**AoA Update**

**Volume 2Issue 3****Administration on Aging****March 1997**

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#### "Celebrating community:more than a meal" is theme for elderly nutritionprograms’ 25th anniversaryAoA and General Mills Make Breakfast forthe Elderly Stretching Shrinking Dollars; PropertyTax Generates Millions for Home Care ServicesUN Designates1999 As International Year of Older PersonsAoA Serves on U.S.-Mexico Commission’sAging Core GroupNational Older Workers Employment WeekCelebratedAnti-Inflammatory Drug MayReduce Risk of Alzheimer’s

******"Celebratingcommunity: more than a meal" is theme for elderly nutritionprograms’ 25th anniversary**

On Saturday, March 22, the Elderly NutritionProgram (ENP), supported under the Older Americans Act (OAA),celebrated its Silver Anniversary. On that date, 25 years ago,President Richard M. Nixon signed into law the Nutrition Programfor the Elderly Act--legislation, authored by Senator EdwardKennedy (D-MA) and Representatives Claude Pepper (D-FL) and JohnBrademus (D- IN), that created the nutrition programs that havebecome vital to the dignity and independence of millions of olderAmericans across the country.

In 1965, the year the OAA was created, the U.S.Department of Agriculture *National Food Study on FoodConsumption* reported that 6 to 8 million older persons haddeficient diets. As a result, in 1968, Congress appropriated $2million for a 3-year demonstration and research program ofnutrition for older people to be conducted by the Administrationon Aging (AoA). Findings from these highly successfuldemonstration projects resulted in enactment by Congress of theNutrition Program for the Elderly as Title VII of the OAA in1972. Funds were first appropriated in 1973.

In addition to providing nourishing meals,these programs offer companionship and long-term care protectionsto older people in communities across the nation.

*"I live in asenior housing hotel. I have diabetes, arthritis, and heartproblems. It is hard for me to get around even with a walker. Ihave a government lady clean my apartment. I have my meals atnoon here at the hotel and even with food stamps I wouldn’tbe able to live here without them and would have to move into thenursing home."--From an ENP participant*

Acting AssistantSecretary for Aging, Robyn I. Stone, says that, "Because ofthese programs, older people who might be isolated and lonely, orwho lack the ability to buy food and prepare meals, now gather incommunity settings with their friends or receive well-balancedmeals delivered to their home, often by a senior volunteer."

*"DearNutrition Center: Thank you for being there, caring, and cookinga wholesome meal, not only for my mother, but other elderlypeople as well. My mother is 91, lives alone and has very pooreyesight. This program is such that she is picked up each noon,taken to the center for a wholesome meal**and a social hourwith friends and neighbors. This gives her time away from homeand breaks up her day. It also means someone is checking on hereach day and that relieves my mind, knowing someone will beknocking on her door and be of help if needed."--From thedaughter of an ENP participant*

In fiscal year 1995, 123 million meals wereserved to some 2.5 million older persons in congregate settingsand 119 million meals were served to 989,000 home-bound elderly.

As a successful public-private partnership, theENP has been called a "bargain" for the federalgovernment. In addition to federal dollars, the programs receiveparticipant contributions, volunteer support and state, tribal,local, and private funds.

*TheMid-America Nutrition Program is a rural nutrition projectserving five counties. Delivery vans travel as many as 120 milesper day into isolated areas to provide meals. For manyrecipients, it is the one service that keeps them living in theirown homes.*

*Meal recipients so value this service thatindividual recipient contributions, which average $1.10 per meal,account for 35 percent of program operating funds. Other supportincludes 18 percent of operating funds from the OAA; 22 percent,U.S. Department of Agriculture funds; 17 percent, state funds;and 8 percent, county funds*."--*From an ENP provider*

During the 25 yearssince it was enacted, the OAA nutrition program has been anefficient and responsive way to meet the needs of older peopleand the communities in which they live. It demonstrates thehighly effective partnership that exists between the federalgovernment, the State Units on Aging, their 661 Area Agencies onAging, over 20,000 nutrition sites, and 27,000 service providers.

