“It could probably help someone else but not me”: A feasibility study of a snack programme offered to meals on wheels clients

Abstract

Objectives Community-based services, such as Meals on Wheels (MOW), allow older adults to remain in their homes for as long as possible. Many MOW recipients experience decreased appetite that limits intake at mealtimes. This pilot study aimed to determine the feasibility of providing high protein high energy snacks to improve nutrient intakes of MOW clients in a regional centre of New South Wales, Australia.Participants A convenience sample of 12 MOW clients.Intervention Participants received snacks five times a week, in addition to their usual MOW order, for four weeks.Measurements Nutritional status was assessed using the Mini Nutritional Assessment tool. Pre-post changes in dietary intake were assessed using a diet history and food frequency questionnaire. Qualitative interviews conducted in clients' homes were digitally recorded, transcribed verbatim, and themes identified.Results Post-intervention, there was a trend for an increased energy (mean = +415kJ (SD=1477)/day) and protein (+7.2 (±14.06) g/day) intake. MNA scores significantly increased (P= 0.036) and proportion of respondents categorised as 'malnourished' or 'at risk of malnutrition' decreased from 17% to 8%, and 67% to 25%, respectively (P Conclusion Provision of an additional daily mid-meal snack may be a useful addition to existing MOW services, for improved energy and protein intakes. However, not all MOW clients at risk of malnutrition perceived the snacks to be beneficial to them. Keywordsprobably, help, someone, wheels, else, but, not, me, programme, clients, offered, could, meals, feasibility, study, snack

Feasibility of home‐based dietetic intervention to improve the nutritional status of older adults post‐hospital discharge

“…MOW services have been shown to be effective in improving older adults’ nutritional status, and offering a good alternative for older adults who have limited ability to cook and prepare meals . Charlton et al . reported increased energy and protein intakes as well as an improved MNA score with MOW clients after four weeks of receiving nutrient‐dense snacks provided through the existing service.…”

Factors influencing hospital foodservice staff's capacity to deliver a nutrition intervention

“…Previous findings relating to eating environments 14-17 and quality improvement efforts [18][19][20] indicate congruence with these data, suggesting that a number of common challenges to nutritional care are experienced in health care. The frameworks of behaviour and implementation (e.g.…”

“…also report nurses’ challenges in encouraging patients to consume ONS. Elderly clients’ lack of receptiveness of snacks has also been attributed to their misconceptions about nutritional value of these items, their risk of malnutrition and its implications …”

Does Participation in Home-Delivered Meals Programs Improve Outcomes for Older Adults? Results of a Systematic Review

“…Thirteen studies included in this review reported on a non-randomized intervention involving home-delivered meals (73, 74,75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85). Most of these involved tweaking or adding something different to existing home-delivered meals programs; these included: adding snacks (73), allowing food choices (74), receiving nutrition education (75), receiving meals post-hospital discharge (76, 78), adding breakfast (79), providing “heart healthy” meals and education (81), adding more meals and snacks (80), taking homebound older adults out to eat (82), adding dietary supplements (84), and providing frozen meals (85).…”

“…Most of these involved tweaking or adding something different to existing home-delivered meals programs; these included: adding snacks (73), allowing food choices (74), receiving nutrition education (75), receiving meals post-hospital discharge (76, 78), adding breakfast (79), providing “heart healthy” meals and education (81), adding more meals and snacks (80), taking homebound older adults out to eat (82), adding dietary supplements (84), and providing frozen meals (85). Some studies were single group designs, while others had a comparison group.…”