Nanci, a good friend of mine since nursing school, recently left her position as CCU (Critical Care Unit) RN at our large regional hospital. Like me, my friend is a lifelong learner (probably why we’re friends), and after obtaining her CCRN certification, she decided to move on to her next care-giving learning experience, one with better hours and less stress—home health. She’s been at it since the end of October, and after only a few days in the field, she texted me, overwhelmed by the poverty she was seeing up close. “I had no idea, and I thought of Little Free Pantry. Maybe there’d be some way LFP can help.” One of the homes she visited had no running water. Its single working stove burner provided heat.
To qualify for home health care, a person must be homebound; if a person can get to outpatient physical therapy, that person does not qualify. This means most folks who receive home health care are elderly. According to National Association for Home Care and Hospice 2010 statistics, of the 12 million receiving home health care, 69% were over 65. With the “graying of America” well underway, I imagine that number is higher now, and medicare enrollment is expected to more than double over the next 15 years.
When I was in nursing, I had a particularly soft spot for geriatric patients. I guess I have a particularly soft spot for this population more generally because since the LFP Project inception, it’s really bothered me that LFP isn’t a solution for homebound seniors; like most bricks and mortar pantries, folks go to it.
- In 2015 9.8 million older Americans faced the threat of food insecurity, and
- An estimated 19.56% of Arkansans over 60 are either food insecure or face the threat of it, making Arkansas 5th in the nation. (As my friend, Autumn, likes to say,” Dammit, Arkansas.”)
- In 2011 about 2 million seniors were completely or mostly homebound, many more semi-homebound.
- Literature has consistently found food insecurity to be negatively associated with health.
I told Nanci I’d think about it.
Food security involves several components—access, distribution, stability…. In America we have more than enough food for everyone. For those doing hunger work, distribution is often the most challenging part. Mobile food pantries are trending, but these usually work through host locations, and folks must still go to them. Hard for the homebound. This is why Meals on Wheels is such a critical social support (and why you should call your Senators/MOCs and ask them to increase its budget funding). But Nanci’s patients often aren’t even getting that. Unlike the home I mentioned in the first paragraph, most do have a way to prepare their own food.
Then, I remembered six area law enforcement agencies had recently partnered with our local food bank. Officers receive boxes of food for distribution on their beat, feeding folks, building relationships.
Nanci works M-F, seeing around eight patients a day. Her agency employs eight RNs. These have a similar case load. More LPNs and therapists. Estimating, the RNs at this single agency make 320 house calls a week.
What if home health care providers partnered with anti-hunger agencies, empowering their nurses to utilize the two-question food insecurity screening tool and equipping them with healthy, emergency food supplies to promote nourishment and healing?
These nurses would not only be feeding the old, sick, and hungry. They’d be uniquely positioned to conduct assessments tracking outcomes of healthy food as intervention for a demographic that will only grow. As the most trusted profession, they would also be uniquely positioned to provide point of care nutrition education.