Food insecurity was already common in older adults before the pandemic.
image by congerdesign from Pixabay
Years ago, when I worked as an ED nurse at Bellevue Hospital, one patient who became a favorite was a charming octogenarian named Sam. He would frequently present in congestive heart failure or pulmonary edema. He always responded quickly to treatment and often just needed a bit of furosemide to get rid of excess fluid.
After one of his almost monthly admissions, we found out that Sam relied on canned soup for much of his diet. The high salt content would cause him to retain too much fluid. He knew the salt wasn’t good for him, but soup was cheap and sometimes all he could afford.
What is food insecurity?
The United States is one of the world’s richest countries, yet we know that hunger is a common problem for many people. Older adults, especially those over 65 with multiple chronic conditions and who take multiple medications, are especially at risk for food insecurity—the inability to afford healthy and nutritious food.
Hard choices for elderly on a fixed income.
Many older adults live on fixed incomes and many don’t have supplemental insurance to cover medications. Some may have to choose between paying for medication or paying for other necessities like housing and food.
Many rely on programs like Meals on Wheels or food banks, but a number of these programs were suspended, at least for a time, during the early days of the COVID-19 pandemic. This worsened the situation for many older adults, no doubt causing some to experience food insecurity for the first time and in some cases, to have to choose between food and medications (or opt for cheaper, processed foods that can be damaging to your health).
Health care providers should be aware of drug costs issues.
AJN‘s June issue original research article is a systematic review: “The Relationship Between Food Insecurity and Cost-Related Medication Nonadherence in Older Adults.” The authors note:
“An important finding was that, even with access to food aid, a lack of prescription drug coverage and higher out-of-pocket health care costs were predictive of increased CRN [cost-related medication nonadherence] behaviors in subjects with food insecurity. In light of this, it’s vital that health care providers be knowledgeable about costs of prescription drugs and possibly cheaper alternatives. Ultimately, lower drug prices and improved Medicare drug coverage are needed for older adults.”
You can also watch lead author Shaunna Caouette discuss the article in the video abstract: https://journals.lww.com/ajnonline/Pages/videogallery.aspx
One hospital in Boston writes prescriptions for food in the ER and in a nutrition clinic. It’s mostly used for malnourished children, of whom there are too many, but also for pregnant women and, I think, folks like your Sam. It’s way cheaper than an ER visit and the rxs are honored by many of the gorcery stores at reduced or no cost.