Nutrition and Social Engagement: An Interview with NANASP Executive Director Bob Blancato

In recognition of National Nutrition Month, engAGED: The National Resource Center for Engaging Older Adults conducted an interview with Bob Blancato, Executive Director of the National Association of Nutrition and Aging Services Programs (NANASP)—and member of the engAGED Project Advisory Committee—to highlight the intersection of nutrition and social engagement.

 Good nutrition is essential for health and well-being, and research suggests that social supports and connections are associated with better nutrition (Shifflett & McIntosh, 1984). Research also shows that older adults who are socially isolated and lonely may experience reduced appetite (Ramic et al., 2011) and an increased risk of malnutrition (Boulos, Salameh & Barberger-Gateau, 2017).

 Through Older Americans Act nutrition programs, older adults can receive nutrition services through home-delivered meals or meals served in congregate settings, both of which help provide older adults with a nutritious meal and an opportunity for socialization. The following interview highlights ways nutrition programs have helped promote social engagement of older adults prior to and during the COVID-19 pandemic—and what the future of nutrition programs and social engagement may look like.

 engAGED: Can you share a little bit about the work of the National Association of Nutrition and Aging Services Programs (NANASP) and who your members are?

 Bob Blancato: We are a professional association with 1,100 members serving 4 million older adults per year. Our members range from local senior nutrition providers to Area Agencies on Aging to Senior Community Service Employment Program (SCSEP) grantees to others (researchers, independent dietitians, state agencies) with an interest in older adult nutrition and aging services.

 We like to emphasize the nutrition and aging services part of our name—we have members who provide transportation, workforce programs, case management, preventive health activities, and many other services to older adults beyond nutrition. However, our primary focus is nutrition and we are working to reshape the future of nutrition and healthy aging. We also work as a member of the Defeat Malnutrition Today coalition to help prevent the growing problem of malnutrition and older adults, which is a threat to healthy aging. 

 We are proud of our advocacy work that we do on our own and with other key aging organizations, including and especially the National Association of Area Agencies on Aging (n4a). Our motto is “National Voice, Local Action”: we serve as a voice at the national level for our members, but the real advocacy work is done at the local level. Our members know their needs. They convey the information to us, and we build it into our advocacy work. We are particularly proud of our work with Meals on Wheels America and in coalition with other partners, including n4a and ADvancing States, that resulted in nutrition programs getting $1.6 billion in emergency COVID-19 funding in four different bills in the past year. We also advocate for strong laws and policies to help older adults and their families, including issues like lowering drug costs, seeking adequate funding for programs like SCSEP, elder justice, Medicare, and more home and community-based services under Medicaid.

 engAGED: Can you describe how nutrition programs help promote socialization and engagement of older adults?

 Bob Blancato: Prior to the pandemic, the congregate nutrition program served almost twice as many older adults as the home-delivered meals program did. The COVID-19 pandemic obviously changed that entirely. However, the fact remains the goal of both programs is to offer socialization opportunities that help older adults remain socially engaged. Both congregate and home-delivered meals programs provide socialization through interaction with volunteers and staff, and provide vital services such as safety checks.

 Before the pandemic, NANASP, with funding from the RRF Foundation for Aging, studied the value of socialization in congregate nutrition programs. I interviewed more than 300 older adults in person across the country, and more than 90 percent of them said that “socialization” (or a similar term) with other older adults, volunteers and staff was the main reason they came to the program—clearly these programs go beyond the meal, allowing older adults the opportunity to spend time together and engage in activities like nutrition education and physical activity. We found through nationwide surveys during our study that respondents who said they have “more friends now” than before they started at the program were also two times as likely to say that their physical health has improved since starting to visit the site.

 This reality was reflected in the most recent reauthorization of the Older Americans Act which, recognized and reinforced three purposes of nutrition programs—to provide a meal, nutrition education and a socialization opportunity.

 engAGED: How did nutrition programs respond to the COVID-19 pandemic to address the increased social isolation older adults have experienced? Can you share any innovative examples?

