| dc.description.abstract | Background: Aging involves bodily changes that impact both the nutritional status and the diet of individuals. Maintaining a healthy diet can reduce the risk of developing diseases and frailty. Older adults’ independence can be prolonged if they have supportive physical and social surroundings. There are more than 1 billion older people in the world today, and the older adult population is estimated to double by 2050. The global burden of Disability-adjusted life years is expected to raise. Simultaneously, the fertility is declining. Therefore, the current and upcoming burden of an aging population can benefit strongly from facilitating a supportive environment for older adults. There is limited data on prevalence and burden of malnutrition among older adults, especially in Low- and Middle-Income Countries. The data is also scant in High Income Countries. Most of the data on malnutrition among older adults in Norway is collected from older people living in institutions. As the population of older people is growing in Norway as well as worldwide, we should ensure that older adults can access food that meets their nutritional requirements. Previous studies about older adults and nutrition in Norway have usually focused on the older adults’ nutritional status or their knowledge about nutrition, but there is a knowledge gap on their food security situation.
Objectives: Explore the experiences of food security among older adults living at home in Oslo, Norway. In addition, this study explored the perception of older adult’s food security according to home care service staff in Oslo and Bergen, Norway.
Methods: This study used a descriptive qualitative design, including in-depth interviews with older adults and semi-structured interviews with staff. The older adult participants were recruited through nonprobability convenience sampling by municipal health care workers and the interviews were conducted in the participants’ own homes. The home care service staff were recruited by home care service staff leaders in Nordre Aker, Oslo and Arna and Åsane, Bergen, and the interviews took place in the staffs’ respective departments. The interviews were audio taped, and the recordings were stored safely. Analysis was conducted using the NVivo 12 PLUS software, involving inductive coding and theme development. Ethical approval was acquired from the regional ethical committee REK, and written informed consent was collected from all participants.
Results: The study found that food security experiences of older adults could be divided into the following themes: The first theme, securing food, revealed how finances impact food choices although none of the participants considered their financial status to be poor. In addition, conversations on food planning and purchasing highlighted food security barriers, where it was revealed how some older adults would rely on transportation options, municipal food services and non-municipal food services to access food. The second theme, preparing food, introduced the topics of pre-made or homemade food and how it was related to food security. The third theme, food intake, showed that the food items chosen, and variation reflected the food access the older adults had. Taste of food, the social aspect of eating and health was connected to appetite and food intake. The final theme, opinions about food security, highlighted how the older adults believed their nutritional status as a responsibility mainly was their own, shared with family and the municipality under certain circumstances. In addition, the participants revealed that it was difficult to put into words how older adults get malnourished. Conversations with home care service staff revealed additional information on barriers to a sufficient nutritional intake among older adults, including personal weight management, nutrition knowledge, loss of independence, loneliness, and depression.
Conclusion: This study explored food security experiences of older adults in Oslo, and views by home care service staff in Oslo and Bergen, identifying factors such as finances, mobility, family support and health issues. The importance of food preferences and loneliness and mental health were identified as potential threats for food security. Future research should aim to include several demographics and regions of Norway to uncover more experiences, to be able to fully address the food security challenges older adults in Norway face. The study may inform the public health sector facing an increasing older adult population living alone or with limited social networks. | |
