Implementing a Community-Based Initiative to Improve Nutritional Intake among Home-Delivered Meal Recipients.

Lisa A Juckett,Dimitri Camargo Dodonova,Govind Hariharan,Melinda Rowe,Benetta Mason,Elana Burak,Leah Bunck,Jared Klaus

doi:10.3390/nu14050944

Lisa A Juckett, Dimitri Camargo Dodonova + Show 6 more

Open Access

https://doi.org/10.3390/nu14050944

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Abstract

Home-delivered meal (HDM) recipients are a highly vulnerable group of older adults at risk for malnutrition and subsequent health decline. To help HDM recipients increase their nutritional intake, HDM agencies may provide expanded meal options that allow older adults to have greater autonomy over their meal selection; however, the extent to which recipients are able to select nutritious meals that are responsive to their health complexities is unknown. This study examined the nutritional content of meals selected by HDM recipients enrolled in an expanded menu plan through a large HDM agency. Data were drawn from a retrospective chart review of 130 HDM recipients who had the option of selecting their own HDM meals and frequency of meal delivery. Findings indicate that older adults who selected their own meals chose meals that were significantly lower in protein, potassium, fat, and calories. The lack of these nutrients suggests that older adults enrolled in expanded menu plans should be referred to registered dietitian nutritionists who can provide skilled guidance in meal selection. To address this need, we also describe and provide preliminary data representing a referral program designed to connect HDM recipients to dietetic services with the goal of optimizing older adult nutrition and health-related outcomes.

Highlights

Home-delivered meal (HDM) programs aim to provide older adults with nutritional support, those who are food-insecure and at high risk for health decline and hospitalization [1,2]
One potential option to improve the nutritional intake of HDM recipients is to expand meal options and provide older adults with greater choice and control over selecting their daily meals [15]
To understand how best to integrate registered dietitian nutritionists (RDNs) services in HDM settings, the present study aims to answer the following research questions: (1) To what extent are HDM recipients able to select nutritious meal options from an expanded HDM meal plan? (2) What are the health characteristics of HDM recipients with the highest need for RDN services? To conclude, we present a referral model, currently being implemented by one HDM agency to streamline RDN services to HDM recipients—a subgroup of low-income older adults at high risk for malnutrition and associated health disparities given their difficulty in routinely accessing specialty healthcare

Summary

Introduction

Home-delivered meal (HDM) programs aim to provide older adults with nutritional support, those who are food-insecure and at high risk for health decline and hospitalization [1,2]. One potential option to improve the nutritional intake of HDM recipients is to expand meal options and provide older adults with greater choice and control over selecting their daily meals [15]. This option aligns with prior research which found that autonomy over food selection and the opportunity to select meals from a variety of food choices are associated with increased food intake in older adult populations [16,17]. The concepts of malnutrition, dietary quality, and macronutrient intake are quite complex, warranting the need for skilled professionals, i.e., registered dietitian nutritionists (RDNs), who can provide personcentered, dietetic services to improve healthy lifestyle behaviors of older adults in HDM settings [18,19]

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