• Journal of Nutrition and Health
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• v.46 no.6
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• pp.589-596
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• 2013

As the importance of elderly's dietary life have increased, low-income elderly's meal should be taken care by social policies. Nevertheless, there is a lack of systematic management in home-delivery meal service. This study aims to investigate the elderly's experience on home-delivered meal service, especially identifying the symbolic meaning of home-delivered meal service on elderly's dietary life. Using an in-depth interview, qualitative data was collected from five elderly participants who received home-delivered meals. Data was analyzed based on Colaizzi's 6 steps method, deriving 148 significant statements, 18 formulated meanings, and 5 themes: , , , , and . Elderly participants regarded the home delivered meal as not only a decent meal but also felt appreciated. The home-delivered meals were found to be their only meal all day; thus, they considered these meals as a means of survival. Home-delivered meals are considered as a lack of consideration for the elderly's physical condition, including their tastes, portion size, and cooking method. Also, these elderly seemed to lose their appetite due to aging and it caused the enjoyment of eating. The elderly have kept silence never expressing any opinions regarding the home delivered meals because they were offered for free. The results suggested that the home-delivered meal service should be developed with the multilateral evaluation methods to reflect the elderly's needs to improve the quality of the home-delivered meal service.

• Korean Journal of Community Nutrition
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• v.15 no.3
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• pp.379-392
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• 2010

The purposes of this study were to investigate recipients' handling and consumption of home-delivered meals at home and to assess their perceptions on home-delivered meal services for older adults. A total of 312 elderly people who received home-delivered foodservice were surveyed using an individual interview technique. A statistical data analysis was completed using SPSS (ver. 14.0). It was found that 90.2% (n = 166) of the lunch box recipients received services for six days per week, and 76.6% (n = 95) of the side-dish recipients got services once per week. More than half of the clients reported that they cooked meals by themselves on days when meals were not delivered. The two hundred thirty-two (75.3%) ate their meals as soon as they were delivered. It was found that 66.8% of the lunch box recipients and 7.3% of the side-dish recipients left delivered meals on the counter (at room temperatures) before eating. Only 11.4% of the lunch box recipients and 48.4% of the side-dish recipients kept delivered meals in the refrigerator before eating. Less than half of the lunch box recipients consumed all foods they were served at once. The reasons the recipients did not eat their all meals delivered at once were "saving for next meals" and "big portion size" Of those clients who left delivered meals, 19% of the lunch box recipients and 9.7% of the side-dish recipients ate leftovers without reheating. An average score of quality of delivered meal services was 3.5 out of 5 points. The results suggest that the clients of the home-delivered meal service should be provided information on proper handling and consumption practices with delivered meals at home. The findings of the study will be used to develop nutrition and food safety management guidelines for senior foodservice.

• Korean Journal of Community Nutrition
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• v.19 no.5
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• pp.459-467
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• 2014

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.

• Journal of the Korean Dietetic Association
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• v.25 no.4
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• pp.295-309
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• 2019

The purpose of this study were to identify the dietary practices of vulnerable older adults and to assess the foodservice and food provision service programs perceived by the health and welfare service providers in the community. A survey was conducted on health and welfare service providers working in outreach community centers and community health centers in Seoul. A total of 260 nurses and social workers participated in the survey and 224 responses were used for data analysis after excluding significant missing data. The respondents consisted of nurses (58.5%) and social workers (41.5%). In terms of the dietary life of the vulnerable older adults, they perceived that the food cost was burdensome to the older adults and poor dental conditions prohibited them from eating various foods. The health and welfare service providers rated highly for 'home-delivered meal and side dish services are effective for checking older adults' conditions' but rated low for availability of menu choices. In targeting vulnerable older adults for food and nutrition service programs, the home-delivered meal service was found to be suitable for older adults living alone, those over age of 80 years, those with mobility difficulties, and those with economic difficulties. The food provision service was appropriate for older adults living with their spouse or other family members. Vulnerable older adults are a heterogeneous population with diverse needs related to food and nutrition. Home-delivered meal/side dish service and food provision services will achieve their goals when they reach the correct targets with a customized service.

• Nutrition Research and Practice
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• v.17 no.5
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• pp.1007-1018
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine whether the tailored home-delivered meal (HDM) services included nutrition counseling impacts alleviating self-rated frailty among low-income older adults in Korea. SUBJECTS/METHODS: Pre- and post-test were implemented on May 27 and on November 25 in 2019 during 3 weeks, respectively, before and after the 6 months intervention program. Participants completed a questionnaire measuring frailty, malnutrition, food security, depression, and underlying diseases. Initially, 136 older adults were selected as participants for this study, they were recipients of a free meal program from 2 senior welfare centers in Seoul, the final sample size of those who completed the intervention program was 117 (female 70.9%, male 29.1%). Statistical analyses were conducted with IBM SPSS package program, paired t-test and χ² test to validate the test. RESULTS: There were statistically significant differences in the score of the Tilburg Frailty Indicator (TFI) before and after receiving the tailored HDM services (pre-test 9.46, post-test 2.8, P < 0.01). The differences in the score of TFI by 3 risk groups at the pre-test decreased as a result of receiving these services. CONCLUSIONS: The tailored HDM services alleviated the self-rated frailty of low-income older adults with limited mobility in a community setting. Based on the positive outcomes this study could be applied to developing social services for aging in place.

• Korean Journal of Community Nutrition
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• v.8 no.5
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• pp.736-743
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• 2003

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 ￦2,000 to ￦2,499 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.

