How to Communicate With Older Adults about Food Insecurity and Hunger

Rev. James Ellor, PhD, DMin, an expert on the aging population who has researched hunger among older adults, recalled reading a sign on the door of a former colleague: “You aren’t really paranoid if they are out to get you.”

The sign paraphrases a line from Joseph Heller’s comic war novel Catch-22, but Ellor knows that the reality for older adults is that they have a reason to be skeptical of people who offer help for issues related to health, housing, and finances.

“Older adults just don’t automatically trust other folks because there are so many scams out there,” said Ellor, a professor with the MSW online program at Baylor University’s Diana R. Garland School of Social Work. “They really are out there to get you, and so it’s not paranoia.”

For people who work in helping professions like social work, how they interact with older adults matters. In order to address significant problems affecting aging populations such as hunger and food insecurity, those who intend to help need to be thoughtful about how they communicate in order to build trust.

Feeding America estimated that 5.5 million people age 60 and older were food insecure in 2017. Those who experienced low food security had reduced quality, variety, or desirability of diet and little or no indication of reduced food intake, while those who lived with very low food security experienced disrupted eating patterns and reduced food intake. 

In 2017, 7.7% of adults age 60 and older were food insecure, and 3.1% had very low food security, according to a 2019 report published by Feeding America. Go to a tabular version for data on the demographics of older adults living with hunger in America.

Along with contributing to hunger and malnutrition, food insecurity can have a number of detrimental effects on older adult health (PDF, 1.3 MB) and is a predictor for heart disease, cancer, stroke, pulmonary disease, and diabetes. Adults who live in food insecure households are more likely to experience long-term physical health problems, chronic disease, and depression.

The cost of treatment for these health issues can deplete financial resources and exacerbate food insecurity. Feeding America reports that 63% of senior households in its network are forced to choose between food and medical care.

Some of the major factors that contribute to food insecurity among older adults include:

Acknowledging that they are hungry isn’t always easy for older adults.

“It can be an embarrassing thing, and it shouldn’t be,” said Enid Borden, founder and CEO of National Foundation to End Senior Hunger. “But how do we change somebody who’s 85 years old? There’s no magic wand.”   

Ellor noted that older adults’ experiences at places of worship illustrate the stigma that can be associated with needing assistance. 

Older adults “are the ones [who] have a long pattern of giving to the box or the fund for the poor,” he said. But Ellor adds that they are unlikely to seek out food assistance when they have a need. This can be especially true if the place of worship is of a different denomination.

“That becomes a part of the challenge to get people to go to food, and it’s why so many of the nutrition programs have actually moved out of churches,” Ellor said. 

While government programs can help, participation in the Supplemental Nutrition Assistance Program (SNAP) lags for eligible older adults. The USDA reported a significant gap in SNAP participation rates among the total population of eligible individuals and eligible older adults (PDF, 1.9MB).

84%

of all eligible individuals participated in SNAP.

48%

of eligible adults 60 and older participated in SNAP.

Assessing whether an older adult needs food assistance can be difficult for concerned community members because the relationship between food insecurity, hunger, and malnourishment is complicated. Borden points out that weight loss or gain may be a sign that a person needs help. 

“Depending on what it is that we’re eating, a lot of times you can find people [who] are obese and malnourished because it’s about caloric intake and whether they’re good calories or bad calories,” she said.

That’s why it’s so important to create a space where open conversations with seniors can occur in order to more accurately assess their needs. Ellor and Borden identified senior centers or other congregate nutrition sites as natural places where people can direct older adults because they address another issue that often comes hand-in-hand with hunger — loneliness. 

“A lot of older adults are lonely, and loneliness in and of itself creates health hazards,” Ellor said. “You don’t get out. You don’t get food. You don’t have human interaction. And, certainly, you’re closed down.”

Borden says that breaking bread with other people can help people to get a handle on issues related to lack of food and malnourishment. 

“I love the whole notion of going to the senior center because we tell them to socialize, play bingo, take an exercise class — and while you’re there, have a meal,” Borden said.

It also provides an opportunity to determine whether older adults are eating and doing so healthfully. Social workers and other volunteers at senior centers can open up conversations by asking simple questions:

This approach may also help to avoid some of the common communication mistakes people make when talking to older adults (PDF, 1 MB), as noted by the Gerontological Society of America.

AVOID

Simplifying vocabulary which can sound patronizing or like “baby talk.”

Using endearing or diminutive terms such as “sweetie, cutie, honey, and darling.”

Emphasizing intonation that puts stress on certain words or uses a sing-song pitch pattern.

INSTEAD

Use adult vocabulary. Correct medical terminology is acceptable but should be followed with a nontechnical explanation.

Address the person by their name. “Mr. Smith or Mrs. Watson” is usually a safe approach.

Use regular conversational intonation without exaggeration.

Those who seek to help older adults aren’t limited to just senior centers.

“We need to work in unison,” Borden said. “It’s a community issue, and it requires a community solution.” 

Food delivery programs such as Meals on Wheels and food banks or pantries may also be places to volunteer time. Those working at food banks or pantries can ensure that older adults who visit know where to find the closest senior center. Volunteers can likewise look for organizations that help to sign seniors up for benefits such as SNAP. 

Ellor pointed out that identifying natural leaders among the older adult community to participate in efforts on food insecurity and hunger may be a good way to engage their more vulnerable peers. Clergy, postal workers, police officers, firefighters, and hospital workers can also help identify at-risk adults.

“Their primary job is something else, but because they’re with the public, they have become referral sources to other places,” he explained. 

And sometimes, all it takes is a simple neighborly check-in to ensure that the person living down the block is doing OK.

“We want to live with dignity, we want to live in our own homes, and we want to live in a community where people care and are cared for,” said Borden. “We can’t change a lot about [older adults] … but we can help them live better lives.”

If you are interested in helping older adults facing food insecurity, learn more about the following organizations and programs that can help provide assistance:

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Citation for this content: Baylor University’s online master’s in social work program.