Current Status and Management of Congregate Meal Service Program for the Elderly at Community Centers

To investigate current status of the elderly meal service program, community centers nationwide were surveyed for congregate meal services. The survey was conducted during the month of December 2002 by mail using self-developed questionnaire on administration, staffs, funding, and meal service management. Only 95 out of 356 community centers (27%) answered and returned the questionnaires, and congregate meal menus were also collected from 20 centers for 492 days. Results were analyzed using SAS package program. In more than half of the elderly congregate meal service programs, following criteria were used in multiple form to allow participation; 65 years old or older, low income, or living alone. All centers served lunch, most of them free of charge, and 88.4% of them provided service 5 days a week. About 79% of the total cost occurred on the congregate meal service was supported by the government. Most of the menus served at congregate meal service were Korean style dish with rice. On the average, each meal provided 3 side dishes including kimchi, in addition to soup or stew. Only 19% of the centers have employed dietitian working for meal service programs; meal menus were prepared by social welfare workers or other non-dietetic personnels in more than 80% of the centers. Food purchasing and food hygiene control was also practiced mainly by social welfare workers or cooks. This study suggests that dietetic professionals are needed to better manage meal service programs for the elderly in both aspects, food hygiene and nutrition. Development of more nutritious menus and determination of appropriate serving sizes for the elderly meal service programs are necessary to meet the RDAs and dietary action guide for the elderly.

Satisfaction Measurement and Needs Analysis of the Beneficiaries of the Elderly Meal Service Program

In the process of devising an efficient meal service system for the elderly, 478 elderly were interviewed at 6 different social centers with the elderly meal service program in Seoul area to monitor degree of satisfaction and/or needs of the beneficiaries regarding the program. The survey was conducted during the month of December 2002 by well-trained interviewers using self-developed questionnaire. Results were analyzed statistically using SAS package program. Most of the beneficiaries were low economic class and 76% of them had doctor diagnosed disease(s). Among the beneficiaries of congregate meal service, mean score of 12 aspects of satisfaction was 3.72 out of 5. For most of the questions, female elderly and healthy elderly responded with higher score than male elderly and unhealthy elderly, respectively (p<0.05, p<0.01). On the other hand, beneficiaries of the home-delivered meal service were little bit less satisfied with the service (3.54 out of 5). Compared to the beneficiaries of congregate meal service, larger portion of beneficiaries of home-delivered meal service wanted more meats (28.5 % vs. 17.1 %) and vegetables (23.2 % vs. 12.3 %) as side dishes. On the other hand, the most preferred type of cooking and/or seasoning was stewing for both cases. Based on these findings, it is suggested that more fresh foods should be used than processed foods in the preparation of meals for the elderly and, more fish-, meat- and vegetable- dishes should be served to come up to the needs of the elderly. Onto this, mainly Korean style meals with some intermittent Western, Japanese or Chinese style meals served at the right temperature would suffice most of the elderly needs.

Satisfaction Measurement and Needs Analysis of the Beneficiaries of the Elderly Meal Service Program

In the process of devising an efficient meal service system for the elderly, 478 elderly were interviewed at 6 different social centers with the elderly meal service program in Seoul area to monitor degree of satisfaction and/or needs of the beneficiaries regarding the program. The survey was conducted during the month of December 2002 by well-trained interviewers using self-developed questionnaire. Results were analyzed statistically using SAS package program. Most of the beneficiaries were low economic class and 76% of them had doctor diagnosed disease(s). Among the beneficiaries of congregate meal service, mean score of 12 aspects of satisfaction was 3.72 out of 5. For most of the questions, female elderly and healthy elderly responded with higher score than male elderly and unhealthy elderly, respectively (p<0.05, p<0.01). On the other hand, beneficiaries of the home-delivered meal service were little bit less satisfied with the service (3.54 out of 5). Compared to the beneficiaries of congregate meal service, larger portion of beneficiaries of home-delivered meal service wanted more meats (28.5 % vs. 17.1 %) and vegetables (23.2 % vs. 12.3 %) as side dishes. On the other hand, the most preferred type of cooking and/or seasoning was stewing for both cases. Based on these findings, it is suggested that more fresh foods should be used than processed foods in the preparation of meals for the elderly and, more fish-, meat- and vegetable- dishes should be served to come up to the needs of the elderly. Onto this, mainly Korean style meals with some intermittent Western, Japanese or Chinese style meals served at the right temperature would suffice most of the elderly needs.

Evaluation and Categorization of Commercially Prepared Enteral Nutrition Formulas / 대한지역사회영양학회지

In order to investigate the types of enteral nutrition formulas currently used in hospitals and evaluate and categorize the commercially prepared enteral nutrition formulas formulas available in the domestic market, we asked dietitians working in 6 hospitals in Seoul to complete the questionnaire and obtained compositional characteristics of 12 commercially prepared enteral nutrition formulas. The average proportion of patients receiving the commercially prepared enteral nutrition formulas(60.6%) was greater than that of patients receiving the in-hospital preparations(31.9%). In the group of patients receiving the in-hospital prepared formulas, the enteral feeding was mainly administered orally, whereas, in the group of patients receiving the commercially prepared formulas, tube feeding was the primary route of formula administration. In both groups, however, a greater proportion of patients received the formulas as total replacements of their meals and for the purpose of dietary supplementation. On the basis of major criteria for evaluation of the commercially prepared enteral nutrition formulas, the 6 products out of the 9 nutritionally complete products formulated for the purpose of dietary supplementation were grouped into the same category(standard protein, caloric density of 1kcal/ml, and tube/oral), so they were considered therapeutically comparable. However, the remaining 3 products were different in protein content(high protein) or route of administration(tube only). Of the 3 nutritonally complete products formulated specifically for the purpose of dietary therapy, 2 products were formulated for patients with renal disease, and the one product was formulated for diabetic patients. Therefore, the data in this study showed that the commercially prepared enteral nutriton formulas became an important part of the enteral nutrition for hospitalized patients in Korea, but the domestic market has not yet generated a wide variety of the formulas, not providing many choices for clinicians to manage the diets for their patients. The results of this study would be helpful for clinicians in choosing appropriate products for their patients, for manufactures in developing new products, and for regulatory authorities to establish the regulation for the broad group fo heterogeneous products that are marketed and will be developed as medical foods. In addition, the process of maintaining the categories for evaluation of the commercially prepared enteral nutrition formulas should be dynamic because new products may not reasonably fit any of the existing categories.