 Hello, everyone. My name is Jane Katten, and I'm the CEO at Age Well. I'd like to welcome you this evening to our show, Aging Matters. I'd also like to take a moment and thank our sponsor, MBP Healthcare, for making this possible. As some of you may know, Age Well is the largest area agency on aging in the state of Vermont. And our goal is to make sure that anyone over the age of 60, or under the age of 60 with a disability on long-term care Medicaid, has all the supports and services they need to remain independent in their homes, wherever that may be. Tonight on Aging Matters, we're going to explore a couple of very interesting topics that have great impact on older Vermonters. And those two topics are food insecurity, and the second one is a concept called food deserts. I'd like to welcome tonight, Chris Moldovan, who is the Director of Nutrition and Wellness Services at Age Well. Welcome, Chris. Happy to be here, Jane. Super. Before we dive into our two topics tonight, maybe what you can do for our viewers is tell them a little bit about your background, your professional experience, and your role at Age Well. Sure. So I am a registered dietitian. I have worked in the field, really all over Northwestern Vermont, for the last 30-plus years, doing lots of different roles within the field of dietetics. I've worked with the aging population, and I worked with the agencies on aging as the consultant dietitian, as well as the last seven-plus years. I've been the Director of Nutrition and Wellness at Age Well. Awesome. Well, you definitely have some pretty amazing credentials for our topics tonight, so I'm excited to dive into those. So as I mentioned earlier, the two things will focus on our food insecurity and food deserts. But before we talk about both, let's hone in on food insecurity. What is this? Yeah, Jane, it's a really good question. You know, food insecurity is something we hear about all the time, and I think there's a little confusion with hunger versus food insecurity. So I just want to state what, you know, the definition of hunger is the actual feeling that someone feels when they don't have access to food. Food insecurity is when they don't have access consistently to healthy food, a variety of healthy foods that would enable them to live a healthy, active lifestyle. Got it. So that's a really important differentiation to make. Absolutely. So, Chris, how exactly are older Vermonters impacted by food insecurity? What does that look like? Well, it's an interesting question. If you look nationally, there are 35 million Americans who experience food insecurity. Of that 35 million, 15 million are older adults. Wow. So in Vermont, you know, it's estimated two out of five individuals are dealing with food insecurity, so lacking the access to consistent food that enables them to live a healthy lifestyle. Two in five. Wow. So let's think about that a little bit more in terms of the work that you're doing. What are some of the barriers that you're seeing that older Vermonters have when trying to access foods, especially healthy foods? Yeah. One of the things to think about, I think, for older Vermonters is, you know, I think it's an issue of not wanting to admit it that they are actually dealing with food insecurity or they actually are experiencing hunger. They have to first kind of acknowledge that, gosh, they do need help. They don't have, you know, a variety of foods that they can plan a healthy meal or get the different nutrients that their body needs. Now, why is it that they don't have it? It may be related to where they live and their, you know, living situation. It may be lack of transportation. It may be directly related to the inability to get out of the house. You know, maybe they used to drive but now they don't and they can't get to the grocery store or if they take a bus and get to the grocery store, they can't physically carry the food back home. So, you know, there's a lot of different reasons why someone would not have access. Of course, you know, income and access to the resources to purchase and get a hold of those foods is a big issue. People are on fixed incomes, limited incomes and, of course, other expenses, like housing, fuel assistance, you know, heating and cooling, transportation costs, medication costs, all of those kinds of things will, you know, have an impact. Yeah, wow. Those are so many issues that we have to be thinking about all the time. So, Chris, is the Nutrition and Wellness Director at AgeWell irresponsible for overseeing numerous programs. There must be many to help with these issues that you just talked about. Can you tell us which AgeWell programs specifically focus on food insecurity? Yes. Well, within the Nutrition and Wellness Department, we have a very extensive home-delivered meals or Meals on Wheels program. So, individuals who live in their homes who are unable to prepare their own meals or get out without considerable assistance to access food can have one meal delivered to their homes Monday through Friday. Those meals meet a third of the DRI or Dietary Reference Intakes for an individual over the age of 60 and are in accordance with the Older Americans Act, which is a federal program which helps to fund that program specifically. I'm really, really proud about the program that AgeWell offers over the last five or so years. We've transformed the whole Meals on Wheels program. The whole nutrition program, really. But we've focused on what the actual healthcare needs or the therapeutic needs of an individual living in their home might be. So, what I mean is we have eight different therapeutic diets available to people in their home. So, our regular diet is considered heart-healthy, which means that it's reduced in fat and sodium. We've looked at saturated fat and we've made sure that it's a well-rounded meal that can meet that individual's needs. A person who might have diabetes, it might need a carb-controlled