Study of meals programs

Aging, Wntr, 1989

Study of Meals Programs

The federally funded Elderly Nutrition Program (ENP) is performing well in providing much needed congregate and home-delivered meals to older people in this country. Furthermore, many nutrition projects are trying new and innovtive ways to serve this population.

These are the conclusions of a newly completed study of this program conducted at Tufts University School of Nutrition and sponsored by the Andrus Foundation, American Association of Retired Persons. Most of the following information is adapted from the executive summary of "Service Innovations: Charting the Future of the elderly Nutrition Program," a new report based on the study.

The Elderly Nutrition Program was authorized by Congress in 1972 under title VII (now Title III) of the Older Americans Act. Since that time the program has grown considerably, accounting for a budget of over $550 million in federal support in 1987 and serving some 230 million meals nationwide.

Data for this study were collected by means of a questionnaire mailed in late 1987 and early 1988 to a random sample of Nutrition Project Directors nationwide. The results are based on 430 completed questionnaires, representing about one-third of all Nutrition Projects.

The survey instrument gathered information on a variety of issues of current interest in the program, including size and structure of the project, the mechanics of food service, characteristics of the Nutrition Project Director, and the extent to which innovative services have been implemented. Data from the National Data Base on Aging (see "The National Data Base on Aging," Aging, No. 351, 1985, pp. 5-6) supplemented the information gathered by the survey instrument.

Service innovations designed to meet the special needs of the elderly are more widely implemented than expected. The most common service innovations are those mandated by the Older Americans Act and its amendments prior to 1980. These services include shopping assistance and information and referral, provided by over 60 percent and 80 percent of projects, respectively. Another common innovation is a modified or special diet option (67 percent of projects), likely related to the strong emphasis given this issue by federal funding agencies.

Other widely distributed service innovations included home-delivered meals on weekends (50 percent of projects), visits to nutrition sites by nursing home residents (36 percent), food pantry programs which donate bags of groceries to low-income elders (23 percent), home-delivered supper option (22 percent), contracts with diners and restaurants (21 percent), ethnic meals programs (18 percent), weekend congregate meals (17 percent), and programs supplying nutritional supplements in liquid or powder form (13 percent--see "A Meals On Wheels Program Adds Liquid Nutrient Supplements," Aging, No. 355, 1987, pp. 31-32).

The extent to which nutrition projects had diversified their service base was found to be related to the size and complexity of the project, the wealth of the service area, the presence of a grants-writer and/or fundraiser on staff, and the importance attached to such service innovativations by the project director. Projects in the Northeast, West, and Central regions had adopted the most innovations.

Relatively few services are provided for certain groups, including socially impaired elders (e.g. homeless people, substance abusers, victims of abuse or neglect) and extremely impaired individuals with needs for more than one meal daily and/or weekend meals. This study documents the extent to which services targeting these groups are being provided by the ENP, and what determines the likelihood that a program will offer these services.

The sizes of elderly nutrition projects varied widely. The trend in food service appeared to be greater reliance on a combined use of on-site preparation, central kitchens and caterer contracts rather than a single mode.

Figures on cost per meal were found to be related to region but not to type of food service. The relationship of cost per meal to program size was ambiguous. Projects were found to ask for a median donation of $1.25 for both congregate and home-delivered meals, although a number of projects had no clear policy on donations. Food stamps were accepted in lieu of cash donations by four-fifths of project surveyed.

The number of clients served varied widely among projects. Nutrition Project Councils, advisory groups comprising community leaders and older consumers, operated in most projects.

The authors of the report observed that the move toward service diversification in Elderly Nutrition Projects is well established. In many areas, however, gaps in the nutrition program remain unfilled. More emphasis needs to be put on serving those in greater social and economic need.

Fundraisers and grantswriters, whether on staff or working as consultants on commission, are an important part of any strategy to diversify the service base in Elderly Nutrition Programs. Programs with a diverse resource base, which raise funds in the private sector, were found to be more innovative.