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Toast for dinner? Senior malnutrition: a silent epidemic

My elderly parents often resort to making toast when no one is around to make meals for them. Once a week, my sister will bring them over to her house for a big meal and send them home with leftovers. Other days my brother brings them a steady stream of casseroles.

But on the days that no one stops by, it’s just them and the toaster. And sometimes they can’t even manage toast.

Like many people over 90, my parents have cognitive problems and they are hard pressed to manage their nutrition. My old-fashioned dad still expects someone to make his dinner. My nearly-blind mother can’t figure out what’s lurking in all those opaque containers in the refrigerator, let alone what to do with it. The result is often toast.

My parents are not alone. Many elderly people end up malnourished for a host of reasons. For some elderly people, dementia or other cognitive problems make it impossible to manage the basic activities of daily life, referred to as ADLs. For other seniors, their lack of transportation makes it hard to get to the store. Still other seniors find that social isolation leads to depression and lack of appetite. Poverty and dental problems also can make good nutrition tough.

One of the primary indicators for all health problems for seniors is social isolation. According to the 2010 Census, 11 million, or 28 percent, of all people over the over the age of 65 lived alone. Looking to the near future, AARP reports that the current cohort of aging baby boomers are the first generation to out-number their children, which means there will be far fewer seniors with family members to keep them company and make sure they have healthy diets.

A 2012 study by the American Academy of Family Physicians found that 3.7 million senior citizens in the United States were diagnosed with malnutrition. Holly Kellner Greuling, the national nutritionist for the federal Administration on Aging, estimated that almost half of all older Americans are malnourished, positing that “senior malnutrition in our country is an epidemic hiding in plain sight.”

The impacts of senior malnutrition can be lethal for seniors and costly for our health care system. According to the Alliance to Advance Patient Nutrition, 1 in 3 older adults admitted to hospitals is malnourished. The alliance estimates that senior malnutrition is the primary factor in health care costs that range over $157 billion dollars annually. Malnourished seniors stay longer in the hospital, are more likely to be re-admitted, and have overall higher rates of mortality.

I worry how my parents fit into those statistics. I visit as often as I can afford, staying as long as I can to keep them company and cook for them. While they appreciate the food, the best part for them is the house being filled with the savory smell of dinner cooking and having company during their meal. They can’t remember what happened 10 minutes ago, but the smell of beef stew brings back happy memories.

Sadly, I live 2,000 miles away and have only so many credit cards and vacation days. Like many children with aging parents, I do what I can, but it never feels like enough.

Here in Olympia, there are thousands of elderly people on their own, many of whom struggle with nutrition. We are fortunate to have an organization like Senior Services, a non-profit with hard-working staff and volunteers to provide more than 9,000 nutritious meals to seniors across the South Sound. They operate community dining sites for seniors to share a meal and break their social isolation. Their “Meals on Wheels” program delivers more than 3,000 meals to house-bound seniors.

We also have a robust network of private home-care providers that will help frail and elderly people stay in their homes. These are real solutions for seniors who don’t have adult children to care for them.

With Thanksgiving coming up, many seniors will likely be invited to a big family meal. Non-profits and faith communities will host community meals. But what happens the following week?

Senior malnutrition is a silent epidemic, deadly for seniors and expensive for our health care system. As family members and community members, we can address the causes of senior malnutrition and make sure there is more than toast for dinner.

Anna Schlecht is a board member of Senior Services for South Sound and a member of The Olympian’s 2017 Board of Contributors. She can be reached at

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