the Experts: Creative Solutions for Local Providers
by Local Providers
Congregate Nutrition Sites
and Restaurant Voucher Programs
Why is participation in the congregate meals programs important?
in the congregate meals programs enhances the daily nutrient intake, nutritional
status, social interactions and functionality of older adults. Improvements
in these key factors for good health and quality of life generates the
necessary environment for older adults to age successfully. In addition,
congregate-based programs increase opportunities for social interaction
and access to a variety of activities and social services. (Refer to the
Ask the Expert Topic: "Increasing Participation at Older Americans
Act Title III Funded Congregate Meal Sites" for additional background
information and references.)
our program do to increase participation?
2001, an inquiry was made on the listserve for Gerontological Nutritionists
(a dietetic practice group of the American Dietetic Association) soliciting
information on restaurant-based Title IIIC congregate meal programs. Declining
congregate participation has been a concern for many and there was interest
in whether or not basing a site in a restaurant could help counter this
eight responses from programs in California, Kansas, South Dakota, New
York, Montana, Vermont and Illinois. Additional input was obtained from
two programs in Washington State. From the feedback received, two separate
types of service delivery emerged. The first is when the restaurant is
used as the meal site instead of a more 'traditional' site such as a senior
or community center, church, or senior housing. In these situations, program
participants meet at the restaurant on a specific day and time and eat
their meal with other senior participants. Often, a separate room is available
for their use. Administrative functions such as signing in for meals,
and registering for the program (including nutrition screening) are conducted
at the restaurant. The services available in restaurant-based sites can
vary as much as traditional sites. In some instances, there is a site
manager, opportunities to volunteer,volunteers deliver meals to the homebound,
nutrition education, and linkages to other services. In other cases, the
contract with the nutrition provider stipulates that restaurant staff
will perform the administrative functions and few other services are available.
planned by the restaurant with input from the provider and approved by
a dietitian. All menus must meet the Older Americans Act (OAA) standards
of one-third Recommended Dietary Allowances and compliance with the Dietary
Guidelines. Cost and client preferences are other significant factors
that influence menu development. Some programs certify a number of menus
that are offered by the restaurant to be used for the senior meal. This
approach provides a menu choice for participants. Other sites serve a
single menu per day, a practice that is similar to more traditional programs.However,
this approach allows the restaurant flexibility in menu planning to take
advantage of specials. Some structure their daily special around the senior
to the programs described above, a second type of services delivery was
described. In these voucher programs, vouchers are provided for individuals
to redeem at specified restaurants or other facilities - a couple of programs
provide vouchers for hospital cafeterias. There is no set meeting time
and participants have greater flexibility in determining the time they
choose to eat. Barring any limitations imposed by the facility (one hospital
honors vouchers only at breakfast or dinner), individuals may eat at any
time the facility is operating, including weekends and evenings. Set menus
are available from which to choose. Menus must be approved by a dietitian
and meet OAA
standards. To obtain vouchers, older adults usually go to a central location
such as a senior center where they provide required registration information
and make their donation. Vouchers are then issued and usage tracked according
to program protocol. Some programs require the restaurant to verify identification
before honoring the voucher.
the benefits and challenges of these two types of programs, several
common themes emerged and are outlined below.
respondents stated the participation was high in restaurant-based
programs are most successful in rural areas and/or with ethnic groups
where there is a lack of traditional sites available to meet the need.
lder adults definitely enjoy the amenities of eating in a restaurant.
appreciate choice in the menu; like food that is freshly prepared and
not held for a long period of time, transported or reheated; there is
a more welcoming ambiance that is less institutional; and the restaurant
doesn't have the "stigma" of some senior centers.
- Some stated
younger individuals and more male veterans attended when meals were
served at a restaurant.
the restaurant has staff to prepare and serve foods, some programs found
it to be more cost effective in terms of labor- staff were better utilized.
adults enjoy the attention from restaurant staff -one stated they were
treated like `kings and queens.'
is a perception of better value - some appreciated the larger meals
and the leftovers they could take home.
- In smaller,
rural communities, the program provides steady income for the
restaurant that allows them to stay open for the rest of the community.
at the restaurant provides more intergenerational socialization
opportunities - they may see friends or neighbors that normally wouldn't
attend a congregate site.
program participants valued the flexibility in meeting times - they
could be used for meal times not offered at congregate sites (evenings,
- A couple
of programs reported that attendance is growing at restaurants while
declining at traditional sites.
- The program
control over what is served can sometimes be difficult and fat
content of the meals tends to be high.
to the donation policy meets with some challenges.
- Meal cost
is a little higher than traditional sites.
- The success
is very dependent on the partnership with cafe/restaurant managers and
may be some confusion about choices and individuals may demand more
than what is on the menu - a clear contract needs to be established
- In a voucher
program, the focus is solely on the meal provided and does not give
the same opportunities for socialization as a more traditional site.
to other services and activities may be more limited.
Participants don't like being labeled as the "discount meal folks."
- In areas
where there is both a traditional and voucher program, the vouchers
compete with traditional congregate program.
was cited several times as a barrier to service. However, this is a
common problem for all nutrition programs, regardless of meal site location.
- For some,
there is a concern that the voucher programs, in particular, may be
less effective in serving the target population of older adults with
greatest social and economic need.
information received, there seems to be great satisfaction with restaurant
based meal sites, especially when they are operated on specific days and
the group gathers as a whole. There were only two people who responded
that actually moved a site from a traditional site to a restaurant. They
reported that participation increased as a result. In a program that has
experienced an overall decline in congregate participation, it would be
interesting to determine whether there is a difference between the restaurant
based sites and traditional sites in the rate of decline.
by Martha Peppones, MS, RD, CD, Nutrition Director, Senior Services of
Snohomish County, Mukilteo, WA, and staff of the National
Policy and Resource Center on Nutrition and Aging, Florida International
University, Miami, FL. Contact: firstname.lastname@example.org
project is supported, in part, by a grant from the Administration on Aging,
Department of Health and Human Services (DHHS). Grantees undertaking projects
sponsorship are encouraged to express freely their findings and conclusions.
Points of view or opinions do not, therefore, reflect official DHHS policy.
Posted on: 08/02/01