Research Highlights

• Older adults and those with physical disabilities are often unable to provide themselves with a nutritious diet due to numerous physical, physiological, socio-economic and psychological limitations.
• As many as 85% of adults in long-term care homes and more than half of all seniors cared for at home suffer from undernutrition or malnutrition.
• As the population ages, the number of elderly and disabled adults in the province is expected to rise from 13.5% to 20% over the next two decades.

And in Guelph & Wellington…

• In 2001 there were 23,403 seniors in Guelph and Wellington County and approximately 27,000 people with disabilities.
• The fees associated with many nutrition and food programs are beyond the means of many low-income adults.    
  

Individuals at Risk of Malnutrition
Senior citizens and people with limited mobility often experience difficulty in accessing and preparing enough nutritious food to remain healthy. Several factors contribute to nutritional risk and can be divided into four general categories: physical, physiological, socio-economic and psychological constraints ¹. Many older and disabled adults suffer from limitations in one or several of these categories and struggle to provide themselves with a balanced diet.
 
Physical Limitations         
General physical deterioration makes shopping and preparing food more difficult, particularly when a person is no longer able to drive and must rely on public transportation. Carrying a large amount of food home from the grocery store is often too difficult for adults who are frail. Statistics Canada reports that 83% of Canadians over 85 have a disability ². It is often much easier to buy what is needed on a daily basis from a local convenience store, where food is more expensive and there is a lack of fresh, nutritious food. When older adults find it too difficult to prepare meals for themselves many have a tendency to exist on easy, but nutritionally empty fare – toast, cold cereal, saltines, etc. Even a loss of teeth, relatively common in older adults, makes eating a difficult, and even painful experience ³.
 
Physiological Limitations
As people age they experience many physiological changes, some of which may impact appetite. The taste of food may change and many people lose their appetites altogether. A person’s sense of taste and smell often begin to diminish ⁴. These factors taken together make food less appealing, and eating more of a chore than something to look forward to and enjoy. Older and disabled adults are also vulnerable to a wide-range of illnesses and diseases, which are treated with medications and dietary restrictions ⁵. These changes limit what a person may eat and can make food preparation difficult because customary preparation and consumption patterns must be altered.
 
Socio-economic Limitations
Older adults who have lost a spouse are less likely to prepare meals for themselves – either because they have never done so in the past, or because they do not want the bother since there is no longer anyone else to eat it. Social isolation and loneliness are big factors in the poor nutritional status of many older and disabled adults. Senior citizens and people with physical disabilities are also disproportionately likely to be low-income than other members of the Canadian population. Single, elderly females are among one of the poorest groups in Canada, with 50% of single women 65 and older living in low-income situations ⁶. Poverty limits the quantity and quality of the food that people are able to purchase. Poverty also contributes to the decline of oral health, which affects a person’s ability to eat.
 
Psychological Limitations
Many people who are older, disabled and perhaps isolated suffer from depression, alcoholism and loneliness ⁷. Depression and mental illness limit a person’s appetite, make him or her less likely to go out into the community and interact socially over a meal, or participate in food preparation clubs or workshops. A person’s emotional state will influence their appetite and their ability to ensure that they are eating properly.

Effects of Malnutrition
According to some estimates, as many as 85% of adults in long-term care facilities and more than half of all seniors cared for at home suffer from undernutrition or malnutrition ⁸. Malnutrition is associated with a variety of medical risk factors. These include disease complications, poor healing, pressure ulcers, longer hospital stays and a significantly increased risk of morbidity and mortality ⁹. A sustained lack of nutritious food also weakens the immune system, increasing the risk of pneumonia and other serious infections and exacerbating existing health conditions. It can also contribute to mental confusion. A healthy diet prevents chronic diseases, and overall decline of the health of the individual ¹⁰.
 
Oral health also plays a significant role in malnutrition. Poor dental health, including chipped teeth, sore guns, and poorly fitting dentures can lead to malnutrition because it becomes painful to eat. Conversely, malnutrition can lead to poor dental health including gum disease, poor calcium retention, and tooth loss.
 
