Optimizing Home-Delivered Meal Services to Provide Better Care for Seniors

The Opportunity
There is growing recognition that social determinants of health can exacerbate health issues and impact healthcare costs. Vulnerable populations such as older adults often have unmet social needs including housing, transportation, access to healthy foods and in-home care. Meals on Wheels programs are well-positioned to identify and address such social and environmental factors because of their regular connection with the older adult clients they serve and close familiarity with the environments in which their clients live.

In March 2018, a two-year study – More Than a Meal Process Evaluation (formerly referred to as the More Than a Meal 3 project) – was completed that developed and implemented a technology-supported change of condition monitoring tool to enhance meal delivery practices, as well as a care coordination protocol to improve the health, safety and well-being of vulnerable, homebound Meals on Wheels clients. This protocol was initially tested with two regional Meals on Wheels programs, where it demonstrated the ability to engage staff and volunteer drivers in using an application on a mobile device to report concerns relating to any changes of condition they identified in senior clients during a meal delivery. All reported concerns were sent via the mobile application to a care coordinator at the Meals on Wheels program, who then followed up with clients to address their unmet needs and took further action as necessary (e.g., connecting the client to social services, health providers, transportation, etc.).

Our Goals
Leveraging learnings from this study, a second research study – More Than a Meal Process Expansion – was initiated in June 2018 to further test, improve and scale the client change of condition monitoring application and care coordination protocol across a wider group of Meals on Wheels programs nationwide. In addition to scaling this innovative model, new robust data tools and a national data repository will be established to organize, monitor and report key data and performance metrics.