INTRODUCTION
Hospitalization is a challenging experience for many older adults as they may
face declines in nutrition status and physical function (1–4). Xia and
McCutcheon suggested that a myriad of factors contribute to the declining
nutrition status of older adult patients during hospitalization, including poor
dietary intake due to illness, the eating environment in the hospital, and the
lack of assistance with meals (5). Functional declines experienced during
hospitalization can be attributed to bed rest or immobility and complications
of underlying health conditions under treatment (6). Thus, the posthospital
discharge period is critical to recuperation from illness and re-entry into community
living for these patients (7). However, once home, older adults often
remain at continued risk of poor dietary intake (8, 9). Many return to solitary
living arrangements, have limited access to in-home nutrition services, and
see little improvement in physical function (10–12). In addition to these
barriers to recuperation, limited finances may also restrict access to
micronutrient-dense foods such as fruits and vegetables (13). Given the
importance of these foods in the primary and secondary prevention of
chronic diseases (14, 15), a greater understanding of the availability of these
food groups in the household and the ability to prepare and consume such
food is of interest for program planning.
Community-based nutrition services including home-delivered meals
(HDM) provided by the Older Americans Act Nutrition Program (OAANP)
are well-positioned to assist older adults in transitioning from hospital to
home (16). According to the Administration on Aging, HDM services are
important in allowing older adults to maintain community residence and in
avoiding negative health outcomes such as premature death and reinstitutionalization
(17). However, a report in 2005 indicated that the increase in
demand for HDM services has resulted in waiting lists of three to five months
in 40% of programs (18), far exceeding the critical 2-week period of recovery
following discharge (7). Additionally, there is poor communication between
the medical and community-based health care systems, so that hospitaldischarged
older adults do not necessarily get timely referral to the OAANP
(19, 20). Thus, vulnerable, homebound, hospital-discharged older adults may
have to rely on themselves and on others for nourishment. Little is known
about the type and amount of food available in the homes of older adults
106 U. O. Anyanwu et al.following discharge and their ability to use these foods or to acquire
additional foods. Anecdotal information suggests that hospital-discharged
older adults return home to foods in poor condition (such as spoiled milk
and stale bread). Thus, the purpose of this article is to (1) document the food
available in the homes of hospital-discharged older adults and (2) examine
associations between health and nutrition risk characteristics and
food-related activities such as the ability to shop and prepare meals among
these older men and women.
INTRODUCTION
Hospitalization is a challenging experience for many older adults as they may
face declines in nutrition status and physical function (1–4). Xia and
McCutcheon suggested that a myriad of factors contribute to the declining
nutrition status of older adult patients during hospitalization, including poor
dietary intake due to illness, the eating environment in the hospital, and the
lack of assistance with meals (5). Functional declines experienced during
hospitalization can be attributed to bed rest or immobility and complications
of underlying health conditions under treatment (6). Thus, the posthospital
discharge period is critical to recuperation from illness and re-entry into community
living for these patients (7). However, once home, older adults often
remain at continued risk of poor dietary intake (8, 9). Many return to solitary
living arrangements, have limited access to in-home nutrition services, and
see little improvement in physical function (10–12). In addition to these
barriers to recuperation, limited finances may also restrict access to
micronutrient-dense foods such as fruits and vegetables (13). Given the
importance of these foods in the primary and secondary prevention of
chronic diseases (14, 15), a greater understanding of the availability of these
food groups in the household and the ability to prepare and consume such
food is of interest for program planning.
Community-based nutrition services including home-delivered meals
(HDM) provided by the Older Americans Act Nutrition Program (OAANP)
are well-positioned to assist older adults in transitioning from hospital to
home (16). According to the Administration on Aging, HDM services are
important in allowing older adults to maintain community residence and in
avoiding negative health outcomes such as premature death and reinstitutionalization
(17). However, a report in 2005 indicated that the increase in
demand for HDM services has resulted in waiting lists of three to five months
in 40% of programs (18), far exceeding the critical 2-week period of recovery
following discharge (7). Additionally, there is poor communication between
the medical and community-based health care systems, so that hospitaldischarged
older adults do not necessarily get timely referral to the OAANP
(19, 20). Thus, vulnerable, homebound, hospital-discharged older adults may
have to rely on themselves and on others for nourishment. Little is known
about the type and amount of food available in the homes of older adults
106 U. O. Anyanwu et al.following discharge and their ability to use these foods or to acquire
additional foods. Anecdotal information suggests that hospital-discharged
older adults return home to foods in poor condition (such as spoiled milk
and stale bread). Thus, the purpose of this article is to (1) document the food
available in the homes of hospital-discharged older adults and (2) examine
associations between health and nutrition risk characteristics and
food-related activities such as the ability to shop and prepare meals among
these older men and women.
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