INSTITUCIONES DE ASISTENCIA PRIVADAS (IAP) 1 Aspectos legales

In order to better understand the food choice processes of older people, Falk et al (1996) undertook a qualitative study of sixteen free-living, relatively healthy Caucasians aged 65 years and older in upstate New York. Using the conceptual model of food choice developed by Furst et al (1996) they refined the model to describe the food choice processes of this older age group (Figure 3).

Social, cultural and physical environments and experiences are all components of ‘life course’ in the model from Falk et al (1996, Furst et al 1996). This

encompasses the importance of childhood food experiences and preferences, which can often come to the fore again in later years, and also refers to the development of different food choices throughout a person’s life as their role changes e.g. as a wife or mother, living with a significant other or living alone. The life course produces a set of influences also shaping the food choice process, namely ideals, social factors, resources, social framework and food context. In the older age group the most prominent influence was ideals,

described by Falk et al (1996) as “strongly held beliefs and attitudes about what should be”. Ideals about the definition of the meal and its cultural significance were common as were ideals about weight management and nutritional balance (Falk et al 1996, Furst et al 1996).

Alongside ideals, social frameworks were found to be the strongest influence on the food choice process of older people such that socialising and

companionship could override concerns about food desirability (Falk et al 1996, Furst et al 1996). Personal factors include physiological or physical conditions that have a strong influence on food choice. Falk et al (1996) found problems with the digestion of certain foods, physical disabilities like arthritis, and

limitations caused by poor dentition, all had a strong influence on food choice by narrowing the range of foods these older people were preparing and eating. Important resources for the older group included available income and food preservation skills. Food context is related to social framework but

encompasses the broader context of food supply factors including seasonality and market influences (Falk et al 1996, Furst et al 1996).

Figure 3 Conceptual model of the food choice processes of older adults, from Falk et al (1996)

Personal systems for food choice are developed over time. The two

components of these systems are value negotiations and strategies (Furst et al 1996). ‘Value negotiations’ describes the weighing of different factors when making food choices. Within these, taste was the sensory perception most frequently described as affecting food choice. Price and perceived worth were important factors, and naturally became more important where money was

L I F E C O U R S E I N F L U E N C E S P E R S O N A L S Y S T E M CHOICE Strategies & Repertoires VALUE NEGOTIATIONS Monetary considerations Managing social contexts Sensory Perception Convenience Physical wellbeing

Ideals Personal Resources Social Food

limited. The management of social context includes factors such as considering one’s own needs and the needs of others, and for those living alone the

practicalities of preparing meals for one and eating meals alone. This latter factor was the most able to overrule considerations of sensory perception. Physical wellbeing encompasses concerns about health and nutrition as well as physical comfort e.g. does the food cause abdominal discomfort? Other

considerations, for example cost and difficulty of procurement or preparation, were more important than health and nutrition issues when making food choices.

Overall the values of managing social contexts and sensory perception were found to be the most important in the value negotiations determining food choice and the dominant conflict between the two is highlighted in the model (Falk et al 1996). Different food activities are often sought out as a means for companionship rather than the other way around.

Convenience is an important value for older people in their food choice (Falk et al 1996). For younger people this value would represent time, but for older people Falk et al (1996) found ease of preparation is the key issue. When older people find meal preparation difficult, but are still trying to manage the task themselves, they are likely to find simple, quick and easy meal solutions (Falk et al 1996).

From the value negotiations, strategies are developed, that is choice patterns that are based on the value negotiations and tend to become habitual over time. While there is flexibility within the strategies, the patterns and rules for making food choices tend to be relatively stable. Strategies used frequently included elimination, limitation or substitution of certain foods and drinks, and the establishment of routines (Falk et al 1996, Furst et al 1996). Falk et al (1996) found that the more health problems people had the more likely they were to have multiple strategies to use in different food choice situations.

The model by Falk et al (1996) encompasses a range of influences and factors affecting food choice by older adults and not all of these factors are considered in this study. The three areas of focus for this study are all encompassed within the influences and value negotiations listed in this model: nutrition (food context, sensory perception, physical wellbeing), social networks (social framework and

managing social contexts) and the ability to undertake everyday life functions (personal factors and convenience). These are circled by a dotted line in Figure 3.

2.5. Nutritional factors associated with healthy ageing and