Meals on Wheels, nutritional health, older adult, Older Americans Act, recommended dietary allowances, RDA, senior nutrition programs, SNPs
Aged, Food Services, Recommended Dietary Allowances
Senior nutrition programs (SNPs) play a vital role in enhancing health, independence, and quality of life in older adults. An estimated 17% of seniors face hunger (Meals on Wheels America, 2016). There is a great deal of evidence that SNPs improve the nutritional health of the individuals who participate in the programs. Improving or maintaining nutritional health of older adults is critically important to promoting their health and well-being; poor nutritional status and physical inactivity are considered the second leading cause of death—behind smoking—in the United States.
There are more than 5,000 SNPs in the United States, providing more than 2.4 million senior meals each year. Meals on Wheels meal programs (i.e., Meals on Wheels) and (b) congregate meal programs. These two types of nutrition program have similar objectives, but there are differences— some obvious, some subtle—between the programs, and between the populations they serve. Home-delivered meal programs deliver meals directly to the homes of elders whose mobility is limited. Congregate meal programs are offered in community settings such as senior centers and adult day centers, where older adults can assemble and partake in meals together. Both SNPs are provided to, individuals aged 60 years or older (and their spouses, in home-delivered meal programs) and adults with disabilities who live in facilities where there are congregate meal programs. Because demand far outstrips available services, both programs are targeted, by law, to prioritize serving those in greatest economic and social need.
The Older Americans Act of 1965 (OAA), most recently reauthorized in 2016, is the principal law governing the operation and practices of SNPs and is the primary source of federal funding. The National Resource Center on Nutrition and Aging (NRC) is a cooperative initiative of the Administration on Aging and the Meals On Wheels America, and is designed to assist the national aging network in implementing the nutrition portions of the OAA. The primary objective of home-delivered and congregate meal programs is to furnish hot, nutritious meals to needy seniors at least 5 days per week. Each meal must meet the minimum standard of furnishing at least one third of the recommended dietary allowances (RDAs) of key nutrients. Most meals actually exceed this RDA minimum, approximating 40% to 50% of the daily requirement, and typically the meals are “nutrient dense” (i.e., their ratios of nutrients to calories are high). As a result, the daily intake of key nutrients is greater for program participants than it is for similar individuals who do not participate in the program.
SNPs provide program participants with more than a meal. Over half of all programs provide nutrition screening and education, and more than a third also include nutrition assessment and counseling. Although it is accomplished in different ways and to a different degree in congregate programs and in the home-delivered meals, socialization—or at least the reduction of social isolation—is a critical benefit that all SNP participants enjoy (Timonen & O'Dwyer, 2010). Older adults participating in senior meal programs have more social contact than similarly situated nonparticipants. This is true, even though older adults who participate in SNPs are more than twice as likely as elders in the general population to reside alone.
Other than setting, programs differ in the demographic characteristics of program participants. Program participants in all SNPs are older, more likely to be female, a member of a racial/ethnic minority group, and poorer than the overall population of like-aged peers. Moreover, home-delivered meal recipients are, on average, older, poorer, and frailer than their counterparts in congregate programs. An estimated 63% of older adults receiving home-delivered meals have six or more chronic conditions, compared with 45% of those receiving congregate meals (Kowlessar, Robinson, & Schur, 2015). In addition, the majority of homebound participants have some type of functional disability.
Demographic forecasts of aging into the next century suggest that demand for the nutritional services will continue to increase. Historically, policies supporting SNPs have been sensitive and responsive to the changing and growing needs of an ever-burgeoning cohort of aging Americans. However, the degree to which SNPs continue to contribute to the health and well-being of America's older adults is dependent on public support in the form of federal, state, and local funding; financial support from individuals, the corporate sector, and private foundations; and the investment of the time and personal resources of volunteers and staff who prepare, serve, and deliver meals. SNPs are one of the most prudent, economical investments the public sector can make to promote health in later life. The cost of providing a senior citizen with Meals on Wheels for a year is roughly equivalent to the cost of a hospital day for a Medicare patient.
SNPs are well-established, effective, and valuable national programs that provide a broad range of nutrition services and interventions for vulnerable adults. By preventing, reducing, and postponing of the onset of chronic diseases and functional disabilities in older adults, SNPs, including Meals on Wheels, can enhance quality of life, delay individual institutionalization, and reduce overall national health care costs.
See also Aging Agencies: City and County Level; Nutritionists; Senior Centers; Senior Hunger.