• Nutritional Sciences
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• v.6 no.1
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• pp.53-66
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• 2003

This study was performed to assess the perception and need for the elderly meal service program of the Korean elderly. The purpose of this study was to assess the dietary environment factors which are related to the perception and need for such service. Subjects of this study were 800 elderly persons of whom responses were received from 769(male: 26, female: 543) aged over 60 years. Their mean age was 7.51 $\pm$8.1 years. Seventy two point two percent of them lived with their family and 54.5% of them were supported economically by their children. Among their meal management behaviors, food purchasing was hard to perform and the most aid-needed activity. In their dietary environment, 47.1% of them were supported by their children. The percent of the subjects who were aware of the elderly meal service program was 48.4%. Men were more aware of the meal service program than women(p<0.01). Elderly who were supported by government were more aware of this service than others. Elderly who were in poor dietary environment, were less affluent or had trouble preparing meals expressed better perception this service than others (p<0.05). Those who requested meal services had poor dietary environment than those who did not (p<0.001). The elderly who were younger, with higher income, and lived with a spouse had more demand for home delivered meal service. This study showed that the poorer the greater desire for meal services. Therefore, the need for urgent improvement and expansion of meal services for elderly is suggested by this study.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.5
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• pp.618-625
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• 2009

The purposes of this study were to evaluate food safety knowledge and to assess home food safety performance of home-delivered meal service recipients. Two facilities providing home-delivered meal services for older adults were located in Seoul. A total of 120 service recipients were surveyed using an individual interview technique and 97 responses were used for data analysis. A statistical data analysis was completed using SPSS program (ver.14) for descriptive analysis, t-test, ANOVA, and correlation analysis. The majority of the participants were 70 years old or older and females. They perceived their health status as poor or very poor and took more than one kind of medicines. An average score of the food safety knowledge test was 11.48 based on 18 points (63.8%). The results revealed that the older adults knew the importance of hand washing but were not aware of when and how to wash hands. There was room to improve knowledge on cleaning and sanitizing fresh fruits and using wiping cloth. The knowledge score for each category was not significantly different by gender and age. The home food safety practices of the older adults was rated as 2.8 out of 4 points; the highest score was associated for proper food handling category and the lowest score was for cleaning and sanitizing. The worst performance was related to managing hand cuts and wounds (1.96). The total knowledge score and an average performance score were significantly correlated (p<0.01). Food safety education programs targeting the older adults who receive home-delivered meal services would improve the recipients' food safety knowledge and practices related to consumption of the meals at home. The programs should focus on not only improving food safety knowledge but also changing food safety practices.

• Journal of the Korean Dietetic Association
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• v.10 no.2
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• pp.197-204
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• 2004

The purposes of this study was to analyze the operational difference of foodservice center for homebound elderly by the presence of the dietitian. The questionnaire was developed to measure all variables for menu management and distributed to 103 meal service centers in charge of congregate meal service program and 57 centers for home-delivered meal service program. The data of 160 centers in charge of congregate meal service and home-delivered service centers were usable for analysis. Statistical data analysis was completed using the SAS 8.1 package program for descriptive analysis and chi-square test. Only 21.9% meal service centers had dietitians, what is more, they were not professionals who did menu management but foodservice managers, volunteers, cook or social workers. The current foodservice programs for the homebound elderly were operated without professional. In the part of menu managemet, dietitians were more actively involved in menu planning in the elderly foodservice center in the presence of the dietitians. The performance level of healthcare service was not significantly different, but the nutrition education in the elderly foodservice center with the dietitians was more frequently performed than that without the dietitians(p<0.05). In the food purchasing and food production management, the significant differences were shown that in the elderly foodservice centers in the presence of the dietitians, the proportion of the contract purchasing was significantly higher than that of direct purchasing(p<0.01). In food sanitary management, the significant differences were not shown in the part of management of keeping meal for identifying the cause of food-borne illness and left-over, but the sanitation education for the foodservice employees was performed more frequently by the presence of the dietitians(p<0.01). In conclusion, the foodservice management was more systematically conducted in the elderly foodservice centers in the presence of the dietitians than that without dietitians. The elderly foodservice program has offered the health-related support for homebound elderly. Although there were several problems in elderly foodservice management, the program delivered well-targeted, effective, and efficient nutrition services and wide range of supportive service to the at-risk older population. It needs to be managed by professional for the improvement in the elderly foodservice.

• Korean Journal of Community Nutrition
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• v.24 no.3
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• pp.197-207
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• 2019

Objectives: This study examined the characteristics and nutritional risk of the elderly who receive home delivery services. We then analyzed the effects of the characteristics of the elderly who receive the home-delivery meal service on their nutritional risk. Methods: A total of 220 respondents who receive home-delivery meal service in Seoul participated in the survey. The survey consisted of the characteristics of the elderly (health status, tooth condition, physical activity, social participation activity, depression and relationship with neighbors), nutritional risk assessment and other general matters. The data was analyzed by using the SPSS program. Cross-tabulation analysis, t-test, correlation analysis and regression analysis were all conducted. Results: 47.0% of the subjects were under 80 years old and 53.0% were over 80 years old, The nutritional risk score, as evaluated by a Nutrition Screening Initiative (NSI) checklist was 10.7 points, and the high nutrition risk group was 91.5% of the subjects. The subjective self-health status score was 2.24 points (out of a total of 5 points) and the tooth status score was 3.30 points. The physical activity level was 2.17 points for the under 80 years old group and 1.76 points for the over 80 years old, and there was a significant difference according to age (p<0.01), The higher the health status, tooth condition, physical activity and social participation activity level, the lower was the nutritional risk. Further, the higher the degree of depression, the higher was the nutritional risk. Conclusions: For the healthy life of the elderly in the community, various welfare policies should be planned to increase social participation as well as to promote physical health and reduce depression.