Nutritional Programs Designed to Assist
Seniors & Adults with Limited Mobility
Congregate Meal Programs
Many seniors’ centres and community centres will organize congregate meal programs, also known as “Wheels to Meals”, which allow seniors to have a nutritious meal while also interacting with other people. Most of these programs also have a transportation service, driving people to and from their homes.
 
Cooking Clubs/Workshops
Many community centres offer courses and workshops, usually for a fee, to help older adults learn about their dietary needs and how to prepare nutritious meals easily and economically.
 
Meals on Wheels
Programs which prepare and deliver hot or frozen meals to people with limited mobility are operated by a number of different organizations in various communities. There is a fee for the meals, which is not subsidized by the Ontario Disability Support Program, so many disabled people are unable to afford this service. Some providers have a benevolent fund that allows them to subsidize meals for people who are low-income and cannot afford the cost of the meals, but many programs are lacking this support.
 
Outreach Programs
In addition to the congregate meal programs, many seniors’ centres also provide outreach programs that aim to allow older adults to spend a day out among peers. Activities often include a gourmet dining club, arts programs, book clubs, cooking groups, and workshops on different food and nutrition topics. These programs often also provide transportation services for people to and from their homes.
 
Transportation Services
Adults with limited mobility are often at risk of poor nutrition because they are unable or unwilling to travel to the grocery store on their own. Free or low-cost transportation services are offered by community centres, local grocery stores, and public transportation providers in an effort to assist people to access nutritious and fresh food.
 
Nutritional Program Usage in Guelph and Wellington County
According to Statistics Canada, people living with disabilities constitute 13.5% of Ontario’s population. This number is expected to climb to 20% over the next two decades. The City of Guelph bases its accessibility planning on these statistical estimates. At the current provincial average, it can be assumed that there are approximately 15,517 people with disabilities (2006 population) in Guelph and 27,057 in Wellington County.
 
The Meals on Wheels Program in rural Wellington County serves an average of 84 clients per month, three days per week, at a cost of $5.75 for hot meals and $4 for frozen. In the City of Guelph, Meals on Wheels serves an average of 158 clients per month.
 
Community Supports and Services
Service providers in Guelph and Wellington County offer a wide range of programs designed to improve the nutritional status of adults with limited mobility. The following is a brief description of these programs and services.
 
Canadian Red Cross Society
The Red Cross in Guelph is contracted by VON to provide a Meals on Wheels service to the residents of the City of Guelph. This service is available Monday to Saturday.
 
Community Care Access Centre of Wellington - Dufferin
The Community Care Access Centre (CCAC) provides a single point of access for information and referral on a full range of health and social services for all ages. Case Managers work with clients and their families/caregivers. They assess clients’ needs and coordinate a broad range of services, which may include: nursing, physiotherapy, occupational therapy, nutrition counselling, speech-language pathology, personal support and homemaking and access to adult day programs.
 
Evergreen Seniors Centre
The Evergreen Seniors Centre offers a multitude of nutrition courses, workshops and other activities for older adults. Services include a dining room, where seniors can purchase a nutritious meal for a reasonable cost, nutritional counselling with a registered dietician, two hour workshops on different food and nutrition topics, Garden Fresh Box, cooking groups for men, and an outreach program which has a mobility van pick people up at their homes and bring them to the centre for refreshments, activities, speakers and entertainment. Evergreen also provides free buses to the Stone Road Mall, the Ultra Food Mart and the Willow West Mall, and offers a “meals to go” service.

Home Help Services for Guelph-Wellington
The goal of this service is to improve the quality of life for the frail elderly, adults with disabilities and those convalescing, through an affordable homemaking program. The homemaker can assist with routine household activities such as: light housekeeping, shopping, meal preparation and laundry. Four community support service agencies provide the services by matching a homemaker to a client.
 
No Frills
The No Frills grocery store in Guelph holds a Seniors’ Day every Wednesday. A free bus is provided to and from the store for the seniors, and free delivery of the groceries to seniors’ homes is also provided.
 
