Increasing evidence proves the Meals on Wheels preventative model of care successfully supports the desire of older Australians to remain in their own homes.

Our collection of research demonstrates the significant impact the Meals on Wheels service has on the Australian community through empowerment, reablement, improved wellbeing and independence.

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Meals on Wheels; Royal Commission into Aged Care Quality and Safety Submission, 2019’, Page 5.

In January 2020, Meals on Wheels Australia made a submission to the Royal Commission into Aged Care Quality and Safety highlighting the importance of nutrition in ensuring our health and wellbeing as we age. It discusses the impact Meals on Wheels has on supporting older Australians to remain living independently and well at home, through delivered meals and an invaluable social and wellbeing check.

The paper recommends improvements to the aged care system to ensure more Australians have simple and timely access to in-home and community care services that support their desire to live at home and out of aged care, as well as discussing the economical savings this has to the Government. In line with MoWA’s key advocacy issue, it highlights the need for an increase in Government funding to ensure meal delivery services are affordable and accessible to the people who need them most.

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Rist G, Miles G & Karimi L. 2012. The presence of malnutrition in community-living older adults receiving home nursing services. Nutrition & Dietetics, 69: 46-50.

This study aimed to determine the extent of malnutrition and the risk of malnutrition among people aged over 65 years old who live in the community and receive support from a metropolitan home nursing service in Victoria. Of the 235 clients assessed over a three month period, 34% were identified as being at risk of malnutrition, while 8.1% were considered malnourished. This highlights the vulnerability of older Australians and the urgent need for regular nutrition screening and a targeted intervention program to address nutrition issues.

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Dieticians Association of Australia. 2019. Submission to Royal Commission into Aged Care Quality and Safety.

As the peak body for dietitians in Australia, the Dietitians Association of Australia (DAA) considers that safety and quality frameworks for nutrition care must be improved to promote quality of life and to protect the most vulnerable groups in the community against malnutrition, dehydration, foodborne illness and other risks of harm related to food and nutrition.

In this submission to the Royal Commission into Aged Care Quality and Safety, the DAA recommends improvements to the community aged care services to ensure older Australians receive the nutrition they need to stay living independently and well.

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Beer A, Faulkner D, Law J, Lewin G, Tinker A, Buys L et al. 2016. Regional variation in social isolation amongst older Australians. Regional Studies, Regional Science 3:170–84.

Social isolation is often experienced by older Australians. Social connection is a key element in ensuring our wellbeing and mental health as we age.

This study looks at the social connections and wellbeing of Australians aged over 65 years old and examines regional variations in the incidence of social isolation. It also considers the impact of community-building activities in addressing social isolation and the role of urban design.

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Ariel S, Lackoff B, Hickling B, Collins PF, Stevenson KJ, Nowicki TA, Bell JJ. 2019. The association of malnutrition with falls and harm from falls in hospital inpatients: Findings from a 5‐year observational study. Journal of Clinical Nursing.

We know malnutrition is a known risk factor for falls, however, few studies have considered its association with hospital inpatient falls. The results of this study revealed malnourished patients are more likely to experience a harmful fall, with 171 inpatients experiencing a harmful fall and the prevalence of malnutrition at 32.4%. Shockingly, malnourished inpatients were almost eight times more likely to have a harmful fall compared to those not malnourished. The study highlighted the importance of good nutrition in preventing falls and reducing risk.

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Charlton K, 2014. Time to address the skeletons in the hospital – and bedroom – closet. Australian Association of Gerontology Newsletter, September.

For many years it has been known the detrimental effect malnutrition has on hospitalised patients on their road to recovery and over time, attempts have been made the improve the detection of malnutrition.

Despite evidence suggesting those who are either malnourished at admission or become malnourished during their hospital stay experience increased surgical complications, greater morbidity and increased length of hospital stay, as well as higher rates of mortality, malnutrition often remains undetected and untreated as it is not considered a clinical priority.

Failure to recognise patients who are at risk of malnutrition and therefore implement a nutritional intervention in a timely manner often results in a downward spiral, whereby patents are discharged back to the community or to a higher level of care, only to be later re-admitted in a more compromised nutritional state. This study aims to address this issue.

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Access Economics. 2010. Cost benefit analysis of an intervention to improve the nutritional status of community dwelling older Australians. Report by Access Economics Pty Ltd for Australian Meals on Wheels Association.

This study reports the findings of a cost-benefit analysis (CBA) of a proposed intervention to prevent under-nourishment among older Australians living in the community who are at risk of malnutrition or who are malnourished and who receive Meals on Wheels. It was commissioned by the Australian Meals on Wheels Association (AMOWA).

Results found malnutrition among some older Home and Community Care (HACC) clients receiving Meals on Wheels may lead to poor outcomes, such as admission to hospital, lengthy hospital stays, falls and premature admission to residential aged care. These outcomes are also associated with high financial costs and therefore, effective interventions to improve nutrition will have significant potential to save costs to the healthcare system.

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Australian Meals on Wheels Association. (2016). National Meal Guidelines: A Guide for Service Providers, Caterers and Health Professionals Providing Home Delivered and Centre Based Meal Programs for Older Adults. Australian Meals on Wheels Association

The National Meal Guidelines, created by the Australian Meals on Wheels Association and endorsed by the Australian Government ensure the quality and safety of our essential service.

These guidelines are specifically targeted to meet the nutritional and wellbeing needs of older Australians, setting a standard for delicious and nutritious food, delivered by over 592 services across the country.

Landeiro F, Barrows P, Nuttall Musson E, et al. 2017. Reducing social isolation and loneliness in older people: a systematic review protocol. BMJ Open;7:e013778.

