COVID-19 and Food Train – more food security, kindness and dedication to vulnerable older people at home

Michelle Carruthers, MBE CEO Food Train
Laura Cairns, Project Manager, Eat Well Age Well
Dr Kate Reid, Lecturer, School of Education, University of Glasgow
Dr Catherine Lido, Senior Lecturer, School of Education, University of Glasgow

In these unprecedented times of the coronavirus (COVID-19) pandemic, many organisations in the third sector are occupying a frontline role in supporting the needs of vulnerable older people who face the greatest risk of severe disease and death from COVID-19. During this crisis our registered charity and social enterprise, Food Train has stepped up to meet this challenge. With the aid of a new wave of volunteers and with the support of emergency Scottish Government funding, Food Train has rapidly expanded and re-designed its services to support older people to ensure that they are food secure and socially connected at home.

Since it was founded in Scotland in 1995, Food Train’s mission is to reduce the risk and prevalence of loneliness and malnutrition among frail, vulnerable, and isolated older people by helping them live well at home through affordable food access. This is delivered primarily through a weekly grocery shopping and delivery service (for a small customer fee) and volunteer befriending and neighbourhood meal sharing.

All this is possible through teams of dedicated local volunteers across nine regions of Scotland (Dumfries and Galloway, Dundee, West Lothian, Glasgow, Renfrewshire and East Renfrewshire, Borders, Clackmannanshire and Stirling). This not only enables older people to live healthy and independent lives at home, but also tackles the growing public health issues of social isolation, loneliness and malnutrition for Scotland’s fastest-growing age group: it is predicted that people aged 65+ will make up a quarter of Scotland’s population by 2041 (National Records of Scotland, 2017). In addition, the numbers of those aged 75+; the very elderly are expected to rise by 79% between 2016-2041, making this is fastest growing age group in Scotland. Even before COVID-19, we continued to see a demand for our services all over Scotland but could not meet this demand due to the insecurity of funding.

Challenges – Moving from crisis to control

A woman with a full shopping trolley in a supermarket — Food Train volunteer in a supermarket

In the first few weeks of COVID-19, the charity dealt with multiple challenges, including the exponential increase in referrals (51%) for older customers looking for food deliveries, whilst at the same time the loss of 250 existing volunteers representing 31% of the shopping service volunteer numbers; critical in making the wheels of Food Train run smoothly. The charity, like many others, has faced intense and urgent challenges over obtaining and distributing hand sanitiser and personal protective equipment (PPE), in particular masks, gloves and cleaning wipes. This is both to ensure volunteers are safeguarded and to ensure adequate protection to the older person being visited in their own homes during meal and shopping drop-offs while maintaining social distancing guidelines.

Second, our biggest asset at Food Train and for many third sector organisations is our volunteers. Perhaps the biggest challenge for regional branches was the rapid loss of older, committed volunteers who had volunteered with the service for many years but reluctantly had to stand down due to self-isolation for health or age reasons. This was an extremely difficult decision for volunteers to make, as they are part of the Food Train family and knew the Food Train members as friends. Importantly, they were a source of continuity for many isolated older members.

Response – Expanding and adapting our services

Despite these challenges, the charity has been adapting quickly to meet the new demands. The charity has adapted by rapidly prioritising scaling up the shopping service, re-deploying staff to more critical operational roles and moving to contactless payment to minimise the need for physical contact with the older person. We have also created a new service called ‘Food Train Connects’ to extend support to other local authority areas where we were not previously on the ground, making sure those who were at greatest risk and not previously known to us have access to food and essentials. This new service matches older people with local community volunteers to offer a point of contact for support and help.

As a result, we can report that in the last four weeks, we have increased our shopping service by 66%, expanding its reach to 972 more older people, and initiated almost 2000 ‘check-in’ phone calls to reassure and signpost our older members (Figure 1). We have also enlisted 548 new volunteers (an expansion of 44%) from all walks of life, including University of Glasgow students. Both our new and existing members have reported feeling an overwhelming relief that they would have food in the midst of this crisis and the comfort of knowing that they were not alone: in the words of one member, “I have no family, no friends, it’s just me on my own. Food Train are the only people I see once a week. I am so grateful”.

Figure 1: Food Train headline statistics

It is anticipated that these numbers will increase every day as more older people will be able to access the support they need. Volunteer support and the welcome measures implemented by the Scottish Government to ensure rapid, cost free processing of PVG clearance for these new volunteers has been the single most important factor in scaling up our services, and has meant we can continue to operate ourservices and reach even more vulnerable older people.

Emergency Scottish Government funding via the Food Fund has also been instrumental in helping to take on 20 temporary staff to assist with these increased demands, additional work and ensuring the funds have the biggest impact in our communities.

