Nutrition Education for Homebound Elderly

The rural elderly are at great nutritional risk because of poor economic and social conditions, inadequate services, and the presence of at-risk subgroups, such as widows and people in poor health. Diet quality and quality of life can be improved by providing community food-related services and home-delivered meals.1 Rural elders also have been shown to interact with and depend more frequently on friends and neighbors, as well as relatives, than do urban elderly.2

Peer NETWORK, an acronym for Peer Nutrition Education Training with Older Resource Knowhow, was developed by Iowa Extension to address the needs of homebound elderly. Program objectives are to stimulate interest in and awareness of adequate dietary intake for older adults, and to establish a network of older peers with sound nutrition information to provide a strong support system.

The Peer NETWORK provides 16 hours training based on the Dietary Guidelines. In turn, the peer educators spend one hour a week for eight weeks with each of two clients. The peer educator receives a resource notebook of Extension nutrition publications and a set of six single concept leaflets to give the client.

Program volunteers were located through recommendations from public health nursing, hospice, area agencies on aging, and Extension programs.

Homebound clients were identified through referrals from public health nurses and Congregate Meal site managers.

The Peer NETWORK program was pilot-tested in three Iowa counties in 1989-1990 and is now available throughout the state. The pilot program revealed that 70% of the 22 clients improved their dietary intake, and that the elderly were receptive and interested in learning new food habits to improve their health.

The program provides an excellent opportunity for interagency cooperation. Hospice-trained volunteers have been a high-quality source of peer educators. Hospice training combined with Peer NETWORK training provides confident, well-trained, community volunteers of the highest caliber.

The Iowa Peer NETWORK program is now being used in various ways. In addition to supporting Extension-sponsored programs, the educational materials are being used for a peer educator program in an urban Supplemental Foods Kitchen, peer counselor programs in other agencies, Homemaker Health Aides training, Congregate Meals and Elderbridge programs, and as a nutrition-in-aging resource.

1. D. A. Roe, "Nutritional Surveillance of the Elderly: Methods to Determine Program Impact and Unmet Need," Nutrition Today, XXIV (September/October 1989), 24-29.

2. V. R. Kivett, "Aging in Rural Society: Non-Kin Community Relations and Participation, in The Elderly in Rural Society, R. T. Coward and G. R. Lee, eds. (New York: Springer Publishing Company, 1985), pp. 171-91.