Meals on Wheels drivers good early warning system for senior's health and safety issues

Meal delivery drivers bringing food to homebound seniors can be an effective early-warning system for health and safety problems, according to a new study published in the Journal of the American Geriatrics Society by researchers at the West Health Institute, Brown University and Meals on Wheels America.

The study, titled "Leveraging Home-Delivered Meal Programs to Address Unmet Needs for At-Risk Older Adults: Preliminary Data," was designed to test the feasibility of leveraging routine meal delivery service in two home delivered meal programs at Meals on Wheels San Diego County and Meals on Wheels Guernsey County, Ohio to proactively identify changes in older adult meal recipients' (clients') health, safety and well-being and address unmet needs.

In the study, meal delivery 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.

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—"Mobile Meals," part of Accessible Solutions, Inc.'s ServTracker software—easy to use and valued change of condition monitoring as an important contribution.

A special editor's note accompanying the publication highlighted the potential for this program to improve the health and safety of homebound seniors.

"As healthcare systems struggle to address the social determinants of health, this innovative Meals on Wheels model may provide part of the solution," said Dr. Michael L. Malone, a section editor in models of geriatric care, quality of improvement, and program dissemination with the Journal of the American Geriatrics Society. "As leaders in geriatric medicine, we should champion social programs (such as Meals on Wheels) that meet the needs of vulnerable individuals in our communities. In retrospect, our core business is to help the whole person, whose healthcare needs are intertwined with his/her social needs."

West Health and Meals on Wheels America recently announced plans to expand this successful research program to include up to 30 Meals on Wheels sites across the country, helping ensure the wellness of an estimated 40,000 seniors.

"By collaborating with Meals on Wheels America, we've developed a safe, cost-effective and scalable program to preemptively identify and address concerns that too often result in deterioration of a senior's medical condition or pose a major safety risk," said Dr. Zia Agha, chief medical officer at West Health. "We're excited learnings from this research program are now being implemented across the country within Meals on Wheels America's expanded program that will positively impact as many seniors as possible."