dessert. So, our regular diet, which is heart-healthy with a carb-controlled dessert, is our diabetic-friendly meal. We also have a renal-friendly meal for those people dealing with renal failure or end-stage renal disease. So, we focus on protein, potassium, fluids, as well as sodium. We also have gluten-free meals, lactose-free meals for those people that have intolerances and can't manage those or digest those foods appropriately. And, of course, we have a vegetarian option. So, that's a lacto-ovo meal, which has milk, eggs, and cheese as good protein sources, meets the dietary requirements for the Older Americans Act, and yet is a well-balanced meal. We also offer texture-modified meals. So, people who might have chewing and swallowing problems, maybe they've had a stroke and they're recovering, maybe they have poor dentition, maybe they're weak from different therapies that they might be undergoing for acute or chronic health problem. So, we have mechanical soft, which is fork-tender food, as well as puree, which is more like an oatmeal consistency. And any combination thereof of all of those meals. So, someone might have diabetes, they might also have problems with chewing, and they might also be gluten intolerant. So, they would get a diabetic-friendly, gluten-free, mechanical soft meal delivered to their home. Monday through Friday, we deliver those meals, and then on Fridays, we are able to deliver frozen meals for them to reheat over the weekend so that they can have a meal in their home. Wow. So, that sounds amazing. If I knew someone who needed some help with access to food, how would they arrange that through H-Well? Well, you know, the easiest thing to do is for anyone to call the helpline. That's the 1-800-642-5119 number. Speak to one of our information and assistance experts, and they'll gladly make the referral and get that person set up. If an individual is not, say, unable to get out of their home but they're still driving, they're out in the community, but they just don't really feel up to or want to or know how to plan a well-balanced meal, they can actually come to one of our community sites. And they're sprinkled all over the four counties that we serve, Chittenden, Franklin, Addison and Grand Isle. We work with senior centers and other meal site locations in some situations in faith communities as well as schools. We work with restaurants to make sure that we can have a nice meal available to people within the community and within a reasonable drive from their home. Sometimes we hear about friends picking up another friend and driving them to the meal site so they can share a meal and not go alone and have someone to sit with. And then we hear of others who just show up at the site and see friends and community members they haven't seen and they just get to socialize and have a great time as well as a good meal. Wow. Fantastic. I've also heard about grab-and-go meals. Yes. But what is that? So we have, again, a wealth of grab-and-go locations. Those are simply grab-and-go. An individual can come to a site, sign up in advance, let us know you're coming so we have an accurate count. And we'll have a meal ready for that person to come and drive through, get out of their car if appropriate. Or during COVID, we had, you know, people wear masks and roll down their window or open their trunk. And we'd put the meal packaged to go in their trunk. They could take it home. They could go to a park. They could eat it at a friend's house and enjoy that same meal but in a safe setting. And the grab-and-go's have been so popular that we've continued on, even though a lot of the meal sites are reopening, we're offering a wide variety so that if there's a day that we don't have a sit-down meal available, they can still go to a grab-and-go location and get a nice meal. Wow. What about restaurants? We have, again, relationships with quite a few community restaurants, again, throughout the four counties. And we have a restaurant ticket program, which is simply a voucher that someone would donate for. All of our meals, it's a suggested donation of $5. And so they would make a suggested donation of $5 for a ticket. They would bring that ticket to the designated restaurant of their choice. I think we have eight right now that are actively providing meals. They would show up on a day and a time that that restaurant is participating. And they would ask for the age-well menu. On that menu, there's a variety of choices. It might be three choices or maybe even eight or 10 choices, where, again, well-balanced meal has a good protein source, a good amount of fruits and vegetables, whole grains, serving of dairy, as well as often a dessert. And that whole package is all served to that individual, just like anyone else, in the restaurant. And they would pay for it with the ticket. So they hand in their ticket. The restaurant then gets reimbursed through age-well at the end of that month. And it's seamless. That's a really nice program. I'm sure people love to get out to restaurants. Absolutely. We also have some sit-down restaurant meals. We work with different partners. We work with places like the Glass Onion, down in Middlebury at Hannaford Greer Center. We work with Rosies, which is also in Middlebury. We work with the professional food tech program over at Essex High School. And people can actually come in on a designated day. Again, menus preset, and they can enjoy a meal. Most importantly, they would call age-well. They can use that 1-800 number that I mentioned, the helpline, and ask to speak to the nutrition coordinator in their county. And then we can get them hooked up and find out about the different programs and meal sites and dates for different programs that they could access. That's wonderful. Chris, I've heard all about age-well service areas and the kinds of programs that we offer. Are these programs also available throughout the state of Vermont? Yeah, that's