The words of one participant sum up the valueof the ENP "I’d be lost without it."

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**AoA and General Mills Make Breakfast for theElderly**

The Administration on Aging (AoA) and GeneralMills Foodservice (GMF) have formed a public-private partnershipto provide *Morning Meals on Wheels,* an innovative pilotprogram that will serve breakfast to homebound elders who are atrisk of losing their independence.

The AoA believes that providing a second meal,such as breakfast, delivered in conjunction with a noon meal is acost-effective way to meet the needs of the vulnerable elderlywho receive home-delivered meals by further increasing theirnutritional intake.

There is ample evidence that the OlderAmericans Act Home-Delivered Nutrition Program successfullyincreases the nutritional intake of program participants who areat nutritional risk and experience food insecurity. Data from the*Serving Elders at Risk, the Older Americans Act NutritionProgram, National Evaluation of the Elderly Nutrition Program,1993-1995* indicate that among home-delivered mealsparticipants, 90 percent are below 200 percent of the povertylevel, 88 percent are at moderate or high nutritional risk, 76percent have functional impairments, 16 percent experience foodinsecurity, and 18 percent participate in the Food Stamp Program.The evaluation indicated that the single meal provided by thehome-delivered meal program accounts for 40 to 50 percent of thedaily nutrient intake for most participants and that for many,this meal was their primary source of food for the day.

The AoA and GMF are accepting proposals toparticipate in a feasibility study which will test the concept ofproviding breakfast as a way to offer a cost-effective secondmeal to at-risk elders participating in the ENP. 

The breakfast and noon meals combined wouldfulfill the Older Americans Act nutrition requirements that thetwo meals, together, meet two-thirds of the Recommended DietaryAllowance and the Dietary Guidelines for Americans published bythe Secretary of Health and Human Services and the Secretary ofAgriculture.

Successful applicants will receive a $500General Mills product credit; product discounts; funds to supportcontinuing education; and a *Morning Meals on Wheels Manual:How to Start a Breakfast Program*; technical assistance,including menu planning and a newsletter; volunteer recognitionitems; and local publicity/press kits.

Acting Assistant Secretary for Aging, Robyn I.Stone, has asked the State and Area Agencies on Aging to sharethe proposal with nutrition service providers and otherinterested organizations.****

It is expected that 10 to 20 pilot breakfastprojects will receive support under the new agreement which willprovide an opportunity to evaluate the type and level of supportneeded to establish and maintain breakfast projects and tomeasure their effectiveness in improving the nutritional statusof at-risk elders who participate in home-delivered mealsprograms.

The National Policy and Resource Center onNutrition and Aging at Florida International University willassist the AoA and General Mills in accomplishing the pilotprogram’s objectives.

Additional information is available from JeanL. Lloyd of the AoA at (202) 619-2005.

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***S t r e t c h i ng*****shrinking********$$$****Property Tax GeneratesMillions for Home Care Services**

**(***This is the first in a series thatprofiles innovative ways that aging network members can expandtheir resource base.)*

In Hamilton County, Ohio residents have comedown solidly on the side of their senior citizens. In 1992,citizens voted 57 to 43 percent to approve a 5-year property taxlevy which raises $12.6 million dollars annually to provideelderly home care services, with $600,000 earmarked for elderlylegal services.

Many states, including Ohio, permit specialproperty tax initiatives to provide services for targetpopulations. Such initiatives can be placed on the ballot eitherby the county commissioners or by petition.

Like other counties across the country, theelderly’s need for home care in Hamilton county far exceedsthat which can be supported through public and private funds.Lack of home care often forces the elderly to choose betweenentering a nursing home and living in unsafe conditions at home."The family, friends, and neighbors of the elderly,"says Gregory French, Executive Director of ProSeniors, "findsuch a stark choice no more palatable than do the elderly."

To deal with this problem, the Council onAging, the aging network and ProSeniors, a Title III legalservices provider, worked to design the Elderly Services Program,whose purpose is to provide the elderly with home care so thatthey can live safely in their own homes.

