Autonomy as Conveyed by Food Environments: Nourishment vs Restriction Among Neurodiverse Older Adults

TL;DR

This study explores how food environments affect the autonomy of neurodiverse older adults, showing how food can be a tool for control or empowerment.

Contribution

The study introduces intersectional narratives to examine autonomy in caregiving through food experiences of neurodiverse older adults.

Findings

Formal and informal caregivers often impose controls over food consumption and choices, restricting autonomy.

NDOAs internalize messages from food environments, leading to feelings of empowerment or constraint.

Promoting autonomous eating is recommended to support agency and well-being in neurodiverse older adults.

Abstract

Food serves as a lens to understand identity, memory, and belonging. However, in the context of care, food often reflects a mechanism of social control (Davies, 2007; Gerber, 2020). Feminist scholars have critiqued conceptualizations of autonomy as “self-sufficient independence” for overlooking how individuals and their contexts are intertwined (Salami & Lashewicz, 2015, p. 93). Narrow conceptualizations of autonomy, which emphasize functional independence, hold sway in many caregiving environments, shaping food experiences (Dickson et al., 2022; Boyle, 2008). This study explores food-related experiences among neurodiverse older adults (NDOA) in Quebec. We collected intersectional life story narratives (Brotman et al., 2021) of 21 neurodiverse older adults, 15 family caregivers, and 27 service providers about challenges encountered and agency enacted across the life course. Findings highlight the interplay between NDOAs’ food experiences, identities, memories, and relationships. Our observations reveal how formal and informal carers across sectors enact controls over food consumption, schedules, and daily choices, restricting NDOAs’ autonomy. We illuminate structures of dominance and expressions of resistance, highlighting how NDOAs internalize messages conveyed through their food experiences, leading to feelings of empowerment or constraint. Findings highlight how experiences of nourishment versus restriction affect neurodiverse people into older age. We encourage carers across settings to support autonomous eating to promote agency and well-being. Such inclusive recommendations would serve to safeguard NDOAs’ autonomy and rights.