Healthy Eating for Healthy Aging: Combating Hunger and Improving Nutrition for Older Adults

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Healthy Eating for Healthy Aging: Combating Hunger and Improving Nutrition for Older Adults Lesha Spencer-Brown, NRPA Katie Jantzi, Meals on Wheels America Sara Shepherd, Tualatin Parks and Recreation Lisa Dillman, Meals on Wheels of Central Indiana

S E N I O R N U T R I T I O N KATIE JANTZI 2018 Meals on Wheels America

MEALS ON WHEELS AMERICA A national leadership organization supporting the 5,000+ local, communitybased Meals on Wheels programs across the country through advocacy, education, research and national partnerships and campaigns. 3

SO MUCH MORE THAN JUST A MEAL SAFETY Helping at-risk seniors feel safe and more secure in their own homes SOCIALIZATION Providing social interaction that contributes to overall physical and emotional well-being Serving as the eyes and ears in the home to monitor client change in condition and connect seniors to needed services in the community NUTRITION Meeting the nutritional needs of at-risk seniors 4

ADDRESSING A GROWING PROBLEM Our nation s senior population is growing exponentially, outpacing available resources and leaving more and more Americans at risk of facing hunger and isolation. 5

SENIOR HUNGER AND ISOLATION THE IMPACT ON HEALTH & WELLBEING Seniors struggling with hunger are more likely to experience adverse health outcomes that lead to hospitalization or institutionalization 1 in 7 seniors face the threat of hunger Socially isolated seniors experience negative feelings that have the same health effect as heavy smoking 1 in 5 seniors feels lonely A PROBLEM EXACERBATED BY POVERTY Millions of seniors today live in poverty, where they are twice as likely to be forced to leave their home or rely on caregivers Food insecure and low-income seniors are not receiving the community support services they need 6

SENIOR HUNGER AND ISOLATION THE ECONOMIC COST OF HUNGER & ISOLATION Malnutrition contributes to $51 billion in healthcare costs among seniors Costs associated with senior falls is an additional $50 billion Costs associated with negative effects of isolation are equivalent to those of having high blood pressure 7

THE GREATER IMPACT SENIOR HUNGER & ISOLATION HARMS EVERYONE Failure to address these growing these problems will only cause the number of seniors who struggle with hunger and isolation to rise especially as this population grows and lives longer We all share the healthcare and economic costs when our seniors experience malnutrition and loneliness 8

OPPORTUNITIES TO PARTNER 9

MEALS ON WHEELS OF CENTRAL INDIANA Our mission: Meals on Wheels of Central Indiana innovates, advocates and collaborates to end hunger and malnutrition for our senior, disabled and critically ill neighbors.

Food Is Medicine

Medically-Tailored Meals (MTMs) Meals customized specifically for a client s chronic disease(s) or medical conditions. ~ Involves nutritional therapy & education ~ Physician-directed

Even though we have been providing these meals since 1971, Meals on Wheels of Central Indiana officially changed from using this term physician-directed to MTMs several years ago.

Key themes: Education Accessibility Partnerships Advocacy

15

Length of hospital stays for malnourished patients are up to 3X longer than for properly nourished patients.

For the Price of Average cost of an ED visit ($2,168) = 3 months of 3 medically-tailored meals per day Average cost of hospitalization paid by Medicaid ($7,500) = 10 months of meals = Center for Health Law and Policy Innovation, Harvard Law School

For the Price of Average cost of hospitalization all payers ($9,700) = 1 year of meals Average cost of hospitalization paid by Medicare ($11,600) = 16 months of meals = Center for Health Law and Policy Innovation, Harvard Law School

Chronic disease is the enemy of the natural aging process.

Focus on the strong connection to chronic disease and poverty.

Chronic disease causes people to enter into the homebound system prematurely.

Attention on low income and vulnerable populations & become safety net.

