MORE THAN JUST A MEAL: NUTRITION AND THE CHANGING APPETITE OF TODAY’S OLDER ADULTS

Bob BlancatoExecutive Director, NANASPrblancato@nanasp.org

INTRODUCTION

Summit held at an important and interesting time in an interesting year for aging

Year of the anniversaries Year of the WHCOA Also two weeks before end of FY 2015

with big unanswered questions on funding

And we still wait for OAA

BUDGET

On the budget—we are back on the fiscal cliff

Fiscal year ends in 9 days Choices on budget like night and day Sequestration or not Investment or not How many sideshows will there be? Advocacy must be—no sequestration

period

OLDER AMERICANS ACT REAUTHORIZATION

Pending is a 3 year modest reauthorization passed by the Senate on bi partisan basis

Retains most of existing Act; limited changes such as Elder abuse prevention training for staff and volunteers Changes to Title III funding formula Provision of information and technical assistance to

support best practices for the modernization of multipurpose senior centers; encourages promotion of intergenerational models

House must step up and act to get it done this year. No reason not to. Met all tests for effectiveness

OLDER AMERICANS ACT: THE FUTURE OAA has challenges and opportunities before it,

whether we extend for 3 years or something else

Future of existing aging network as landscape changes around it; managed care

Ability to put greater value on services it provides—prove savings, demonstrate evidence base outcomes.

Train next generation of aging service providers And modernize everything!

CHALLENGES AND OPPORTUNITIES

I take on one of those challenges/ opportunities in today’s session:

Challenge—how to modernize the nutrition program, what it provides and the facilities where services are provided

Opportunity—to appeal to the new wave of 60 plus adults and keep retention high for existing people and make it MORE THAN JUST A MEAL!

BACKGROUND AND STATISTICS

Number of senior centers: estimated at around 20,000

Percentage that offer OAA Title IIIC congregate meals: 53.9%. That should be higher

OAA nutrition program as a whole serves 208 million meals to almost 2.4 million older adults 60 and over

Average age of a congregate meal recipient: 76 (the average age for HDM is ~80)

Both current strength and future weakness

VALUE OF OAA

Program built on participation of generation of older adults

High support: 95 percent would recommend to friend (hopefully younger), 94 percent like the meals, and ¾ say it improves their health

Proper data would show how much been saved in Medicaid and Medicare

Value to older person and taxpayer

NUTRITION AS A DRIVING FORCE

Nutrition was a big driver that brought people to OAA programs and kept them there but…

Recent research indicates that among boomers surveyed in one state, only 3 percent went to centers for nutrition.

How to address: About offering choices in menus Where, when and how meals are served Enhanced nutrition education showing linkage to

healthy aging which boomers relate to Tie to continuum of services

IDEAS FOR THE FUTURE

Survey of NANASP members: Restaurant partnerships “Chef On Site” programs with farm-to-table food Salad bar entrees Culturally competent meals Intergenerational garden onsite Local high school filming a senior giving a cooking

demonstration Obama budget for FY16: new nutrition demos $20 million to invest in evidence based models to

modernize both home delivered and congregate

OTHER NOVEL IDEAS

Aging & In-Home Services of NW Indiana runs Wellness Cafes at 4 congregate meal sites and 2 hospital sites. These sites cover a 5 county area. The Café is coordinated by an RD and was launched in March 2015. Wellness Cafes at congregate meal sites occur weekly and include group health and wellness education and activities provided by the RD or community experts. Attendees also receive printed materials and give-a-ways that promote physical activities and wellness. Aging & In-Home Services has also partnered with a major hospital system to offer Wellness Cafes at 2 hospitals.

OTHER IDEAS

In New Jersey, to meet a big increase in Asian-Indian population, older adults meet and get input for menu items, even do taste tests—increase in attendance at these centers. No additional cost to provide special meals

In Chicago, a program with a goal to prevent isolation as a result of cultural barriers and reduce nutritional risk in designated sub-populations. In various sites including centers

OTHER IDEAS

Upstate New York program serving Native Americans Africans, Hispanic and Polish: they have a senior nutrition/fitness program in a holistic approach combining nutrition and exercise as they say to increase social capital—wellness, diet, activity and socialization—multiple sites including centers

Again in NJ a program to promote cultural diversity through cultural readiness at senior centers featuring nutrition and nutrition education and health promotion in centers

OTHER IDEAS

Novato (CA) Independent Elders Program, part of the Margaret Todd Senior Center, takes calls from older adults who can no longer drive but need groceries and they are matched with a volunteer who shops

People Coordinated Services Senior Multipurpose Center in LA, through public-private collaboration with a local food bank, supplements its hot meal program to host a weekly food giveaway focused on healthy foods

OTHER IDEAS

Gary and Mary West Wellness Center, operated by Serving Seniors in San Diego, provides 750 meals per day, 365 days a year, as well as physical and mental health care and soon a dental clinic

LA County Be Well program: improve access to appropriate exercise and nutritional health education for low income, minority, older Americans at moderate to high nutrition risk due to multiple chronic conditions. In 7 sites including centers.

