Andrea M. Morris PhD, Jessa K. Engelberg PhD, Brenda Schmitthenner MPA, David Dosa MD, Emily Gadbois PhD, Renee R. Shield PhD, Uche Akobundu PhD, Kali S. Thomas PhD

https://doi.org/10.1111/jgs.16013

Portions of this work were presented at the annual American Society on Aging, Aging in America Conference, March 2018; the annual meeting of the American Geriatrics Society, May 2018; and the Social Interventions Research and Evaluation Network, National Research Meeting, February 2019.

Abstract

BACKGROUND
Home‐delivered meal programs serve a predominantly homebound older adult population, characterized by multiple chronic conditions, functional limitations, and a variety of complex care needs, both medical and social.

DESIGN
A pilot study was designed to test the feasibility of leveraging routine meal‐delivery service in two home‐delivered meal programs to proactively identify changes in older adult meal recipients’ (clients’) health, safety, and well‐being and address unmet needs.

INTERVENTION
Meal delivery personnel (drivers) were trained to use a mobile application to submit electronic alerts when they had a concern or observed a change in a client’s condition. Alerts were received by care coordinators, who followed up with clients to offer support and help connect them to health and community services.

RESULTS
Over a 12‐month period, drivers submitted a total of 429 alerts for 189 clients across two pilot sites. The most frequent alerts were submitted for changes in health (56%), followed by self‐care or personal safety (12%) and mobility (11%). On follow‐up, a total of 132 referrals were issued, with most referrals for self‐care (33%), health (17%), and care management services (17%). Focus groups conducted with drivers indicated that most found the mobile application easy to use and valued change of condition monitoring as an important contribution.

CONCLUSION
Findings suggest that this is a feasible approach to address unmet needs for vulnerable older adults and may serve as an early‐warning system to prevent further decline and improve quality of life. Efforts are underway to test the protocol across additional home‐delivered meal programs.