I work for Brighton & Hove Food Partnership, a non-profit organisation helping people learn how to: cook, eat a healthy diet, grow their own food and waste less food. Our city-wide food strategy brings together nearly 100 organisations and council departments and sets out how, as a city, we can collectively achieve a vision of a healthy, sustainable and fair food system for Brighton & Hove.
In the last year we have been working with colleagues in public health, health and social care services and local voluntary groups to take a look at malnutrition (or undernutrition as it is more correctly called) which affects far more people than most of us realise.
Eating as we get older
Lots of us don’t realise that we may need to eat differently as we get older - we may see losing weight as just a natural part of the ageing process. Who hasn’t heard the term ‘little old lady’ – encapsulating the idea that weight loss is just part of getting older? But this is a stereotype and it’s not right. It’s one we want to challenge.
If you are under-nourished you are more likely to have a fall, and you are more likely to get ill. If you do get ill you are more likely to go to hospital, and your hospital stay will probably be longer. This issue deserves to be taken seriously.
We know that 9 out of 10 older people with undernutrition aren’t in homes or hospitals, but in our community, living in their own houses and flats.
We also want to make sure that the voices of older people themselves inform the way this project develops. So with one of our amazing partner organisations, Impetus, we held a focus group to better understand the issues. This allowed us to hear directly some of the voices of people who are currently, or who may be at risk of, experiencing issues around eating well.
No easy solutions
One thing that was clear was that there is no one-size-fits all problem - let alone a simple one-size solution. This was a range of different individual people each with their own unique experience. And participants themselves made their point.
“I don’t like being stereotyped as ‘old’.”
In discussion, however, some common themes emerged. When we asked about barriers to eating well, health and mobility issues played a crucial role for some people and there was frustration at difficulties shopping or cooking.
“I want to cook my own but can’t get it or prepare it.”
Activities including ‘shared eating’ options such as casserole club, which connects neighbours together over sharing food, or lunch clubs had a positive impact for some.
“Hove Lunch club on a Thursday is brilliant.”
Online or Offline
However, it was difficult to find out about shared eating and other activities. Having online access – not just for lunch clubs but also for online food shopping and information about specialist mobility or adapted cooking equipment - was very helpful for around half the participants and one participant highly recommended this solution to the others on the group. However, approximately half of the group had no or very little internet access, or had access but lacked confidence in navigating.
“If you don’t use the internet you are helpless”
Importantly some people without digital access didn’t want to go online- and stressed it was important that information was provided in a form they could access:
“I don’t want internet access – people should make the information available without me having to make a change I don’t want to make. “
Other important themes were challenges due to housing, for example accommodation which hadn’t been adapted to meet physical needs, or which was expensive leaving little money left over for healthy eating. Also moving into shared housing for one participant had led to loss of privacy and control over cooking facilities.
Some, but not all, felt they lacked info on healthy eating.
However, there was a general distrust of nutritionists, with a perception that messages on healthy eating are unreliable because they have changed over time. It was also important to avoid the feeling that being dictated to by ‘experts’ or given ‘rules’:
“How to put a message across without feeling dictated to... how to not be patronising and not boring?”
There was a suggestion that peer-led sessions from other older people might be more acceptable and this recommendation has been passed on to the council’s public health team.
What came across to me most strongly from the session is the need to raise awareness whilst empowering older people to look for their solutions. Our city has a particularly high proportion of older people who live alone, which for some can make cooking and eating less of a pleasure and more of a chore. At the same time, we have an incredibly vibrant food sharing culture. We need to share information better – but also open up conversations.
Your can read the report from the focus group here.
Emily O’Brien is the Policy & Partnerships Manager at Brighton & Hove Food Partnership
Have you been affected by any of these issues?
If you have been affected by any of the issues described in this blog, or simply need someone to reach out to, you can call Independent Age’s freephone Helpline for information and advice on 0800 319 6789.
The views and opinions expressed in this article are those of the author and do not necessarily reflect the policy or position of Independent Age.