Older persons, who meet activity of dailyliving eligibility requirements, can contact the Council on Agingto have their needs accessed, and, if eligible, to receive alimited amount of home care, including personal care, homemakerservices, home-delivered meals, medical transportation, and minorhome repairs through a Council on Aging care plan.

The Council on Aging and the aging networkagreed that legal services are essential to any home andcommunity-based home care system since they are needed to resolveMedicare, Medicaid, insurance, income, housing and consumerproblems. These problems can make it impossible for an olderperson to live at home, if they are not resolved.

Following development of the Elderly ServicesProgram concept, the next step was to obtain county commissionerapproval to place the initiative on the ballot. While the agingnetwork was prepared to place the home care initiative on theballot by petition, the county commissioners decided that thevoters should decide whether or not to tax themselves to fund theElderly Services Program.

While efforts were underway to place theproperty tax initiative on the ballot, other efforts wereundertaken to gain a broad-based aging coalition to support thelevy. Organizations serving the elderly required littlepersuasion to join the coalition and their staff and clientsprovided hundreds of volunteers to conduct a grassroots campaignto obtain voter approval. Even with the broad community supportof the elderly, their family and neighbors, and the agingnetwork, the campaign needed more than $100,000 to inform thebroad community about the need for home care and how the ElderlyServices Program would meet that need. Home care providers,hospitals, banks, and corporations gave the needed funds whichwere spent on 10,000 yard signs, radio, newspaper inserts,mailings, brochures, and fliers.

Campaign staff expenses were limited to apart-time campaign consultant and a coordinator who startedpart-time some 6 months before the election but became full-timein the month preceding the elections.

ProSenior’s Board President, a partner inone of Cincinnati’s largest legal firms, had considerableinfluence in the community and served as Chair of the campaign.His prestige lent an aura of legitimacy to the campaign. 

"Hamilton County’s success story canbe replicated in any community whose law permits special taxinitiatives to meet the needs of special populations,"French emphasizes. "Legal services can be included, providedthe legal services provider has a track record in documenting itsability to help meet the home care needs of older persons,"he concludes.

Additional information is available from:

Gregory S. French Executive Director ProSeniors105 East Fourth Street, Suite 1715 Cincinnati, OH 45202-4008

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**UNDesignates 1999 As International Year of Older Persons**

The United Nations General Assembly hasdesignated 1999 as the **International Year of Older Persons**with the theme, "Towards a Society of All Ages." Thetheme was chosen to promote the philosophy that societies shouldbe inclusive in nature, should embrace all population groups andshare their resources equally.

Deputy Assistant Secretary for Aging, WilliamBenson, served on the Ad Hoc Working Group on the Fourth Reviewand Appraisal of the Implementation of the International Plan ofAction on Ageing and Preparations for the International Year ofOlder Persons. This group is part of the Commission for SocialDevelopment, Economic and Social Council of the UN.

The AoA will serve as the focal point in theU.S. government for the**International Year of Older Persons.**The AoA is working with the American Association of RetiredPersons to host a meeting with senior U.S. Government officialsto inform them about the **International Year of Older Persons.**

Mr. Benson announced that the AoA is preparedto serve in a clearinghouse role for information related to the **InternationalYear of Older Persons** for federal, state, and localgovernmental and nongovernmental organizations. Plans are alsounderway for activities to recognize the year within the UnitedStates.

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**AoA Serves on U.S.**-**MexicoCommission’s Aging Core Group**

****ActingAssistant Secretary for Aging, Robyn I. Stone, has accepted aninvitation for the AoA to become a member of the Aging CoreGroup, established under the Health Workgroup of the U.S.-MexicoBinational Commission. The Commission is a forum established bythe two nations to allow for regular exchanges at the Cabinetlevel on a range of issues critical to U.S.-Mexico relations.

Fourteen working groups have been formed since1981. A Health Work group was established at the 1996 annualmeeting attended by Secretary of Health and Human Services DonnaE. Shalala in Mexico City. Four priority health areas were agreedupon for collaboration between the two governments which includedwomen’s health, immunization, smoking prevention, andmigrant health. Four core groups have been established. Each hasa U.S. and a Mexican team charged with establishing communicationlinkages between the two countries, identifying possibleactivities for joint collaboration, and developing plans ofaction to be discussed at the annual Commission meetings.

