified Alcohol and Drug Counselor (ADC). These credentials require years of additional experience and education focused on addiction. Many times, these are additional credentials and education that general licensed mental health providers (LPC, LCSW, PsyD, PhD, etc.) acquire in order to provide adequate treatment to those struggling with addiction. Being well versed on the treatment options available can be especially beneficial.

The rise of opioid misuse and abuse among older adults continues to be a growing concern and challenge. There are a number of related dangers and outcomes on the rise, particularly since the population of older adults continues to increase. Many of the needs and risk factors of older adults using opioid prescriptions are unique and require well-informed interventions. The UCA Addiction Studies Program prepares students to work in the addiction field by providing comprehensive education in the field of addiction. Students obtain knowledge of addiction including mental health, counseling skills, prevention, as well as, epidemiology and etiology of addiction. The program also requires an internship experience within the field of addiction treatment. UCA Addiction Studies Program continues to prepare students with a special skill-set to address this ever-growing need.

References

Carew, A. M., & Comiskey, C. (2018). Treatment for opioid use and outcomes in older adults: A systematic literature review doi:https://doi-org.library.capella.edu/10.1016/j.drugalcdep.2017.10.007

Chang, Y. (2018). Factors associated with prescription opioid misuse in adults aged 50 or older doi:https://doi-org.library.capella.edu/10.1016/j.outlook.2017.10.007

Collins, S. (2018). Older Americans and opioid misuse: supporting an often overlooked populations in the opioid crisis. Retrieved August 29, 2018

Dowell, D., Haegerich, T., & Roger, C. (2016). CDC guidelines for prescribing opioids for chronic pain-United States. Retrieved August 27, 2018 from: https://www.collins.senate.gov/newsroom/older-americans-and-opioid-misuse-supporting-often-overlooked-population-opioid-crisishttps://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm

Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10-15. doi:http://dx.doi.org.library.capella.edu/10.3928/00989134-20160314-04

Hazelden Betty Ford Foundation. (2018). Older adults deserve recovery from alcoholism, addiction to prescription drugs. Retrieved August 29^th, 2018 from: http://www.hazelden.org/web/public/ade60306.page

Substance Abuse and Mental Health Services Administration. (2017). Opioid use in the older adult population. Retrieved August 27, 2018 from: https://www.samhsa.gov/capt/sites/default/files/resources/resources-opiod-use-older-adult-pop.pdf

By Jacquie Rainey, DrPH, MCHES
Department of Health Sciences, University of Central Arkansas

Students from the Nutritional Services Administration class in the Department of Family and Consumer Sciences at the University of Central Arkansas are learning how to plan and serve a meal for clients at the Faulkner County Senior Center. The Faulkner County Senior Center is part of the Faulkner County council on Aging, Inc. Its mission is to meet the social, nutrition and transportation needs of seniors. The partnership between the senior center and UCA students is a win for both groups. The students get real world practice in meal preparation and delivery, the seniors are fed a nutritious meal, and everyone has a good time. Any food that is not eaten the night of the theme meal is portioned for use the next day to serve to home delivered meal participants throughout Faulkner County. The event in April was centered on the theme of a 1950’s diner and included bingo and ‘50’s attire.

The Faulkner County Senior Center is one of the many organizations in the state that is working to combat food insecurity among older adults. Food insecurity is when someone is unable to acquire nutritionally adequate food in sufficient quantities and in socially-acceptable ways.¹ Arkansas ranks in the top tier nationally in the proportion of older adults (currently about 20% of all Arkansans over the age of 60) who are living with food insecurity.² Food insecurity is associated with many negative health effects, including nutritional inadequacy, poor overall health, extended hospital stays, cardiovascular disease, and worsening of chronic conditions. These health consequences have significant costs in terms of quality of life and financial impact.¹

For older adults, food insecurity is primarily an issue of access. Many areas of Arkansas, especially rural areas, are considered ‘food deserts’ where a large portion of the population does not live near a grocery store. Financial hardship is another common cause of food insecurity among seniors. People on fixed incomes have a difficult time purchasing the amount of healthful food that they need. Reduced mobility may produce barriers to older adults shopping for food or leaving home to secure a meal.  In Arkansas, 21% of older adults have a health problem that requires the use of specialized equipment such as a wheelchair or walker. ¹ Additionally, lack of access to transportation or the inability to drive due to physical limitations can significantly contribute to food insecurity.

Food insecurity is more common among women, minorities, individuals without a spouse, those who use alcohol or tobacco, have high blood pressure, diabetes or depression, those who have been hospitalized or visited an emergency room in the previous year, and grandparents caring for grandchildren. ^3,1 Efforts should be made to recognize the risk factors for food insecurity and to connect older adults with resources within the community. Resources include but are not limited to: the Older American Act Meal Program that provides meals at sites administered by the Area Agencies on Aging (AAA), local nonprofit organizations such as the Arkansas Hunger Relief Alliance, the Arkansas Foodbank Network, and the Arkansas Rice Depot, and the federally-funded Supplemental Nutrition Assistance Program (SNAP). One example of how Arkansans can make a difference is letting seniors in Northwest Arkansas know about the Double Your Dollars (DYD) Programs at Farmers’ Markets. Senior Farmers’ Market Nutrition Program participants may receive a ‘match’ for purchases made at participating NWA farmers’ markets with their vouchers. Participants receive market coupons that are to be used like cash to purchase fruits, vegetables, meats, eggs, dairy, jam/jelly, honey and food-producing plants. If the market is participating in the DYD project, participants can receive a 1:1 match in market coupons.

The Supplemental Nutrition Assistance Program benefits are reported to be underutilized by older adults.¹ The recommendation from the Senior Hunger in Arkansas report was to increase the number of seniors who participate in the SNAP program thus providing access to sufficient amounts of healthful foods for Arkansas seniors.¹ The Arkansas Hunger Relief Alliance quoted Tomiko Townly, SNAP outreach director as saying, “We often see eligible seniors who don’t know they can receive food assistance or believe they will be taking food from those who are worse off than they are, so they are opting instead to cut back on medications to afford food.” ²

The threat of hunger among seniors in Arkansas is a continuing challenge. Food insecurity is associated with numerous poor health outcomes that can lead to additional challenges for the individual and the healthcare system. An avenue to potentially reduce the burden of disease on these individuals and the healthcare system is to ameliorate the problem of food insecurity in America.⁴ UCA is happy to have a small part in helping to do this.

1. Division of Aging and Adult Services, Arkansas Department of Human Services. Senior Hunger in Arkansas. https://arhungeralliance.org/wp-content/uploads/2014/12/Senior-Hunger-in-Arkansas-2014-FINAL.pdf. Accessed June 5, 2018.

2. Arkansas Hunger Relief Alliance. (2018). Senior Hunger. https://www.arhungeralliance.org/programs/senior-hunger/. Published 2018. Accessed June 5, 2018.

3. American Geriatrics Society (2018) How common is food insecurity among older adults? https://www.eurekalert.org/pub_releases/2018-03/ags-hci030818.php. Published March 8, 2018. Accessed June 5, 2018.

4. Ziliak J, Gunderson G. The state of senior hunger in America 2015: An Annual report. Feeding America and the National Foundation to End Senior Hunger. http://www.feedingamerica.org/research/senior-hunger-research/state-of-senior-hunger-2015.pdf. Published August 16, 2017. Accessed June 5, 2018.