How to feed the elderly better?
Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.
Angela Clutton is a food writer and co-director of the British Library Food Season. This year, alongside talks on fermentation and African-Caribbean foodways, the Season will include a panel discussion on an issue particularly close to her heart: how do we feed our increasingly elderly population? Her concern was raised by the experiences of her mother who after becoming widowed fell ill and lost interest in feeding herself. “It was such a surprise, someone who had for decades fed a whole family suddenly didn’t see the point,” says Clutton. “It happens a lot. It’s not just about getting three meals a day. It’s sitting across a table from somebody, that socialisation. When you’re on your own and lonely, it’s easy for things not to seem important.”
When her mother later entered a nursing home, Clutton was shocked by the standard of meals being provided. “Sausage roll, baked beans and chips every day,” she reports. Worse, the staff had no time to assist residents like her mother who needed help. Her mother then moved to a better home, where Clutton was struck not only by improvements in the food but also by a culture of eating that engenders happier, healthier residents. “The dining room felt like a restaurant with menus and flowers on the tables,” she says. “There was a sherry trolley on Sunday. Cake for birthdays. All these roles food plays in making people feel part of a community. Food is a connector.”
Broadcaster Joan Bakewell, who is on the panel, has long been a campaigner for elderly rights. Now 90, she’s keen to make a broader point about the importance of taking pleasure in food at every age: “The temptation as we get older is to find life boring and routine,” she says. “It’s as though people forget the pleasures they once had in food. That’s a mistake. As you get older, small stimuli of one’s taste buds are thrilling.” Bakewell herself enjoys everything from home-cooked pressed tongue (“wonderful”) to jelly dressed up with treats. “I’m a great fan of squirty cream,” she admits.
But what about more vulnerable people in care settings? Kath Dalmeny is chief executive of Sustain, the alliance for better food and farming. “The signs of an institution doing it well are that food matters,” she says. Some hospitals, for instance, institute a red-tray system that tells nurses when patients need help eating. Some ensure mealtimes are protected so procedures can’t be scheduled then and patients don’t miss out. “We all know how important food is for people’s wellbeing,” she says. Food is a vital “point of humanity”.
While meals-on-wheels services have been severely cut in the UK, other countries have fared better. Simon Shaw, former head of the food poverty programme at Sustain, lauds the network of senior welfare centres in South Korea, where meals-on-wheels, lunch clubs and other activities such as ping pong and calligraphy are organised under the same roof. Delivering good services is seen as a “badge of honour”. In France and Italy too, meals-on-wheels services are enshrined as preventive measures to help avert malnutrition (which leads to hospital admissions) and ensure people can stay at home for longer with daily contact and welfare checks. In Paris, for example, staff use an app to answer welfare questions and their responses can be sent directly to family members or social workers.
Many too are looking to Japan, the only nation currently defined as “super-aged” with more than 28 per cent of its population at 65 or older. Japan has become an incubator for elderly-friendly services and products, including restaurants that offer senior meal options and texture-modified foods that take into account difficulties with chewing and swallowing. In recent years, the government has introduced initiatives to guarantee the quality of these products. These include “Food for Specified Health Uses” markers (in categories such as foods for people with bone-health issues) and a “Smile Care” classificatory system for foods for those who have at-home nursing. It’s a holistic approach to health that prioritises food as a need and a pleasure, which helps older people stay connected and thrive – and a salutary lesson to countries that need to do better.
“Eating for the Elderly” with Joan Bakewell, Kath Dalmeny and Neel Radia, is at the British Library (and online) on 17 May