Pathways to service for older persons

As services for older persons continue to shift from hospital and nursing h ome care to greater reliance on support for care at home, the need to under stand the ways older persons obtain services becomes more important. This s tudy examines the use of home-delivered meals as a case study to gain insig ht into the process of service use from the recipients' point of view. It e xplores the research question: What are the pathways by which older persons acquire home delivered meals? Narrative analyses of structured and unstruc tured questions asked of thirty frail older persons suggested that the proc ess of acquiring home delivered meals was accompanied by patterns of adjust ment in shifting between independence and dependence in managing loss of ph ysical function, and themes of isolation, loss, and abandonment. The result s provide insights for social workers in providing the support needed for t he role transition that service acceptance symbolizes for older adults.