the elderly nutrition program

With the aging of the U.S. population, increased attention is being given to delivering health and related services to older persons in the community. Since adequate nutrition is critical to health, functioning, and the quality of life, it is an important component of home and community-based services for older people.

The Administration on Aging’s (AoA) Elderly Nutrition Program (ENP) provides grants to support nutrition services to older people throughout the country. The ENP, authorized under Title III, Grants for State and Community Programs on Aging, and Title VI, Grants for Native Americans, under the Older Americans Act, is intended to improve the dietary intakes of participants and to offer participants opportunities to form new friendships and to create informal support networks.

Through Title III, grants are provided to the aging network which is made up of the 57 State Units on Aging (SUA’s) and their 655 Area Agencies on Aging (AAA’s) and through Title VI, to 221 Tribal Organizations, representing American Indian, Alaskan Natives, and Native Hawaiians, to promote the delivery of nutrition services in local communities.

The ENP provides for congregate and home-delivered meals. These meals and other nutrition services are provided in a variety of settings, such as senior centers, schools, and in individual homes.

Meals served under the program must provide at least one-third of the daily recommended dietary allowances established by the Food and Nutrition Board of the National Academy of Sciences-National Research Council. In practice, the ENP’s 3.1 million elderly participants are receiving an estimated 40 to 50 percent of most required nutrients.

The ENP also provides a range of related services, by some of the aging network’s estimated 4,000 nutrition service providers, including nutrition screening, assessment, education and counseling. These services help older participants to identify their general and special nutrition needs, as they may relate to health concerns such as hypertension and diabetes.

The services help older participants to learn to shop for, and/or to plan and prepare, meals that are economical and which help to manage or ameliorate specific health problems as well as enhancing their health and well-being. The congregate meal programs also provide older people with positive social contacts with other seniors at the group meal sites.

Volunteers who deliver meals to older persons who are homebound are encouraged to spend some time with the elderly. The volunteers also offer an important opportunity to check on the welfare of the homebound elderly and are encouraged to report any health or other problems that they may note during their visits.

In addition to providing nutrition and nutrition-related services, the ENP provides an important link to other needed supportive in-home and community-based services such as homemaker-home health aide services, transportation, fitness programs, and even home repair and home modification programs.

Eligibility

While there is no means test for participation in the ENP, services are targeted to older people with the greatest economic or social need, with special attention given to low-income minorities.

In addition to focusing on low-income and other older persons at risk of losing their independence, the following individuals may receive service including:

a spouse of any age;
disabled persons under age 60 who reside in housing facilities occupied primarily by the elderly where congregate meals are served;
disabled persons who reside at home and accompany older persons to meals; and
nutrition service volunteers.

Since American Indians, Alaskan Natives, and Native Hawaiians tend to have lower life expectancies and higher rates of illness at younger ages, Tribal Organizations are given the option of setting the age at which older people can participate in the program.

Program Outcomes

A congressionally-mandated evaluation of the ENP, released in fiscal year (FY) 1996, found that its participants have higher daily intakes of key nutrients than similar nonparticipants and that they have more social contacts as a result of the program.

Among ENP participants, 80 to 90 percent have incomes below 200 percent of the Department of Health and Human Services’ poverty level index, which is twice the rate for the overall elderly population. More than twice as many Title III participants live alone; and two-thirds of participants are either over or under their desired weight, placing them at risk for nutrition and health problems. Title III home-delivered meals participants have twice as many physical impairments compared with the overall elderly population.

In FY 1995, ENP funding neared $470 million and provided 123 million meals to 2.4 million people at congregate meal sites and 119 million home-delivered meals to 989,000 homebound older persons. In FY 1994, 226 American Indian grantees received nearly $17 million, which provided 1.3 million meals to 41,000 congregate meal participants and 1.5 million meals to 47,500 homebound elderly participants.

In FY 1998, total funding for the Title III congregate and home-delivered meal programs was $486.4 million which is 56 percent of the AoA’s budget. For every $1 of federal congregate funds, $1.70 additional funding is leveraged; for every $1 of federal home-delivered funds, $3.35 additional funding is leveraged. The leveraged funds come from other sources including state, tribal, local, and other federal moneys and services, as well as through donations from participants. Nationally, total contributions amounted to $170 million.

The average cost of a meal, including the value of donated labor and supplies, was $5.17 for a group meal and $5.31 for a home-delivered meal under Title III. Comparable costs for a meal under Title VI were $6.19 and $7.18, respectively.

Resources...

Your AAA listed in the government section of the phone directory usually under "aging" or "elderly" services. The AAA can provide information about the ENP in your area. If you are unable to locate your AAA or for information about AAA’s in other areas of the nation, please call the AoA’s Eldercare Locator at 1-800-677-1116. It is helpful if you can provide the address and zip code of the older person you are trying to assist.

For information and publications about nutrition and nutrition programs geared to professionals, please contact:
The AoA’s National Policy and Resource Center on Nutrition and Aging, (305) 348-1517
The National Association of Nutrition and Aging Service Programs, (616) 531-9909
The National Association of Meal Programs, (703) 548-5558
For general information and publications regarding nutrition and health, please contact:
American Diabetes Association, (703) 549-1500
American Dietetic Association, 1-800-366-1655
American Heart Association, (214) 373-6300
Food and Nutrition Information Center, US Department of Agriculture, (301) 504-5719

Last modified 02/14/2001

Additional information is available from:

Administration on Aging
U.S. Department of Health and Human Services
330 Independence Avenue, SW
Washington, DC 20201

Telephone: (202) 619-0724
TDD: (202) 401-7575
Fax: (202) 260-1012
E-Mail: aoainfo@ban-gate.aoa.dhhs.gov
Internet Web Site: http://www.aoa.dhhs.gov

Hard copies of the AoA Fact Sheets may be obtained by contacting AoA's National Aging Information Center, 330 Independence Avenue, SW, Washington, D.C. 20201; (202) 619-0724; TDD: (202) 401-7575; FAX: (202) 260-1012; Internet email: naic@ban-gate.aoa.dhhs.gov