Abstract
Selected findings are presented from 152 semi-structured interviews of people aged 75 and over on the theme of dietary beliefs and practices. Participants resided in urban and rural localities in Scotland and were interviewed in their own homes. Data are presented on the perceived importance of food, defining healthy eating, locality and financial constraints. Maintaining independence was the priority for participants and food was perceived as a contributing factor to keeping bodies going and limiting the potential for dependence on others.
Introduction
The project had the overall aim of identifying and exploring the dietary beliefs and practices of older people living in the community. The research was conducted in urban localities and rural communities. The overwhelming majority of older people continue to reside in the community and wish to do so. Poor nutritional status adds time and financial costs to the recovery period for illness and there are proven links between malnutrition and the progression of chronic diseases. Independence is of paramount importance for many older people although the role of food and diet in this is rarely considered.
Methods
The methodological approach drew on the disciplines of nutrition and anthropology. An integrated interview schedule was developed. Participants were interviewed in their own homes. The sample was derived from the practice lists of three General Practitioners. We selected the age range of 75 and over as this age group is invited into primary health care for an annual health check.
Of the 152 participants, 72 lived in urban localities and 80 in the rural locality. Just over two thirds of the total sample was female. Just under half of the sample were aged 75-79 years, and almost half of the sample were widowed. Lone households accounted for 55 per cent.
Selected findings
The perceived importance of food
The first priority of participants was to remain in their own homes and communities. Their second priority was to retain or improve their existing levels of independence. Participants placed most stress on remaining active, comprising three strands:
- Physical: The importance of keeping moving
- Psychological: Remaining mentally active
- Social: Developing strategies to counter social isolation
Within this overall agenda, the perceived importance of food lay with the notions of food as a necessity of life.
Healthy eating
Healthy eating was conceptualized as:
- Proper meals: Traditional in composition, comprising at least two courses
- An eating routine: Seen as important to overcoming fluctuations in appetite
- Proper food: Equated to having fresh natural ingredients
- Variety of food: Highlighted as being a good thing
- Eating in moderation: Had both practical and moralistic dimensions
The nature of the locality
In urban localities, proximity to shops and supermarkets increased food choices. In contrast, few rural participants were within walking distance of any shops. Access to food choices was reliant on the participant’s ability to access a car or cope with the bus journey.
Financial constraints
Financial constraints on food choices were implicit in many interviews. Among low income households, participants were keenly aware of the amount they spent on food each week. The greatest cost for participants was the heating bill. Cooking in these circumstances was simply adapted to save costs.
Conclusions
Participants’ main priority was to remain in their own homes and communities. Three strategies underpinned this:
- Nutritional independence
- Motivation to have a good diet
- The use of routines to give meaning to daily activity
The main emergent theme was that of proper food and keeping to familiar food patterns. The food patterns of this study group were similar to the Scottish population as a whole. However, people aged 75 and over may have to overcome structural hurdles to continue to access the foods they prefer.