OBJECTIVES The purpose of this study was to suggest the strategies for improvement of home-delivered meal services for the elderly, to identify reasons for recipients to get started with the services and to evaluate the attitude, acceptability and adaptation of recipients to the services from the perspective of life context. METHODS The data was collected through face-to-face in-depth interviews with eighteen low-income elderly recipients of home-delivered meals and analyzed using a qualitative research method. RESULTS The results were deduced as four themes which comprised of long-term vulnerable socioeconomic contexts resulted in entry to the services, conflicting acceptability to the services, passive adaptation to taking the services, and positive practices to cope with supplement free meals or other services. The service participation was initiated because of a combination of prolonged, vulnerable socioeconomic contexts, including poverty and unexpected life events such as diseases, disability, living alone, aging and unemployment. With regard to taking the services, conflicting acceptability was observed: positive aspects including saving living cost and good quality of meals, and negative aspects including lack of a tailored service and feeling of stigma. Although the recipients needed an individualized service, they did not express their needs and demands for the services and they accepted the unavailability as an accustomed, prolonged vulnerable socioeconomic context. With regard to lack of tailored services, either self-solution such as modification of eating patterns or community-based network and services were used. CONCLUSIONS We suggest that a system to concretely identify recipients' attitude, acceptability and adaptation for home-delivered meal services should be developed in the establishment of a tailored nutrition support system for the low-income elderly.
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The purpose of this study was to research the current home delivered meal (HDM) service programs for seniors living in the community. Fifty seven centers which operated a HDM service program were surveyed with respect to their administrative structure, menu management, food purchasing and production management, hygiene and equipment and facility. -Statistical data analyses were completed using the SAS 8.1 program for descriptive analysis and t-test. The results showed that 55 percent of the study group were from 70 to 79 years old. All of the participants received free HDM. As a result of the meal cost analysis, the meal cost at 56.1% of the HDM service centers was from won2,000 to won2,499 per meal. A total of 68.4% of the HDM service centers were operated without the services of a dietitian. According to the menu analysis, all nutrients except Vitamin B2 were at levels of more than 33% of the Recommended Dietary Allowances for Koreans. Although 96.6% of the HDM service centers required a therapeutic diet menu for the health of the elderly recipients, 68% of the directors responded that they could not afford to serve therapeutic meal. Food purchasing, menu planning and other foodservice management processes were handled by non-professionals, such as volunteers, cooks or social workers. Forty two percent of the HDM service centers never used standard recipes. For determining portion sizes, 75.4% of the HDM service centers depended on personal experience. Finally, the current HDM service programs for the homebound elderly were not operated systematically. It is suggested that professionally trained personnel should be included among the staff members to provide a more effective HDM service. The HDM service programs should be supported financially and systematically by the government.