Since its inception, a key hallmark of occupational therapy has been its emphasis on the rich potential of occupation to promote health and well-being, a theme etched in the seminal work of the profession’s early leaders, such as Eleanor Clarke Slagle (1934) and Adolf Meyer (1922/1977). Older adults are at increased risk for a variety of physical and functional limitations that threaten their ability to lead independent and fulfilling lives. Consequently, elderly clients in home settings stand to benefit from personalized strategies of adaptation that enable them to achieve successful outcomes in their daily activities and desired goals. The changes to occupational performance and engagement attributable to a chronic condition can be significant over time, leading to occupational injustices, most notably occupational imbalance and occupational deprivation. The time and energy required to manage a chronic condition, coupled with often-challenging symptoms, can disrupt activity patterns and occupational engagement. This disruption, in turn, can potentially exacerbate the condition, creating a negative cycle (Lambdin-Pattavina & Pyatak, 2022). Chronic conditions often have a complex etiology, including nonmodifiable risk factors (e.g., genetic, environmental), potentially modifiable risk factors (e.g., excessive alcohol use, smoking, exposure to secondhand smoke, poor nutrition, lack of physical activity), and social determinants of health (SDOH) e.g., food insecurity, unemployment, neighborhood safety (CDC, 2019a). Although technological breakthroughs in modern medicine have increased the average life span, corresponding advances in the treatment of chronic health conditions that beset older persons have failed to develop, as a result, older adults are commonly forced to cope with long-standing health conditions such as arthritis, rheumatism, hypertension, heart disease, orthopedic problems, and impairments in hearing, vision, sensation, or cognition. Potentially modifiable risk factors play a significant role in the development of complications, disease progression, and limitations in occupational performance and engagement.

When considering the prevalence of chronic disease in older adults, disease-related symptoms and healthcare costs can impact older adults’ functional abilities to shop for food, transport food home, and prepare nutritious meals (Fernandes et al., 2018). The combination of these disease-related consequences can place older adults with chronic conditions at particular risk for food insecurity and subsequent malnutrition, which may further complicate their health statuses.

This scenario exemplifies the unique impact of chronic (vs. acute) conditions that is important to consider in the occupational therapy process. Moreover, it highlights the need to intervene holistically, to consider interconnections among mind, body, and spirit that are inextricably linked. The occupational therapy practitioner’s role is in understanding the unique needs of the person, group, or population in context, as it relates to the occupational impact of the chronic condition. However, limited information was found in the literature about how occupational therapy practitioners address food insecurity within the elderly population, particularly those who are living at home, or those from skilled nursing facilities that may then live in a home setting. Occupational therapy practitioners who provide community-based services may be in a prime position to integrate basic food security screening/assessment measures into their encounters with older adult clients in order to identify those at risk for food insecurity and who have difficulties performing food-related activities.