Nutrition of Older People in
Emergencies
Mary Manandhar
Carmel Dolan
Paul Rees-Thomas
Pascale Fritsch
Background
• Ageing world: today, more people aged 60 and above than
children under 4
• Lack of awareness and knowledge within the
humanitarian sector, including donors and governments,
about the demographics of ageing, active roles of older
people, the complexity of their vulnerability to
undernutrition in emergencies, and their rights.
• Inadequate skills to deal with undernutrition in this
population group within humanitarian agencies, national
government systems and at operational level in
emergencies.
• Persisting ageism and age discrimination within the
humanitarian system, and breaches of the UN Principle of
Impartiality.
• Underfunding of programmes tackling undernutrition in
older people in emergencies.
• Address gaps and inconsistencies in existing policies and
guidelines on nutrition, ageing and emergencies
Nutrition of Older People in
Emergencies
• Part 1: Fact sheet
overview of the nutrition of older people in emergencies
• Part 2: Technical notes
technical details, challenging areas and clear guidance
on accepted current practices
• Part 3: Trainer’s Guide
guidance on how to design a training course by giving
tips and examples of tools that a trainer can use and
adapt to meet training needs
• Part 4: Training Resource List
comprehensive list of reference material relevant to this
module including guidelines, training courses and
reference manuals
Part 1: Fact sheet
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Who are “older people”?
Our ageing world
Commitments and policies addressing ageing
Underfunding for older people in the humanitarian response
Rights of a ‘vulnerable’ but missing group
Ageing and nutrition
Nutritional requirements
Risk factors for undernutrition
Undernutrition in older people
Assessing nutritional vulnerability
Clinical and medical concerns
Anthropometry
Undernutrition and functional outcomes
Interventions for older people in emergencies
Preventing undernutrition through food
Non-food interventions to prevent undernutrition
Treating undernutrition
Integration
Monitoring and evaluation
Participation, voice and inclusion
Key messages
Part 2: Technical notes
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Older people in a changing and challenging world
Vulnerability and rights
Undernutrition in older people
Assessment of nutritional status and vulnerability
of older people
• Interventions and responses to address
undernutrition in older people
• Monitoring and evaluation
• Existing challenges and areas for research
Challenges and areas for research
• Advocacy, awareness and capacity
• Lack of awareness and knowledge within the
humanitarian sector,
• Inadequate expertise to deal with older people’s
undernutrition
• Persisting ageism and age discrimination within the
humanitarian system, and breaches of the UN Principle
of Impartiality.
• Underfunding
• The child-focused nutritional conceptual framework and
focus on children under five, recently re-invigorated with
prioritisation of the ‘1000 days’ period, should not
prevent inclusion of older people in nutrition policies
and programmes.
• Organisational policy development and guidance
Challenges and areas for research
• Assessment
• Continued preference for, and use of BMI
• Research is needed on the relationship
between various MUAC cut-offs and
functional outcomes of importance to older
people, such as muscle strength, mobility and
ADLs.
• Research to agree on the best assessment
methodologies for all aspects of nutritional
vulnerability of older people in emergencies.
Challenges and areas for research
• Interventions
• Adaptation of RUF for the treatment of acute malnutrition
in older adults
• How to improve techniques and standardisation for nonfood interventions? (eg Cash transfers)
• How to link nutrition interventions for older people with
interventions for other population groups, and with other
sectors?
• Limited evidence for what works in the treatment of acute
malnutrition in older people.
• Participation
• Strengthen use of participatory methods with older people
on all aspects of planning, assessment, intervention and
monitoring programmes aimed at preventing and treating
undernutrition in older people in emergencies.
Questions
• Why are the nutrition needs of
older people not very often
addressed in emergencies?
• What do NCC or implementing
partners need to be active in
addressing the nutrition needs of
older people?
Way Forward
• What can we do with this module?
– Identify areas of research
– Use it as an advocacy tool
– Include in NiE training modules
• How can the GNC support the dissemination
of the content?
– With the NCCs
– Should we have an “age-marker” in project
proposals, like the gender marker?