Many elderly people in Kentucky are mostly able—and prefer—to stay in their own homes rather than move into a nursing home, but they find they cannot prepare their own meals any longer because of arthritis, vision decline, or other physical problems. During their final years, they are faced with moving out of their familiar surroundings and into a strange place with people they don’t know. What if someone could take them meals every day?
The Older Americans Act
With the increasing “graying of America” in the 20th Century came a corresponding increase in the need for community social services for the elderly. To address this need, Congress passed the Older Americans Act in 1965 as part of the Great Society domestic programs. According to the Administration on Aging (AOA), this legislation provides grants to states for
- community planning and social services;
- research and development projects; and
- personnel training in the field of aging.
The OAA is considered the main instrument for the planning and delivery of social and nutrition services for the elderly.
The Brown University Study
Kali Thomas and Vincent Mor, researchers in gerontology, analyzed annual OAA program reports from each state between 2000 and 2009. They considered Medicaid spending, nursing home capacity, and performance information from a variety of nursing home and public health data sources. Much of this information came from the Brown University study “The Shaping Long-Term Care in America Project.”
The study found that states with lower nursing home occupancy rates had something in common: they spent more on home-delivered meal programs. The researchers concluded that providing meals to elderly people who are no longer able to prepare their own meals is a major factor in extending independence.
Low-Care Nursing Home Residents
In 2000, 17.9 percent of the residents in U.S. nursing homes were designated “low care,” requiring few of the services that a nursing home typically provides. Thanks to the OAA and other services for the elderly, including Medicaid-sponsored home- and community-based services (HCBS), this number declined to 12.6 percent by 2009.
The 2009 figures varied widely from state to state, and the researchers determined that what seemed to make the difference was the amount the state spent on programs such as Meals on Wheels. For every $25 above the national average that a state spent per adult per year on home-delivered meals, the state reduced the number of low-care nursing home residents by one percent.
Home-Delivered Meal Programs
According to Age Well Senior Services, Meals on Wheels delivers nearly half a million meals each year to people who are unable to prepare their own meals or go out to eat and have little or no assistance to obtain adequate meals. The meal plan for the day is prepared by a registered dietitian. It includes a hot, ready-to-eat meal; a cold meal for later in the day; and breakfast for the next morning.
The drivers not only deliver food; they also observe the senior’s condition. If no one answers the door when the volunteer arrives to deliver meals, it gets reported.
Kali Thomas, a post-doctoral research fellow at Brown University and lead author of the study, is a firm believer in the value of Meals on Wheels. She credits the program for enabling her grandmother to remain in her own home until she died at 98 years old.
“She lived four hours away from any family and refused to leave her house,” Thomas said. “We had comfort knowing that every day someone was in her house to see how things are.”
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