Home-delivered meal programs such as Meals on Wheels are low-cost long-term
care services that have potential for contributing to the delay of costly
institutionalization and to the maintenance of self-sufficiency and quality
of life among community-dwelling frail elders. In this study, reasons for
elders' termination from a Meals on Wheels program and determinants of thei
r lengths of stay in the program are analyzed. The findings show that the r
easons for elders' termination are largely associated with their deteriorat
ing health. But it was also found that a significantly higher proportion of
African American elders than White elders discontinued their participation
due to their dissatisfaction with the meals offered or their poor appetite
. The Cox proportional hazard regression analysis also confirmed that elder
s' health status, race, and appetite are significantly associated with the
hazard of elders' termination. Strategies to improve the acceptability of t
he services are discussed.