St. Joseph’s - Community Outreach Services
The Out ‘N’ About program is designed to assist older adults who wish to remain in their homes but are having difficulty staying engaged in community life. Preparation of a lunch by the staff and participants is a component of the Out ‘N’ About program. All snacks (morning and afternoon) are prepared by staff and participants in the baking/cooking programs.
 
St. Joseph’s also has a transportation program geared towards seniors and physically disabled adults living in Guelph and the surrounding areas to access needed services, such as grocery shopping.
 
Victorian Order of Nurses (VON)
VON offers Meals on Wheels programs throughout rural Wellington County. They also offer a transportation program geared towards seniors and adults with disabilities in Guelph and Wellington County to access needed services, such as grocery shopping or food banks. VON has a telephone Reassurance program which offers a daily call to seniors or adults with disabilities and many calls are to remind clients to eat or take their medication.
 
VON also has a Seniors’ Day Out program in Mount Forest which offers a day program service for seniors and adults with disabilities in North Wellington. Lunch is freshly prepared by the VON Meals on Wheels cook. Clients also participate in exercise, music and baking programs during the day.
 
* Of the above mentioned services, the United Way of Guelph and Wellington funds and supports the Red Cross.

What are the Social Service Needs in Guelph & Wellington?

• Senior citizens are expected to account for 21% of the Canadian population by 2026 (up from 13% in 2002) ¹¹. The population of Guelph and Wellington County is aging and more services will need to be established in order to meet the increased demand.
• Statistics Canada indicates that 13.5% of Ontario’s population is in some way disabled. They estimate that this figure will increase to 20% over the next two decades ¹². Considering local population projections, there are not enough services in Guelph and Wellington to meet these additional needs.
  
• The Meals on Wheels service in Wellington County does not have a benevolent fund, as does the Red Cross program in Guelph. This means that rural people without the funds to purchase these meals must go without.

1. Ontario Community Support Association (2001). Meeting Nutritional Needs in Home Care. Retrieved June 23, 2006, from http://www.ocsa.on.ca/PDF/Meeting_Nutritional_needs_reprint.pdf.
2. Social Planning Council of Cambridge and North Dumfries (2006). Seniors: Poverty and how it Affects Nutrition. Factsheet presented at the Social Planning Council of Cambridge and North  Dumfries Poverty Symposium, Friday June 9, 2006, Cambridge, Ontario.
3. Ibid.
4. Ontario Community Support Association (2001). Meeting Nutritional Needs in Home Care. Retrieved June 23, 2006, from http://www.ocsa.on.ca/PDF/Meeting_Nutritional_needs_reprint.pdf.
5. Mayo Clinic (2005). Malnutrition and Seniors: When a Relative Doesn’t Eat Enough. Retrieved June 23, 2006, from http://www.mayoclinic.com/health/senior-health/HA00066.
6. Social Planning Council of Cambridge and North Dumfries (2006). Seniors: Poverty and how it Affects Nutrition. Factsheet presented at the Social Planning Council of Cambridge and North  Dumfries Poverty Symposium, Friday June 9, 2006, Cambridge, Ontario.
7. Mayo Clinic (2005). Malnutrition and Seniors: When a Relative Doesn’t Eat Enough. Retrieved June 23, 2006, from http://www.mayoclinic.com/health/senior-health/HA00066.
8. Ibid.
9. Ontario Community Support Association (2001). Meeting Nutritional Needs in Home Care. Retrieved June 23, 2006, from http://www.ocsa.on.ca/PDF/Meeting_Nutritional_needs_reprint.pdf.
10. Mayo Clinic (2005). Malnutrition and Seniors: When a Relative Doesn’t Eat Enough. Retrieved June 23, 2006, from http://www.mayoclinic.com/health/senior-health/HA00066.
11. Statistics Canada (2005). Golden Oldies. Retrieved July 24, 2006, from http://142.206.72.67/02/02a/02a_003_e.htm.
12. City of Guelph (2005). Accessibility. Retrieved July 23, 2006, from http://guelph.ca/living.cfm?subCatID=1037&smocid=1622.