Where next? Research and policy change

This crisis has put the spotlight on two major issues affecting older people in particular: loneliness and isolation, and food security. Many of our members were already ‘socially isolated’ before COVID-19. As lockdown measures have been put in place for the majority of society, perhaps more of us can now empathise with the issues of disconnect and loneliness that have been impacting Food Train members before and during the pandemic. These issues must continue to be highlighted to policymakers and community members. Second, the issue of malnutrition is a significant threat in older age. The social risk factors that can contribute to malnutrition such as access to food, interest in food, social eating as well as bereavement, social isolation and loneliness have been exacerbated by this pandemic.

Our recently completed commissioned research with the University of Glasgow, led by Dr Kate Reid and Dr Catherine Lido, has begun to evidence the links between physical health and social factors such as isolation, feelings of control and social connectedness. Findings from this research with 169 older-age adults found that Food Train is supporting very vulnerable older age adults at home, and what little control food-insecure older adults have is attributed to accessing the regular and reliable volunteer-led food delivery service. The physical need for food must be paired in the context of meaningful social interactions in order to reduce the risk of isolation and loneliness which create a vicious cycle of under-eating, poor self-care and low mood (Figure 2).

A diagram with a circle in the centre containing the words Food Insecurity in older age adults: Risk Factors. Around that are a series of icons and labels with arrows pointing from one to another. Starting at the top of the graphic with the Older Age icon and label; the arrow then points to Unintentional weight loss; then from that to Difficulty accessing services; then to Loss of autonomy to make decisions; then to Few opportunities for 'social eating'; then to Change in local access to food; and returning to Older Age — Figure 2: Risk Factors and Older Age Adult Food Insecurity (Reid and Lido 2020)

These have been prime concerns for the charity for over 10 years and Food Train’s national malnutrition project Eat Well Age Well, funded by the National Lottery Community Fund. Since 2018 it has been at the forefront of campaigning for more work on prevention of olderage malnutrition and advocating and educating about the interaction between risk of malnutrition and social indicators such as isolation and loneliness as threats long before COVID-19.

What has been abundantly clear during this crisis is we all need food. Nutrition and hydration are so crucial to everyone’s health and wellbeing and particularly so for older people. However, our national infrastructure supporting older people and food is inadequate. The years of austerity has seen the slow erosion of well-funded, secure community-based support for older people. Funding for lunch clubs, shopping support and cooked meal delivery such as Meals on Wheels services have dwindled across Scotland and have negatively impacted on older people, increasing inequality for Scotland’s ageing population. We have also seen large numbers of older people turn to charities such as Food Train to access food. Food Train operates in nine areas across Scotland but has the capacity to operate across the whole country; however, this is not currently possible due to lack of secure longer-term funding. Staff work in a sector that is unpredictable, where branches are operating on minimal staff and their jobs only certain in the short term. The pandemic has shone a spotlight on the fragility of the food access infrastructure in Scotland. We are but one example of a charity that is stretched but committed and willing to respond when the right support and longer-term funding commitment is provided.

Beyond COVID-19

Based on our experience at the frontline supporting food-insecure older people in Scotland, we recommend that policymakers:

urgently make these vital services available for all older people of Scotland – particularly for those who are already vulnerable, isolated and marginalised
securely resource these services in terms of core funding and secure career pathways for staff
recognise and harness the critical role of volunteers and look to ways to formalise this role to ensure we can react and expand quickly if we ever meet these acute challenges again
make the conversations about under-eating, unintentional weight loss as well as malnutrition visible as a public health discourse and challenge perceptions of weight loss and frailty as part of a normal process of ageing.

We hope sharing our experiences will put the spotlight on the central efforts of the charity sector, and organisations like Food Train, who utilise volunteers to support those most in need. Right now Food Train and its national projects will continue to support food access, reduce social isolation and campaign for action on the commitments made on tackling malnutrition as part of the Fairer Scotland for Older People framework to support older people to lead long and healthy lives. We will continue to listen to older people’s views, and feed into Government the challenges that older people are facing in their homes and communities. We are well placed to inform and shape how we move on from COVID-19 in terms of the role of the charity sector and as we look forward, we will continue to repeat just how important food is to our wellbeing. We can and must do more for our isolated older citizens if we are to be considered as a compassionate society. We will continue to do everything we can to help older people live flourishing healthy lives as they age well at home.

More resources

Find out more about these projects at the project websites and on Twitter:

For more information about the University of Glasgow School of Education’s research with Eat Well Age Well, please see:

Research project website
Dr Kate Reid’s reflections on this work during COVID-19
The project’s Open Science Framework resources, including visual minutes from the recent Healthy Ageing Conference held in collaboration with Food Train and Eat Well Age Well.

To cite this article: Carruthers, Michelle; Cairns, Laura; Reid, Kate; Lido, Catherine. COVID-19 and Food Train – more food security, kindness and dedication to vulnerable older people at home, Policy Scotland, 6 May 2020, https://policyscotland.gla.ac.uk/covid-19-and-food-train-more-food-security-kindness-and-dedication-to-vulnerable-older-people-at-home

Written content is published under a Creative Commons BY-NC-SA 4.0 licence.