Project:
A Study of Older Adults on the Waiting List for Home-Delivered Meals in North Carolina

Year: 2002

Investigator: Salmon, Mary Anne P., and Jessalyn Gooden

Institution: The University of North Carolina at Chapel Hill

Project Contact:
Mary Anne P. Salmon, Clinical Associate Professor
The University of North Carolina
School of Social Work
Center for Aging Research and Education
CB# 3550, 301 Pittsboro Street
Chapel Hill, NC 27599-3550
Phone: 919-962-4362
masalmon@email.unc.edu

The Nutrition Services Incentive Program (NSIP) is a Federal program that provides incentives for State agencies to provide meals to older adults. The program is administered by the U.S. Department of Health and Human Services (HHS), and States may obtain commodity foods from USDA.3 The NSIP provides funding and commodities for the provision of home-delivered meals to adults over age 60 in a number of States. The NSIP does not allow State agencies to set income limits for the receipt of home-delivered meals. However, the NSIP is not an entitlement program, and a number of applicants may be placed on a waiting list if the State does not have sufficient resources to provide meals for all applicants. This study examined a population of older adults who have been placed on a waiting list for home-delivered meals in five counties in North Carolina to assess their functional ability, nutritional status, and strategies to obtain food.

The authors conducted telephone interviews with 110 people who had been assessed as eligible and placed on the waiting list for home-delivered meals in one Area Agency on Aging (AAA) Region in North Carolina.

They found that those on the waiting list were about the same age as those who began receiving home-delivered meals in 2001, about as likely to be female, and somewhat more likely to be African-American and to live alone. Almost half of those on the waiting list lived in households with incomes below the poverty line. Survey respondents were asked whether they needed assistance with nine standard activities of daily living, such as getting dressed and transferring from bed to chair. About 20 percent reported that they did not require the help of another person for any of the nine activities. Those on the waiting list were less likely to report needing help getting dressed and transferring from bed to chair than those who began receiving home-delivered meals in 2001.

Almost all of those on the waiting list were at high nutritional risk, based on an index used by the HHS Administration on Aging. More than a third reported that they had neither eaten fruit nor drunk fruit juice the day before the interview, over 40 percent had eaten no nonstarchy vegetables, less than 15 percent had eaten neither fruits nor vegetables, and over 40 percent had neither drunk milk nor eaten calcium-rich products. While many on the waiting list were at high nutritional risk, very few were underweight. In fact, more than half were overweight.

Those on the waiting list to receive home-delivered meals relied on a variety of sources for their meals. Seven in 10 reported that they had someone bring them prepared meals, which accounted for an average of 3.2 of their meals each week. Almost two-thirds had someone bring them groceries, which provided a weekly average of almost 16 meals. The respondent’s adult children were the most likely to bring prepared meals or groceries. Almost 10 percent of respondents did not receive prepared meals or groceries or the help of someone coming to their home to cook for them. Almost half of the survey respondents reported that they did not always have enough money (or food stamps) for food. However, only 15 percent reported that they were receiving food stamps.

The study results indicate that almost all of those on the waiting list to receive home-delivered meals are at high nutritional risk. However, there is some variation in their access to an informal support network to help provide them with meals, which suggests a need to focus resources on applicants who do not have informal supports.