an interesting point. There are five area agencies on aging in the state. Age-well is one. We serve Northwestern Vermont. So there are four others throughout the state. And they have nutrition and wellness programming as well. It's a little different. Each agency on aging does it slightly different. But they have sit-down meals. They have those home-delivered meals that we talked about as well. That's fantastic. I read some statistics recently that said throughout the state of Vermont, all of the area agencies on aging last year delivered over a million plus home-delivered and congregate meals. That's fantastic, isn't it? It's amazing. It's really amazing. The other nutrition programming, I guess I would like to just mention, we do a great deal of outreach with Three Squares Vermont. So Three Squares Vermont is what's known nationally as the SNAP program. But basically it's a food supplemental program to help people that are within a certain income level expand their food dollar so that they can access and purchase healthy foods. So if you're over the age of 65, the money goes directly into your bank account. So there's no debit card or anything that you have to fumble around with and you can choose to spend the money at any grocery or store you'd like to. However, if you're under that age, 60 to 65, you would have some sort of a card to use. It's a great program and many, many Vermonters access that program and many more should. As the money filters into Vermont, it enables people to access food, and it also stimulates the economy here in Vermont. So if you're eligible, you absolutely should apply and you also could apply for the Three SNAP program, which is a three-year program versus a two-year program. So that means paperwork is less. You do it every three years instead of every two years. So it's an easier way to access that. Nice, and it sounds like Agewell and all the AAAs, as we call them, can help with that. Absolutely. We have experts in the field who can help you with the application access. They can help you fill it out. They can help you troubleshoot any of the documents or paperwork that you might need and answer questions to find out if truly it's worth your while to fill out the application. But in many cases, people will get anywhere from $25 a month to over $100 a month. It just depends on that individual and their income. Super. Chris, I know there are older Vermonters who are taking advantage of these programs, home-delivered or congregate. What if they can still manage at home and cook for themselves but just can't get groceries? How does that work? How do they get access to food? Yeah, and again, that could be a clear barrier for some people. At Agewell, we have an extensive volunteer cohort where we have well over 1,000 volunteers. Some deliver meals on wheels. Some teach Tai Chi. Some do work with the state health insurance program. But others actually will help run errands. They'll take a list from an older Vermonter and they will go to the grocery store, pick up the groceries, bring back the change, as well as the groceries delivered right to the home. Some of the grocery stores we work with also will deliver. It just depends on your location and what you're near. But if you're ever worried about, concerned about, don't think you can access food, I would encourage you to call the helpline, again, 1-800-642-5119 and speak to one of our INA or Information and Assistance Coordinators, and they'll help you get you in the right direction. We don't want anyone to go hungry. We want people to have access to the right foods to help manage their health care. Chris, I love the way that you have talked about all these different programs under one umbrella that come together to help older Vermonters have access to food or the types of services that might be able to get them access to healthy foods. So those are great updates and thank you for sharing that information. So you've shared some really nice resources and information, some challenges and some of the solutions. Let's take a moment now to just shift gears a little bit and move on to this other interesting topic called food deserts. And we're hearing more and more about this in the media, especially in Vermont, where we have very many rural areas and so on. But maybe you can take a moment and just tell us more about food deserts. What are these? Food deserts, it's a fairly new term, probably I would say in the last 5 or 10 years we've heard more and more talk about it. What it really is referring to access to food, does the individual that we're talking about live in a community where there is a grocery store? Do they have a possible transportation that's available to them, maybe a bus route that will get them to the grocery store? Or do they have to drive three towns over? Do they actually have to drive 20 plus or 30 plus miles to get to a major grocery store to have access? There's a lot of communities, particularly outside of Chittenden County. We think of Chittenden County as having some major grocery stores which are wonderful and great and they have a wide variety of foods and people can go to the local city market or Trader Joe's or Hannaford or Price Chopper. But outside of Chittenden County there are few and far between and in some cases just nonexistent. So those people have to do a trip into town to get to that grocery store. They might be able to go into a small mom and pop or a gas station type store that has a variety of foods but again you're not going to see that full variety of healthy options, things like fresh fruits and vegetables, a variety of good lean protein sources, whole grains. We had a quick bag of chips and a soda but you're not going to be able to get something that's really providing a lot of nourishment and again assistance and support for those individuals to manage their health. Yeah, that's a big challenge. And then it goes back to the whole issue