 Bob Blancato: I would first note the congregate programs around the country that delayed as long as possible the complete shutdown of their facilities.

 We especially salute those who offered grab-and-go meals at the beginning of the pandemic and who are now resuming and adding limited and safe outdoor activities for their participants. A prime example would be the nutrition program in Torrington, CT, which has been providing outdoor meals, outdoor exercise, community gardening and outdoor socialization. But the severity of the pandemic meant that many congregate meal sites shifted completely to home-delivered options. To their credit, program directors and staff absolutely kept providing the important meals to the older adult at home, but also worked to establish as quickly as possible methods to maintain contact. That could be in the form of telephone reassurance or more sophisticated programs using technology to connect. We are aware of programs that have established virtual congregate meals through Zoom or Skype; we know of virtual fitness classes, virtual book clubs and some programs that are even providing iPads. We have monitored a number of these programs and provided them with support.

 Now as we are approaching a more positive juncture, we have and will provide support to allow the continued safe reopening of programs through sufficient personal protective equipment and rearranged physical locations. On that note, we actually also provided a grant to a program in Massachusetts to purchase a large tent for holding their own outdoor activities.

 engAGED: As we look to the future of nutrition programs and social engagement, what lessons do you think we can learn from the COVID-19 pandemic?

 Bob Blancato: One of the key lessons is to have emergency preparedness plans front and center to be able to quickly adapt to depending on the circumstances. Also, being adaptable and innovative, not being reticent about trying new approaches or developing new partnerships to meet the challenge. Also, always keeping the best interests of older adults in mind, as providers did before the pandemic and throughout it. We can take as a positive that our nutrition providers are the trusted entities in their community through strong relationships they have built. This is so important in times like a pandemic.

 The future of the nutrition programs and all aging service programs must be about promoting equity in how services are provided—to whom and by whom. We need a renewed commitment to conducting the necessary outreach to connect with those older adults who have not been reached.

 engAGED: Are there any new nutrition and social engagement innovations brought about because of the COVID-19 pandemic that you think will continue in a post-pandemic environment? 

 Bob Blancato: Depending on how much older adults and programs have adopted technology, we will likely see hybrid activities involving resumption of in-person congregate programs on certain days and virtual connections on others. Where technology has aided connectedness, that should be continued. A home-delivered meal recipient should be able to have the opportunity to have a virtual lunch with those sitting in congregate programs and benefit from other services such as virtual fitness programs and other social opportunities. We also know that some technological innovations like robotic pets have proved very popular in alleviating social isolation during the pandemic, and we expect to see that innovation continue.

 We also plan to survey our members to document other innovations that have proved successful and could be scalable for other programs to consider using now or in the future—we’ll keep everyone updated on this front.

 Further, as the 2020 Older Americans Act reauthorization calls for, we need to get moving on screening for social isolation before it becomes a permanent condition.  We need to screen, then secure programs and services for those individuals.

 Conclusion:

Along with this interview, Bob Blancato also participated in the March 23 engAGED webinar focused on social engagement and nutrition. To learn more about how nutrition programs responded to the pandemic, lessons learned and social engagement innovations that may continue in a post-pandemic environment, listen to the webinar recording. 

 Citations:

 Boulos, C., Salameh, P. & Barberger-Gateau, P. (2017) Social isolation and risk for malnutrition among older people. Geriatr Gerontol Int 17(2):286-94.

Ramic, E., Pranjic, N., Batic-Mujanovic, O., Karic, E., Alibasic, E. & Alic, A. (2011) The effect of loneliness on malnutrition in elderly population. Med Arh 65(2):92-5.

Shifflett, P. & McIntosh, W. (1984) Influence of social support systems on dietary intake of the elderly. J Nutr Elder 4, 5–18.