SENIOR CENTERS IN RURAL AREAS

Older adults are disproportionately represented in rural vs. non rural areas

Expected that boomer migration patterns will increase population of rural and small town settings in future

In some ways dealing with the opposite problem in many places: how to deal with an aging population of oldest old, not younger old. Higher rates of chronic conditions

Also have to deal with issue of serving vast areas of low population density

Inherent transportation issues, socialization issues; how to deliver HDMs regularly address growing concerns about isolation. Health literacy key issue. Digital divide as well

KEYS TO PRESENT AND FUTURE

Stay true to mission Demonstrate and document value Be innovative and adaptable Build, sustain, strengthen partnerships Be proactive on diversity and for family

caregivers Find role in long term services and supports Be better and wider vision advocates Be distinct in age friendly community/aging in

place movements

THE MISSION

To promote independence of older adults in communities with consumer driven home and community based services

Serve those in greatest economic and social need.

Leverage all sources of funds

BROADEN THE CENTER VISION

Senior center as focal point—good in theory But, focal point needs to be specific in what

it does and for who Navigator for family caregivers One stop source of information Place to build relationships between diverse

communities and different generations Driver of local economic development Catalyst for private sector investment

DEMONSTRATE AND DOCUMENT VALUE Aging network services about

outcomes Nutrition—senior centers more tangible HCBS services preferred by seniors Satisfaction one thing—savings another Need that data collected—translates

into showing value to D.C. Show evidence based nature of

services

BE INNOVATIVE AND ADAPTABLE

OAA services have evolved to meet changing needs but have to do more

Innovation needed: program design service delivery including location of services staff selection infrastructure needs Programming that is active and integrated Social media hubs System navigation For the younger senior—amenities amenities amenities

All can be drivers of non-public $$$

BUILD PARTNERSHIPS

Senior centers/nutrition programs need to be leaders in building widest possible partnerships in their communities: business, health care systems, government, foundations

Federal funding makes up less and less May get worse Partnerships can mean payoffs to both

sides Great models already exist across US

DIVERSITY AS DESTINY

Changing face of older population being served—growth in minority and LGBT in particular

Cultural recognition can begin with nutrition services

Socialization has new meaning in nutrition programs

Bringing groups together—respecting individual cultures

Expanding diverse clientele makes good business sense

OUTREACH TO FAMILY CAREGIVERS

Family caregivers need centers but need better outreach to them

Nutrition one important way to connect to them

Navigation services to make lives simpler

Education and training Grandparents raising grandchildren

LEARN LTSS/GRAB YOUR PLACE AND SPACE

While long term care is our national denial issue Developing at the state and local level through

more support for HCBS under Medicaid Aging network in space a long time. Managed

care has just arrived in some communities but 70% of Medicaid enrollees are in managed care nationwide

Newbies need the knowledge of aging network and also the trust.

Communication key

ADVOCACY THOUGHTS

Advocacy needs to be less siloed About core programs like the OAA Also about transportation, housing,

elder justice, health care Advocate for better data collection and

use Push the evidence base Be more specific in relationship building

with House and Senate Members

AGING IN PLACE

Age friendly communities, aging in place, NORCs, villages growing as direction of national aging policy

Senior centers and nutrition programs must solidify their place

Can represent a new and improved form of community focal point

About looking at intergenerational options Hunch is that there will be private

investment in this space

CONCLUSION

Senior nutrition, aging are growth industries, but who grows? Senior centers should be!

Need to do what works best for the community—senior centers are key to the community

It’s about knowing your value so others value your knowledge

Put a price on what you do and make the business case

But above all, keep putting the older person first, in service and in focus

SAVE THE DATES - JUNE 1-3, 2016

“Dream with Your Eyes Open”

RESOURCE PAGE

NANASP: www.nanasp.org; for more info/slides: rblancato@nanasp.org

ACL Nutrition Programs: http://www.aoa.acl.gov/AoA_Programs/HPW/Nutrition_Services/index.aspx

OAA Reauthorization: https://www.congress.gov/bill/114th-congress/senate-bill/192

Find Your Members of Congress: www.govtrack.us/congress/members