Social isolation and loneliness affect approximately one-third to one-half of the elderly population and has a negative impact on both their physical and mental wellbeing. This study assesses the effectiveness of health promotion interventions on reducing social isolation or loneliness in older people.

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Walton K, do Rosario VA, Pettingill H, Cassimatis E & Charlton K. 2019. The impact of home-delivered meal services on the nutritional intake of community living older adults: a systematic literature review. J Hum Nutr Diet.

It is believed that physiological changes that occur during the ageing process may increase the risk of malnutrition in older adults. To prevent this issue, home-delivered meal services provide meals in the home or in congregate settings for older adults who require support to stay well-nourished.

This study explores whether nutritional intake is improved in older adults living in the community when receiving meal services compared to when meal services are not received.

The results support the benefit of home-delivered meals including the dietary intake of energy, protein and/or certain micronutrients in older adults in having a positive influence on malnutrition risk in frail older adults, supporting good health, promoting recovery from illness and assisting in maintaining functionality.

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Campbell AD, Godfryd A, Buys DR, & Locher JL. 2015. Does participation in home-delivered meals programs improve outcomes for older adults? Results of a systematic review, Journal of Nutrition in Gerontology and Geriatrics, 34(2), 124-167.

Participation in home-delivered meals programs may contribute to the health and independence of older adults living in the community, especially those who are experiencing food insecurity or making transitions from acute, subacute, and chronic care settings back to the comfort of their homes.

This study tests whether being a recipient of a home-delivered meal program improves health and independence outcomes of older adults.

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Thomas K, Akobundu U & Dosa D. 2016. More than a meal? A randomized control trial comparing the effects of home-delivered meals programs on participants’ feelings of loneliness. J Gerontol B Psychol Sci Soc Sci., 71(6), 1049-1058.

The slogan “more than a meal” is used to describe the multi-faceted benefits of the Meals on Wheels service, including improving social connection and wellbeing and reducing feelings of loneliness and isolation. This study evaluates the extent to which the home-delivered meals program, and the type of delivery model, reduces homebound older adults’ feelings of loneliness.

Results showed participants receiving meals from Meals on Wheels programs across the United States had lower adjusted loneliness scores at follow-up compared with the control group.

Additionally, individuals who received daily-delivered meals were more likely to self-report that home-delivered meals improved their loneliness than the group receiving once-weekly delivered meals.

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Aged Care Financing Authority. 2019. Annual Report on the Funding and Financing of the Aged Care Industry – 2019, p.13.

This is the seventh annual report on funding and financing by the Aged Care Financing Authority (ACFA), exploring the challenges facing the aged care sector in Australia and includes analysis of the data supplied by service providers in their 2017–18 financial reports.

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Wilson L 2013. A review and summary of the impact of malnutrition in older people and the reported costs and benefits of interventions. Malnutrition Task Force, UK.

In this report Dr Lisa Wilson explores the cost of malnutrition in the UK and the interventions and preventative measures which have been proven to work in tackling both the causes and consequences of malnutrition. Of the results, it is estimated that 1 in 10 people over 65 years old and living in the community are malnourished or at risk of malnourishment. Research has also found malnourished people saw their GP twice as often, had three times the number of hospital admissions and stayed in hospital more than 3 days longer than those who were well nourished. In summary, maintaining independence, preventing isolation, ensuring access to food and services, preventing poverty and ensuring quality of life are critical components in preventing malnutrition.

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Luscombe-Marsh N, Chapman I & Visvanathan R. 2014. Hospital admissions in poorly nourished, compared with well-nourished, older South Australians receiving ‘Meals on Wheels’: Findings from a pilot study. Australasian Journal on Ageing, 33(3): 164-9.

The aim of this study was to evaluate whether Meals on Wheels improves health and reduces hospital admissions in poorly nourished older people. It involved the study of 250 older South Australians. Although the results suggest providing Meals on Wheels to nutritionally vulnerable older people may not prevent age-related decline in health, a potential reduction in hospital admissions warrants investigation.

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Landeiro F, Barrows P, Nuttall Musson E, et al. 2017. Reducing social isolation and loneliness in older people: a systematic review protocol. BMJ Open

Social isolation and loneliness affect approximately one-third to one-half of the elderly population and have a negative impact on their physical and mental health. Group-based interventions with well-trained facilitators and actively-engaged elderly participants seem to be more effective, but conclusions have been limited by weak study designs. This systematic review aims to assess the effectiveness of health promotion interventions on social isolation or loneliness in older people.

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Shan M, Gutman R, Dosa D, Gozalo P, Ogarek J, Kler S & Thomas K. 2019. A new data resource to examine Meals on Wheels’ clients’ health care utilization and costs. Medical Care, 57(3): e15 – e21.

Access to social services, for example, nutrition can impact older adults’ health care utilisation and subsequent health outcomes. However, data documenting the relationship between receiving services and objective measures of health care utilisation remain limited. This study involved 29,501 Meals on Wheels clients and aimed to examine the client’s health and health care utilisation through Medicare claims. Linking this data has the potential to shed additional light on the relationships among social services, health status, health care use, and benefits to clients’ wellbeing.

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Thomas K & Mor V. 2013. The relationship between older Americans Act Title III state expenditures and prevalence of low-care nursing home residents. Health Services Research, 48(3), 1215-1226.

This study aimed to test the relationship between older Americans Act (OAA) program expenditures and the prevalence of low-care residents in nursing homes and found states that have invested in their community-based service networks, particularly home-delivered meal programs, have proportionally fewer low-care nursing home residents.

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Report on Government Services 2019, Aged Care Services, Page 3, Table 14A

The Report on Government Services is a vital tool in providing information to the community and holding all Australian governments accountable for the effectiveness and efficiency of Government services.

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