Home‐Delivered Meals and Nutrition Status Among Older Adults

Abstract

The trend among older adults in the United States is to "age in place" instead of opting for institutionalization. To maintain older adults with chronic conditions in their homes and to improve health after hospitalization, comprehensive social, health, and nutrition services are essential. Quality of dietary intake is crucial and yet often underestimated. Calorie needs decrease with age while nutrient needs remain the same, even increasing for some nutrients. This poses difficulties for individuals with functional disabilities who are unable to shop and cook due to physical or mental limitations or on a limited budget. The Older American Act home-delivered meal (HDM) program offers at least 1 healthy meal per day, 5 or more days per week, and targets individuals homebound due to illness, disability, or social isolation and those with greatest economic or social need. This review summarizes the available literature on the relationship between HDM and health outcomes. The HDM program is difficult to evaluate because of the multifactorial effect on health status. However, national surveys and smaller studies show that it is well targeted, efficient, and well liked; provides quality food to needy individuals; and helps individuals remain living independently. Studies show that HDMs improve dietary intake, with greater health benefits when more meals reach the neediest individuals. HDMs also decrease institutionalization of older adults and resulting healthcare expenditures. However, funding has not kept up with increased demand for this program. More studies with improved designs may provide more information supporting the program's impact on nutrition status and decreased health expenditures.

Characteristics of Older Adults on Waiting Lists for Meals on Wheels: Identifying Areas for Intervention

“…Research has also demonstrated that states that have increased their capacity in providing home-delivered meals also have recognized increased Medicaid savings by decreasing the proportion of low-care nursing home residents dually eligible for Medicaid and Medicare (Thomas & Mor, 2013). Beyond providing financial savings to states, home-delivered meals are believed to improve the quality of life of older adults: The meals improve food and nutrient intake, reduce food insecurity, and may help increase older adults’ independence while encouraging autonomy (Sahyoun & Vaudin, 2014; Zhu & An, 2013). …”

Food Anxiety Is Associated with Poor Health Status Among Recently Hospital-Discharged Older Adults

“…Food insecurity (or food insufficiency, a measure used by researchers to estimate food insecurity without using the official questionnaire included in the CPS) in older adults has been associated with low nutrient intakes (16)(17)(18), unhealthy body weight and body size (19), poor self-related health status (17), anemia (20), multimorbidity and disability (18,21), lower cognitive function (22), anxiety and depression (19,20), and decreased quality of life (20,23). Research has shown that HDMs can improve food security status of older adults (24)(25)(26). If we are able to identify those who go into the hospital with the highest risk, we can target programs toward these individuals in an attempt to prevent food insecurity, malnutrition, and related rehospitalization and health declines.…”

Characteristics of Older Adults on Waiting Lists for Meals on Wheels: Identifying Areas for Intervention

“…Programs are generally popular Reprints and permissions: sagepub.com/journalsPermissions.nav with consumers and seen as beneficial in helping them to meet their basic food needs often allowing individuals to age in place (Frongillo, Isaacman, Horan, Wethington, & Pillemer, 2010;Sahyoun & Vaudin, 2014;Zhu & An, 2013). Previous research has demonstrated a relationship between state spending on home-delivered meals and the ability to keep older adults with low-care needs out of more costly care options such as nursing homes (Thomas & Mor, 2012).…”

“…Research has also demonstrated that states that have increased their capacity in providing home-delivered meals also have recognized increased Medicaid savings by decreasing the proportion of low-care nursing home residents dually eligible for Medicaid and Medicare (Thomas & Mor, 2013). Beyond providing financial savings to states, homedelivered meals are believed to improve the quality of life of older adults: The meals improve food and nutrient intake, reduce food insecurity, and may help increase older adults' independence while encouraging autonomy (Sahyoun & Vaudin, 2014;Zhu & An, 2013).…”