The Department of Agriculture shows that people with disabilities are high-risk for “food insecurity,” meaning having high likelihood of poor nutrition. Studies have long shown this to be true for seniors as well. In response, many senior centers and disability community services now offer nutrition education. These efforts are welcomed steps to help participants learn how to improve their eating habits. However, we need to be cautious. Offering workshops or pamphlets that simply advise seniors and disabled people to “eat better” with a list of tips, may not address the many issues that block seniors and people with disabilities from better food choices. Nutrition educators need to understand the many barriers to good nutrition faced by seniors and younger adults with disabilities:
- Those who use wheelchairs, walkers and canes
- People with vision and hearing impairments
- People with chronic illnesses such as Rheumatoid arthritis and Multiple Sclerosis
- People with developmental or intellectual impairments
In order for these educational events to work for disabled participants, trainers must accommodate the specific learning and communication needs.
Barriers to better nutrition
- Transportation: Inaccessible transportation, such as buses without lifts, makes getting to stores with healthier food difficult for people with mobility impairments.
- Store layout: Stores may place food products in inaccessible locations. Some supermarkets have wide aisles, but many have narrow aisles, sometimes cluttered with displays. Often, junk food is placed in the easiest-to-reach locations.
- Preparing food: For the many people who live alone, obtaining needed assistance in the home costs money. Benefits programs for people with disabilities are underfunded.
- Kitchen access: Many homes for wheelchair users may have poor access to their own cupboards, shelves, freezers, sinks, and counter space. Having to twist sideways while seated in the wheelchair to barely reach the sink is a common problem. Lowering counter tops is fine—for people who can afford the thousands of dollars in renovations. Landlords are not required to make these changes for disabled tenants.
- Fast food: Thus, the microwave is often the extent of cooking. Of course, many people “make do” with fast and processed foods, which are already-made and require little clean-up. This “convenience” is, for many people with disabilities, what enables them to eat at all. Fast food chains also offer some service like opening containers and getting water and straws.
- Reading labels: Nutrition informational labels are not accessible to visually-impaired people.
- Inactivity: People with mobility impairments don’t “burn” many calories due to their physical inactivity. That means that, to manage their weight, they must eat much less than non-disabled people eat and yet are advised to eat still less. To many, this seems unfair, when food is, for most of us, a dependable source of pleasure.
- Eating as “work”: For many disabled people, “eating is work.” Often, they must focus all their attention while eating or must hire, schedule, and pay someone to help them eat. Eating takes a lot of time and effort. This can make the idea of meal planning, shopping, and cooking seem daunting or impossible.
- Cost of “healthy” food: The “health food” movement often promotes pricey, organic, unfamiliar foods; difficult recipes with hard-to-find ingredients; and costly supplements and products, without seeing the barriers they present for people with disabilities, low incomes, or who need personal assistance.
- Access to farmers’ markets: Some farmers’ markets are more expensive than grocery stores and are less than accessible or disability-friendly.
- Food Stamps: Food Stamps (e.g. CalFresh) and other vouchers can be a problem. For example, they may pay for candy bars and chips but not protein bars.
Suggestions for Educators: Ways to Accommodate Senior and Disabled Participants
The nutrition education and access/accommodation needs of people vary, depending on their disabilities. It can be quite a challenge to make an event fully accessible and relevant to everyone. In this context, think of seniors and people with disabilities as overlapping constituencies: many seniors have mobility impairments and use walkers and wheelchairs, have hearing and vision impairments, and/or have chronic illness. Thus, education and training events need to accommodate their disabilities.
- Introductions: Having everyone introduce themselves first can help identify people with hearing impairments or language barriers that can then be better accommodated in the session. Younger disabled adults may be more likely to identify as disabled and ask for accommodations, while seniors may not, though it always depends on the individual.
- Assessing questions: Get a sense of the needs of participants by asking things like “How many people here are interested in ideas related to getting around your home or the store?” or “How many are interested in ideas related to vision?” Use plain language, depending on conversational cues offered in the group.
- Ask for current habits: Get the group talking about what they love, even if it’s “bad.” Most people do feel bad about their eating habits and cravings. Voicing and sharing these “secrets” helps people rethink what they might do instead. Laughter helps ease the tension of a charged topic and helps people learn.
- No blame approach: If participants reveal that their habits that include poor choices, avoid admonishing, which makes people shut down to suggestions. Instead, assume people are doing the best they can and express sympathy for the struggle by saying things like “I know how hard it is!” Then, ask, “What’s one healthy food you’d like to add this week? Let’s set a goal. How can you get some of this?”
- Small steps: For these groups, as we know, small steps forward with nutrition can be significant. For example, for some people, frozen fruits and vegetables or frozen dinners can be great progress over sugary snacks or fried fast food. We need to take people on from where they are now. Praise people for their progress, even if it is small.
- Person-specific exercise tips: When encouraging people to move or exercise, remember the access needs of your audience members. Exercise can be good for many disabled people, but they may have limited exercise options. Moving their bodies is a complex issue for this community. Don’t make jokes or offer general tips about everyone needing more exercise. Instead, speak individually to people about real options as they are available.
- Tone: Be aware of tone of voice and attitude. Sometimes facilitators of senior events are used to using a familiar, affectionate tone of voice. This might seem friendly to some but be offensive to younger adults with disabilities who have been treated like children for much of their lives. Avoid “we,” or “our” as in: “Do we need our coat on?” Always ask first before helping someone. For instance, ask, “Do you need assistance?”
- Inclusive handouts: Check that handouts are inclusive and culturally sensitive to the disability community. Don’t just assume that disabled participants should pick out the few tips that are relevant and ignore the rest that are not. This can be alienating for those who have had to do this for their entire lives with so many other issues.
- Accessible handouts: Make handouts accessible to people with visual impairments via web access, on disc, or large print. Ask the visually-impaired people what formats work best for them.
Note: This information is originally from a handout created by Marsha Saxton from WID on the topic of disability nutrition education for people with disabilities and seniors.