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Advocates Testify on Senior Malnutrition Bill

Senate Bill 245 had its second hearing before the Ohio Senate Health and Human Services Committee with proponent testimony. The bill would create an Ohio Malnutrition Prevention Commission to document the problem of malnutrition among older Ohioans, study the impact across care settings, investigate effective strategies to reduce malnutrition, and monitor the influence of malnutrition on older adults' health care costs, quality indicators and quality of life measures.

Report from Gongwer News Service, Inc. April 13, 2016:

Beth Kowalczyk, chief policy officer for the Ohio Association of Area Agencies on Aging, said older Ohioans at lower socioeconomic status are at greater risk of malnutrition simply due to a lack of resources. She pointed out a 26% increase in the number of seniors who were at risk of hunger from 2012 to 2013, with Ohio ranking 1st in the Midwest and 12th nationwide for food insecurity among older adults.

Ms. Kowalczyk said the commission proposed in the bill would serve to document the problem of senior malnutrition and identify opportunities for preventative policies that can make a meaningful difference in the healthy aging of Ohio's older adult population. She concluded that senior malnutrition and senior hunger, in particular, have a significant impact on health outcomes and health care costs presenting an important public health issue needing to be addressed.

Ainsley Malone, a nutrition support dietitian at Mt. Carmel West Hospital and a past president of the American Society for Parenteral and Enteral Nutrition (ASPEN), said disease-related malnutrition is undernutrition as a result of a disease process which may be present on admission or acquired during hospitalization. She added that malnutrition continues to be underdiagnosed in many hospitals and approximately one-third of patients who are not malnourished on admission may become malnourished while hospitalized. "The need to identify at-risk patients is vital in that malnutrition is associated with an increased risk of pressure ulcers and impaired wound healing, immune suppression and higher infection rates, high treatment costs and increased mortality," he said in urging support for the bill.

Ms. Malone said ASPEN recommends an increased focus on the services of nutritional screening, assessments and treatments as essential health benefits adding that establishment of the proposed commission would be an excellent means to guide such efforts.

Pauline Madison, representing the Columbus Chapter of the Black Nurses Association, testified that despite the recognized link between good nutrition and good health, routine medical treatment and health care coverage in Ohio have not addressed adequate therapeutic nutrition in the hospital, faith-based or community settings. "This must change if the goal of healthcare reform is to keep people healthy and out of institutionalized care," she said.

Belle Likover, honorary lifetime trustee of the Western Reserve Area Agency on Aging, said food insecurity is a significant public health problem for older adults. According to the USDA, she said food insecurity means a household-level economic and social condition of limited or uncertain access to adequate food. She noted that in 2014, nearly 8% (3.47 million) Americans age 65 or older were living in food insecure households and food insecurity is a growing reality.

Ms. Likover reported the WRAAA has developed a campaign to raise public awareness about food insecurity among older adults. She suggested the proposed commission's report will assist the agency in its campaign, increase the awareness of the issue statewide and help communities work to address how older residents are impacted by malnourishment and other nutritional concerns.

On a personal note, Ms. Likover said five years ago, she was diagnosed with congestive heart failure and she has been able to reverse that diagnosis with the proper control of her sodium intake. Unlike many other seniors, she said she has the economic ability to obtain food stock ingredients and make her meals from "scratch" as a means of controlling her sodium intake. Her diagnosis came at age 91. She is 96 today.

Written support for the measure was also submitted by Rita Campbell, executive director of the Lorain County Office on Aging and Mary Beth Arensberg, director of health policy and programs for Abbot Nutrition.

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