After a Hospital Discharge, Food is a Valuable Medicine

When a loved one is discharged from a hospital stay, their doctor will likely give them medicine to help improve their condition so they can stay well enough to avoid having to return to the hospital in the future. As caregivers, we may have the responsibility of making sure a loved one is keeping up on their medication post-discharge. However, are we remembering to pay just as much attention to another source of medication necessary to their healing process: the food they eat?

Lack of nutritious food is the number one cause of poor health in the United States, and for older adults, the health problems caused by a poor diet can be even more severe. A poor diet can lead to: 

• Difficulty handling everyday tasks
• Higher chances of infection
• Physical weakness
• Increased likelihood of contracting illnesses
• Increased hospital admissions and readmissions 

(Seligman, H. K., Laraia, B. A., & Kushel, M. B. (2010). Food insecurity is associated with chronic disease among low-income NHANES participants. The Journal of nutrition, 140(2), 304–310.). 

If a loved one has recently been discharged from the hospital, how they eat after returning home can mean the difference between getting to stay at home and having to return to the hospital.

Why is a good diet even more important after a hospital discharge?

One of the biggest obstacles to a healthy diet after a hospital discharge is food insecurity. The US Department of Agriculture (USDA) defines food insecurity as “a household-level and social condition of limited or uncertain access to adequate food.” It is one of the most common social determinants of health, which are personal or environmental circumstances which can greatly impact a person's health and wellbeing. Many factors can contribute to food insecurity, including:

• Income
• Living distance from stores selling well-balanced foods
• Ability to travel and shop at these stores
• Ability to cook meals
• Ability to eat meals without assistance

A hospital stay, especially a long one, can greatly impact a loved one’s ability to leave the house or prepare their own meals.

Food insecurity and poor nutrition can also lead a loved one to be readmitted to the hospital. According to the United Health Foundation, about 14.9 percent of older adults over the age of 65 were readmitted to the hospital within 30 days of their initial hospital discharge in 2019. Readmissions can happen for several reasons, but two of the leading causes—poor follow-up care and the development of illnesses or infections post-discharge—are connected to nutrition and can oftentimes be prevented by closer attention to a loved one’s diet, in combination with medication. 

What should I consider when preparing meals for a loved one post-discharge?

Rose Centers for Aging Well, a subsidiary of Benjamin Rose Institute on Aging, is currently supporting recently hospitalized older adults in Ohio’s Cuyahoga County who are low income, food insecure and chronic conditions such as diabetes or heart disease by providing: 

• Home-delivered, medically tailored meals
• A weekly check-in call from a volunteer
• Enhanced nutrition education

This medically tailored meal program aims to decrease hospital readmissions, reduce food insecurity and lessen social isolation. Central to the program is the concept of “food as medicine,” which views nutrition as an essential part of a holistic treatment plan to keep a loved one well following a hospital discharge. 

The menus for the medically tailored meals are designed by Registered Dietitians to meet specific nutritional needs. When considering a loved one’s meals, we should also take a similar approach of choosing foods tailored to their needs and medical conditions. 

To learn more about the kinds of meals that would be appropriate for a loved one, we should talk to their doctor, nurse practitioner or other health care providers about their dietary needs. Some hospitals may have a Registered Dietitian or a Nutritionist on staff who can help with these issues and work with us to create menus tailored to these needs.

How else can you help your loved one maintain their nutritional health?

One of the leading factors of food insecurity is social isolation and lack of a support. Our presence, and attention to a loved one’s needs can go a long way in helping them stay healthy. After a loved one is discharged from the hospital, especially within the first thirty days, we should keep close track of the quality and quantity of meals they are eating. 

If a loved one needs help shopping or preparing food, we should be on hand to assist, or enlist the help of other family members, friends or service providers in our area. Even if a loved one can prepare food without assistance, we should ensure that they are continuing to eat healthy, well-balanced meals. Many older adults may feel a decrease in appetite due to their medication or condition, but even so, skipping meals can have a negative impact on their health.

If a loved one’s income is a barrier to them getting the food they need, we shouldn’t hesitate to look into public assistance for support. According to Project Bread, the Supplemental Nutrition Assistance Program (SNAP) is underutilized by older adults for a variety of reasons, ranging from lack of awareness to concerns about stigma. 

However, SNAP can be essential in making healthy food available to low-income older adults, and has contributed to the overall food security, nutritional wellness and positive health outcomes of older adults, especially during the COVID-19 pandemic. For more information on the application process for your state’s SNAP program, visit the Food and Nutrition Service’s locator. There are also online resources available to find dieticians and Meals on Wheels providers in your area.