Home-Delivered Meals Program: A Promising Intervention for Suburban Older Adults Living Alone

Background and Purpose: Home-delivered meals programs are an important community intervention to promote aging in place. The goal of the home-delivered meals program is to reduce hunger and food insecurity to promote the safety, health, and quality of life of older adults living at home. The program also reaches the most vulnerable older adults in the community, including those who are racial or ethnic minorities, live in poverty, or live alone.  For example, in suburban Cook County Illinois, 25.3% of older adults live alone, compared to 65.5% of home-delivered meals participants. Social isolation, a potential consequence of living alone, has been linked to a number of negative outcomes in older adults, including decreased mental and physical health. The purpose of this research is to assess 1) the benefits of home-delivered meals from the participants’ perspective, and 2) differences in perceived benefits between older adults living alone and those living with others.

Method: The target population is home-delivered meals participants 60 and older served by 23 service providers in suburban Cook County, Illinois. National Aging Program Information Systems (NAPIS) data were used to identify 2,653 clients currently enrolled in the program. The Administration on Aging, Performance Outcome Measurement Project (POMP) sample size calculator was used to estimate the sample size. 434 clients were randomly selected to participate in the telephone survey, and 199 completed the survey, yielding a response rate of 45.9%. Open-ended questions addressed participants’ perspectives on the benefits of the program and potential areas for improvement. The contents were analyzed using open coding based on grounded theory after categorizing responses into similar themes.

Results: Overall, 97% of respondents felt that the home-delivered meals program helped them continue living at home. Ten themes emerged from qualitative analysis to identify perceived benefits including: (a) food security, (b) better nutrition, (c) convenience, (d) accessibility, (e) finances, (f) solution to lack of support, (g) emotional well-being, (h) safety, (i) makes care giving easier, and (j) social contact. Of those surveyed, 63% live alone. Four themes appeared more often among older adults living alone compared to those living with others: accessibility (relieves transportation burden), finances (less money spent on groceries), safety (eases safety concerns) and solution to lack of support (addresses meal needs when family is not available).

Implications: Older adults who live alone are overrepresented among home-delivered meal participants in suburban Cook County. The results suggest there is a higher need for transportation options, financial security, regular safety checks, and basic support among those who live alone. Participants living alone are also more likely to find a wider range of benefits from the program than those living with others. Home-delivered meals programs are critical for those who live alone in suburban communities where transportation options are limited. Programs should target outreach to isolated older adults and regularly examine participant demographic data to identify service gaps and ensure equal access to this essential program for promoting aging in place.