As a result of discussions between the AoA andofficials of the Mexican government, a fifth priority areadealing with aging has been approved by the Mexican Ministry ofHealth and the U.S. Department of Health and Human Services. TheAssistant Secretary for Aging will serve as the lead person forthe Department. Dr. Federico Ortiz Quesada, Director General ofthe Office of International Health, will take the lead for theMexican Ministry of Health. The advocacy group is made up ofleading governmental and nongovernmental gerontologists andgeriatricians and aging policy and service providers. 

Dr. Stone noted that, "the United Statesand Mexico face extraordinary challenges with regard to health,long-term care, economic security and quality- of-life issues, asour respective populations take on an older profile," andthat the core group offers "...us a unique opportunity tojointly plan for our future and to learn from each others’experiences."

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**National Older WorkersEmployment Week Celebrated**

President Clinton has proclaimed March 9-14 as"National Older Workers Employment Week" for 1997. ThePresident, in his Proclamation, urged employers to recognize thepotential of older Americans as employees saying that "byevery measure of job performance, older workers are as effectiveas young people..." Nevertheless, the President said,"many experience serious difficulty finding work, if theylose a job or desire new employment. Their search for employmentcan become increasingly challenging as they grow older."

Acting Assistant Secretary for Aging, Robyn I.Stone, in a statement recognizing the week, said that "Olderworkers provide the unique experience and consistent reliabilitythat fill the gaps and keep the nation’s businesses andservices viable. I urge you to salute America’s olderworkers and to acknowledge those employers who are astute enoughto employ them."

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**Anti-InflammatoryDrug May Reduce Risk of Alzheimer’s**

A 15-year study of nonsteroidalanti-inflammatory drugs (NSAID’s), such as ibuprofen, takenfor as little as 2 years, indicates that they may reduce the riskof Alzheimer’s disease. The research findings, conducted byscientists at the National Institute of Aging (NIA) and JohnsHopkins, appear in the March issue of *Neurology* (Vol. 49,No. 3). Using data from NIA’s Baltimore Longitudinal Studyof Aging (BLSA), the researchers tracked the use of NSAID’s,since 1978, among participants in the BLSA. According to ClaudiaKawas, MD, of Johns Hopkins School of Medicine, "manyscientists believe that inflammation may be an importantcomponent of the Alzheimer’s disease process. The amyloidand protein plaques found in Alzheimer’s patients’brains, which are hallmarks of the disease, may be indicative ofan inflammatory response." Researchers believe thatNSAID’s may influence inflammation by interfering with theactions of some proteins and thus lessening their harmfuleffects.

The overall risk of Alzheimer’s disease in1,686 participants from the BLSA who were taking NSAID’s(relative risk 0.5) was half that of those not takingNSAID’s. Relative risk declined from 0.65 in those with lessthan 2 years of reported NSAID’s use to 0.40 in those with 2or more years of NSAID’s use which suggests a greaterreduction in the risk of developing Alzheimer’s disease withlonger NSAID’s use.

Scientists caution that chronic use ofNSAID’s, however, may lead to serious side effects,including peptic ulcers and impaired kidney function.

Additional information about Alzheimer’sdisease can be obtained by calling NIA’s Alzheimer’sDisease Education and Referral Center at 1-800-438-4380.

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AoA Update

**RobynI. Stone**Acting Assistant Secretary for Aging

**JudySatine**Director, Executive Secretariat

**JuneB. Faris**Editor

**AoAUpdate**Administrationon Aging

U.S.Department of Health & Human ServicesWashington, DC 20201(202) 619-0724TDD: (202) 401-7575 FAX: (202) 260-1012 E-mail: AoA_ESEC@Ban-Gate.AoA.DHHS.GOVInternet Web Site:http://WWW.AoA.DHHS.Gov

 

 

AoA Update Executive SecretariatAdministration on AgingU.S. Department of Health and Human Services330 Independence Avenue, SWWashington, DC 20201