Meals-on-wheels providers are failing customers with dementia and face losing business to home-delivery online supermarket services and take-away shops unless they improve their service.
Jill Manthorpe, professor of social work at King's College, London, warned delegates at the National Association of Care Catering Conference in Coventry earlier this month that a recent survey of nearly 4,000 carers revealed a number of problems with meals-on-wheels services.
She said that with cases of dementia increasing as people lived longer, providers were not monitoring the elderly closely enough.
"People with dementia might say the meal was lovely when they didn't eat it," she said. "Don't take what they say at face value."
Providers needed to check meals had been eaten, perhaps stay with customers at mealtimes, and relay information to relatives or carers, Manthorpe said.
The survey also found providers did not deliver a choice of snacks and finger food. "A big meal that requires a knife and fork may faze people with dementia. We mustn't think of just set meals," Manthorpe said.
She concluded that meals-on-wheels providers were going to face stiff competition from online supermarkets and take-aways unless they could prove their service had added value.
But one of the largest UK providers, the Women's Royal Voluntary Service (WRVS), rejected the criticisms, saying it was well placed to beat off the competition. Executive director George Tait said its volunteers were trained to do "safe and well" checks, which would pick up if an individual was not eating.
Snack packs, delivered with a hot meal, were also being piloted in Worcestershire, he said, but he didn't recommend replacing the meals-on-wheels service with "finger food" options, as it was important that people ate a healthy, balanced diet.
The WRVS kept records of clients' medical conditions and, unlike supermarkets or take-aways, could avoid delivering unsuitable food such as a high-sugar, high-salt meal to a person with a heart complaint.
Tait said the WRVS added value by linking customers to other services such as social transport, visiting, books-on-wheels, home shopping, and lunch clubs.
Source: Caterer & Hotelkeeper magazine, 23 - 29 October 2003