Free Meals Available for Seniors, But Too Few Referrals from Case Managers
By Melinda Young
EXECUTIVE SUMMARY
A lesser-known option to improve nutrition for older Americans is congregate meals, which are available in almost every American community.
- Case managers sometimes are unaware of this resource for both nutritious food and socialization, which both of which benefit seniors.
- All congregate meals are free for people older than age 60 years, or are disabled.
- The U.S. Administration on Aging’s Elder Locator website is an easy way to find the nearest daily congregate meal in any county.
Case managers can help older patients access healthy daily meals in a social setting, improving both their nutritional status and social life.
Case managers just need to find these sites for patients by checking the U.S. Administration on Aging’s Elder Locator website or searching for their state’s congregate meals programs.1
“There are sites all over the country, in all counties, for older Americans,” says Nandita Chaudhuri, PhD, a research scientist with the Public Policy Research Institute at Texas A&M University. “Meals are provided in community settings, churches, libraries, community housing, and it’s free of charge.”
Everyone has heard of Meals on Wheels, which delivers food to people’s homes. But this program is the other side of the coin — free meals for people who visit a local congregate meal site.
Research shows people who participate in congregate meal programs report nearly half as many ED visits, and far fewer hospital admissions. About 5% of people who eat the daily meals visit the ED, and 8.5% are admitted to the hospital. For non-participants, data show about 10% visit the ED and 13.7% are admitted to the hospital.2 The only problem is not enough seniors are using this resource, and too few healthcare professionals know about congregate meals.3
“It’s not utilized,” Chaudhuri says. “There needs to be a mention about this program in reputable paperwork for all physicians attending to the needs of older Americans. Unless that’s addressed, there will be problems.”
Modernizing the Program
Chaudhuri and other researchers have studied ways congregate meals can be improved to draw in more seniors. They sent a survey to Texas physicians and nurses who serve low-income Medicaid and Medicare patients in rural and urban counties to find out how they referred patients to food services, such as congregate meals.3
“There is no targeted campaigning and programming for these congregate meal sites,” Chaudhuri says. “That’s why the Administration of Community Living has tried to provide some innovative funds to different grantees who are trying to modernize the settings.”
Earlier research showed that half of older adults in the United States are malnourished. Their health suffers from their consumption of food lacking in essential nutrients.3,4
The need for congregate meals exists. But how could they expand participation in this important program?
“We tried to modernize the congregate meal services by preparing and empowering 16 different pilot [programs] all over Texas,” Chaudhuri says. “This also is happening in other states, like New York, Colorado, Georgia, and Iowa.”
Raising Awareness
The goals are to raise awareness of the free meals and to make the meal sites more appealing to seniors. “It’s a nationwide challenge that no one has tried to address from that perspective,” Chaudhuri says.
Researchers investigated potential causes in the decline of these programs by interviewing physicians and nurses who refer older patients to community-based, long-term support services. Most of the survey participants were unaware of congregate meal programs in their own communities.3
“The older American population may have this in their community, but they may not know about it because there’s no marketing done,” Chaudhuri explains. “If I’m 60-plus and have had a surgery and am getting discharged today, they may come to me and say, ‘You’re going back home. Can you prepare your own food?’ I’m given a referral, and they’re trying to integrate my healthcare needs.”
Patients in these situations have little ability to find their own resources, so they need help and referrals from case managers and providers.
Potential Innovations
These are innovations that could help make both the senior public and healthcare professionals aware of the congregate meal resource in their communities:
• Dining-centered innovations. Congregate meal programs can improve the ambience of their dining halls and reinvigorate their meal choices within federal rules for the program.
“They could make food more culturally compatible and more appealing, and work with local chefs and culinary schools to come up with menu choices and work to improve ambience,” Chaudhuri suggests.
For example, one pilot innovation set up a breakfast café experience. Early bird seniors could meet for a light breakfast and discussions in a setting that replicated a café.5
Another pilot innovation targeted a younger senior population by providing creative advertising of its café-based meal service. The décor was updated, and meal options were expanded to include a salad bar, a frozen drink machine, a cappuccino machine, and partnerships with doughnut shops.5
• Programming at meals. Congregate meal programs can include healthcare and other presentations for participants. They could offer sessions on controlling blood pressure and managing chronic diseases.
“Some people said they don’t go for the food, but they go for the value-added educational components, which they find much more appealing,” Chaudhuri says. “Some sites did those innovations.”
One example is Somervell County, TX, which started the Somervell County Committee on Aging Live initiative that provides entertainment activities using technology, including music, dancing, and karaoke. The county also provides access to social media, a media room, broadcasts with community partners, and big-screen bingo.5
• Technology focus. “One group wanted to improve technology compatibility for seniors, so they provided tech classes with help from community colleges,” Chaudhuri says. “This happened during the pandemic.”
Older adults in the program developed skills to shop online and talk with family and friends via the internet.
One community held curriculum-based internet skills courses as monthly workshops in which senior participants could learn basic internet and computer skills for accessing information. They also could learn how to explore social media to connect with family and friends, and they were taught internet etiquette and safety tips, including how to shop safely online.5
• Marketing and branding. “Another group in San Antonio focused on marketing and branding,” Chaudhuri says. “They used volunteers and active members as models and put in lots of efforts to do marketing better to give it a better profile and image in the community.”
San Antonio’s innovation was to rebrand to “HEAL: Healthy, Eating, Aging & Living Program.” This initiative included nutrition education through collaboration with higher education institutions and community partners, as well as recognizing and rewarding seniors who participate in the program. One poster’s slogan is “Eat Well, Move Well, Age Well.”5
Senior participants liked the pilot projects. About three out of four clients said the congregate program makes them feel better and that it helped them access healthy meals. More than half the clients said the congregate program made them feel less sad and anxious, and 82% said the program expanded their social connection opportunities. Nearly all of them said they would recommend the congregate program to other people in their community.
“It’s replicable, which is why we have a website,” Chaudhuri says. “As we come out of the pandemic, there are more than 400 congregate meal sites across the state.”
People are interested in improving their local programs and attracting more seniors to them, and the pilot innovation program offers some ideas and tools for making changes that will appeal to more seniors.
“We want to inform decision-makers about what could work in modernizing and innovating these sites and bring in more participation in the site,” Chaudhuri says. “We want to help sustain them and then help future sites with similar kinds of initiatives.”
REFERENCES
- U.S. Administration on Aging. Eldercare Locator. 2023.
- Administration for Community Living. Congregate meal programs. 2023.
- Chaudhuri N, Hussain L, Williams A. Long-term support referrals to enhance food security and well-being in older adults: Texas physicians and nurses on what works. Z Gesundh Wiss 2023;Jan 23:1-13. doi: 10.1007/s10389-022-01800-5. [Online ahead of print].
- Ziliak JP, Gundersen C. The state of senior hunger in America in 2020. Feeding America. May 11, 2022.
- Texas A&M University. Texas Congregate Meal Initiative, 2019-Present. 2023.
A lesser-known option to improve nutrition for older Americans is congregate meals, which are available in almost every American community. Case managers sometimes are unaware of this resource for both nutritious food and socialization, which both of which benefit seniors.
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