of being able to have transportation to get to those locations where there is ample healthy food. Absolutely and the thought of do I have transportation, can I manage it, can I pick up the food, even if I wanted to purchase, say a week's worth of groceries, can I get it into my home, do I have to walk up a flight of stairs or two flights of stairs to get to my apartment. Those are all really big concerns. And then of course, what else is out there? And I think that's really sort of the solution if you will to food deserts is really accessing the resources that are in the communities. And then of course, in the grocery store, well we can't just build one, but there might be a farmers market every week and maybe every Wednesday or every Saturday in your town. You might be able to access again a variety of fresh fruits and vegetables at that kind of a setting. Or maybe you're going to your local food pantry. Sometimes faith communities or other nonprofits will set up a nice food pantry or food shelf available to individuals who are trying to be very helpful. Commodity food distribution. So there's a program where each month a box of foods will be delivered to a location and then that person can pick up the box of foods or in some cases it's directly to a senior housing. Or it might be the building in where they live, the box arrives. They just have to bring it up to their apartment and have access to that. There might also be programs like we talked about Three Squares that people know that they do have the ability to get some assistance. And with those programs there's things like Farm to Family Coupons which double the value of what an individual can get through the Three Squares program at the farmers markets. So it's really looking at those community resources and accessing neighbors, friends, volunteers from age well. If there's somebody that can help you maybe they can run to the store, maybe they can split a large 10-pound bag of potatoes if you're not going to use them all this week. Or help you access and get those foods that you need. Nice. Thank you for sharing that information. It makes me think about the network that we work within our communities. Tell me a little bit about your experience with our senior centers and meal sites and how they may be able to help and support food deserts. Oh, absolutely. If there's a local senior center or meal site, you know, those are the people that you want to talk to. Those are the individuals who they know what's out there and what you can access. And in some cases they're sort of acting as a distribution site, right? So they might be able to get, let's say, gleaned vegetables from the local farm that just, you know, they produce too much zucchini this year and they have lots of zucchini and so they might bring it to the senior center to distribute or fresh ripe tomatoes or, you know, maybe fresh lettuce or whatever the produce might be in season. They're going to be able to let you know where the local food shelf is and they may indeed actually have a little mini food pantry within the senior center. So working with the staff at the senior center, the volunteers, they're asking and just saying, hey, I need a little help. There's nothing wrong with that and they will direct you in the right direction. Nice. Thank you for sharing that information, too. I think our senior centers, our community centers, all of them are focused on helping with access to healthy foods. Absolutely. Sometimes that's hard in the wintertime, especially to get fresh fruits and veggies, but I know there's other options out there, especially with the supports you talked about. So, Chris, if you could offer one piece of advice on what you think is the most important steps that older adults can take if they're dealing with any of the challenges we talked about this evening associated with food insecurity or access to healthy foods, what would those steps be? Well, I think the first step really would be to acknowledge that, you know, there's a shortfall. I need some help here and I think I need to, you know, look at the resources that are available to me. I would work with my healthcare provider making sure that, you know, first and foremost, I'm following their advice if there's some direct dietary guidance that would help them better manage their chronic health problems, like diabetes or hypertension or heart disease. I would go for that. I would make sure that those become a priority. I would look to access the area agencies on aging, call the 1-800 number, let them know what you're struggling with. It might be as simple as hooking you up with a volunteer, asking a care and service coordinator to come out and work with you in your home, or get you started on Meals on Wheels. So calling that help line is going to be very, very important to sort of make a plan so that you can manage independently. Wonderful. That's great advice and I think so important as we're thinking about food security matters and how to get access to really healthy foods. So I appreciate your time this afternoon and it's been really, really informative. So thank you for joining us. Thank you. And to all of our viewers out there, I hope you enjoyed our show today. Please tune in next time as we probe and dive into some other interesting topics as we think about aging matters and aging well. And as Chris mentioned and as we think about it every day, if any of you need help at home to allow you to stay at home and be independent and stay healthy, please call Agewell or any of the area agencies on aging in Vermont. We're here to help. Agewell's help line is available here as we've mentioned earlier. I'll repeat that number for you. So you have it. It's 1-800-642-5119 and that help line is available five days a week during business hours and we have so many people ready and willing to help you stay healthy and Agewell. Thank you for tuning in next time on Aging Matters. Thank you.