Home-delivered "Meals on Wheels": role and effectiveness

Meals on Wheels are increasingly used by home-living elderly people. Users are mostly lonely people and old couples. They are using it generally for shopping and/or cooking difficulties (50%), less frequently after an hospitalization period (1/3), sometimes for years. Usually the service offers one meal a day, often with an extra soup for dinner. Customers estimate the offer as good even though they express numerous criticisms: dishes not in relation to their own tastes, little choices and problems to obtain dish changes, too though dish (meat and vegetable), few contacts with delivering persons and too high costs. They do not always eat all served meals at lunch, using part of it for dinner. User's opinions have been inquired, in contrast, energy and nutrient served are unknown, since few studies have been conducted in France and elsewhere. Undernutrition prevention in at-risk individuals remains to be evaluated. In addition, usefulness of such services for health status slow deterioration prevention has still to be proved since delivering persons do not have time to do it. In consequences, it may be urgent that specific rules are taken in order those services take part in prevention for home living elderly.