Understanding the Importance of Meal Delivery for the Well-Being of Frail Elders

Qualitative methods were used to explore the role of Meals on Wheels (MOW) in the lives of frail elders. This study explored the interface between the way MOW operates and clients' need to discover the ways that a meal intervention program integrates with existing lives, beliefs, and cultural values. A random sample of 20 MOW clients (3 receiving frozen meals) was interviewed in the Bronx, New York to obtain data on social contact, lifestyle, meal satisfaction, and eating patterns. General living conditions in clients? homes were observed. Transcribed text was analyzed and coded using Atlas.ti. Most respondents expressed a desire to eat the meal hot upon arrival although it was delivered any time from 9:00 am-3:00 pm. Satisfaction with taste and perceived healthfulness of meals varied, but respondents were appreciative of the program and viewed the meals as important for their daily diet. One-quarter of the sample reported calling to ask for healthier meals or nutritional information for meals provided by MOW. When these requests were unsuccessful, respondents turned to a variety of remedies including boiling meals, rinsing off salt, removing high-fat sauces, giving meals to friends and neighbors, and throwing meals away. Respondents usually did not know their driver?s name and exchanged few words when food was delivered, but this was often the only social contact respondents had during the weekdays. This frequent contact may play an important role in surveillance of elders? health and safety, and may also build personal relationships over time. By accepting help from an organization such as MOW, which has a certain amount of institutional inflexibility, respondents both gained independence and experienced certain constraints on their schedules, social contacts, and ability to make culturally appropriate and personally preferred food choices. Given the importance of MOW for ensuring the food security and well-being of frail elderly, it is important to resolve some of the tensions created by MOW related to health and cultural issues. There is no single meal plan that is appropriate for the entire diverse group of inner city elders participating in MOW. Respondents expressed a desire for healthier meals and meals specific to common health problems, as well as culturally appropriate meals, specifically for the growing population of Latino elders. In addition, alternative meal plans such as those that incorporate cooking education, grocery delivery, or frozen meals may be appropriate for certain groups of elders based on each client?s capability. In this study, capability was captured in two important dimensions: 1) Food Preparation and 2) Food Acquisition. Examining this type of capability provides valuable insight into the food management strategies of elders and may also be a promising new way to ascertain what type of meal plan is appropriate for each client