Medically Tailored Home-Delivered Meals are a Low-Cost Healthcare Intervention Individuals with severe chronic illnesses who received medically tailored home-delivered meals from MANNA of Philadelphia through Health Partners Plans experienced: 20% lower healthcare costs than other groups 32% fewer hospital admissions 8% fewer ER visits

Medically Tailored Home-Delivered Meals are a Low-Cost Healthcare Intervention Individuals with HIV and/or diabetes who received medically tailored home-delivered meals from Project Open Hand of San Francisco experienced improvements in: Food security, nutritional health, mental health, and behavioral health Depression, diabetes distress, diabetes selfmanagement, trading-off between food and healthcare, and HIV medication adherence Glycemic control, and reduced hospitalizations and ED visits (among participants with Type 2 Diabetes)

Programs Traditional Meals on Wheels ~ program provides one hot & one cold meal each weekday, or 10 frozen meals each week. Funded by private pay and financial assistance.

Programs EMBRACE Cancer Treatment program ~ provides low-income cancer patients with medically-tailored meals during their treatment plus another three months posttreatment. Funded by Eskenazi Health.

Programs Head Start Readmission program ~ studies effect of nutrition intervention on hospital readmissions and preventing permanent home bounding specifically for adult cardiovascular and diabetic patients. Funded by Community Health Network.

Programs Ryan s Meals for Life program medically-tailored meals to low-income Persons Living with HIV across Indiana. Funded by a federal Ryan White Supplemental Grant Award through the Indiana State Department of Health.

Partnerships Factors Supporting Growth of the Food is Medicine Movement: Growing recognition of nutrition as a cornerstone to improved health; and of the high costs of malnutrition to healthcare.

Partnerships Factors Supporting Growth of the Food is Medicine Movement: Growing network of medically tailored meals programs across the nation through the Food Is Medicine Coalition (FIMC)

Partnerships Factors Supporting Growth of the Food is Medicine Movement: Growing partnerships between healthcare providers and FIMC agencies to conduct research demonstrating the impacts of medically-tailored meals on health outcomes and costs

Partnerships Factors Supporting Growth of the Food is Medicine Movement: Increasing interest in medically tailored meals from insurers seeking to lower healthcare costs and improve outcomes for their patients

Partnership with Noble Center Provide medically-tailored bulk meals to 20 low-income individuals with disabilities Work with nursing staff Accommodate special diets, such as pureed Started January 2016

Partnership with Noble Center ADVANTAGES: Adherence to dietary needs and enjoy socializing in a group setting. This is one idea of a collaboration Meals on Wheels is open to other opportunities and locations.

Training center for the next generation of health and food lawyers, law and policy reform think tank, advocacy leadership development and law reform advising program Health Law Food Law Access to health care for underserved populations Preventive health care & chronic disease management Access to healthy food Sustainable food systems Center for Health Law and Policy Innovation, Harvard Law School

Center for Health Law and Policy Innovation, Harvard Law School

MEALS ON WHEELS OF CENTRAL INDIANA

City of Tualatin Meals on Wheels People Senior Nutrition Program

Funding Older American Act (OAA) 43% Fundraisers Partnerships Private Donations

Local Partners: City of Tualatin Fred Meyer New Seasons Winco Oregon Food Bank Panera Bread Tualatin Chamber Partnerships

Orientation & Background Check Kitchen Support (food prep, dish salad, servers) Dining Room Assistant (set tables, roll silverware) Greeters Drivers Volunteers

Participant Registration

Participant Registration

Congregate & Home 90 meals served daily Annually we serve 18,300 seniors 9,400 Congregate 8,900 Home Delivery No one is ever turned away and there is never a waitlist Delivery

Congregate & Home Delivery

Congregate & Home Delivery

Congregate & Home Delivery

City of Tualatin & MOWP Positive and continually growing relationship Pride ourselves on teamwork and collaboration Same vision: To serve older adults and make someone s life a little better everyday

Questions? Katie Jantzi, LCSW Meals on Wheels America 571-339-1622 katie.jantzi@mealsonwheelsamerica.org Lisa Dillman Meals on Wheels of Central Indiana 317.492.9569 Lisa@dillmanlawgroup.com Sara Shepherd Juanita Pohl Center- City of Tualatin 503.691.3014 sshepherd@tualatin.gov Kate Clabaugh National Recreation and Park Association 703.858.2145 kclabaugh@nrpa.org