Introduction: Older trauma patients often receive individualized nutrition support beginning in the intensive care unit (ICU), but the influence of social context on sustaining these behaviors after discharge is poorly understood. Post-ICU malnutrition—both in the hospital and after discharge—is well documented in older adults, yet few studies explore how social factors shape recovery trajectories. This analysis explores how social eating and isolation affect nutrition behaviors and supplement adherence following ICU and hospital-based nutrition interventions. Methods: Twenty patients aged ≥ 60 years who received goal-directed nutrition initiated in the ICU and continued throughout their hospital stay, followed by a 30-day oral nutrition supplement (ONS) program after discharge, were interviewed 2 weeks to 6 months post-discharge. Semi-structured telephone interviews explored eating patterns, supplement use, and perceptions of nutrition in recovery. Transcripts were thematically analyzed using NVivo 14 (Lumivero). Results: All participants reported some form of social eating, but 11 (55%) described eating most meals alone. Those who routinely ate with others (n = 9) more frequently reported greater variety and higher-quality meals. One participant shared, “When my daughter was here, she made my eggs with spinach... we’re always connecting on recipes,” while another noted, “When I’m just picking up something for myself... I might stop at the chicken place.” Participants who ate alone more often relied on frozen or convenience foods (n = 6, 55%) and reported lower motivation to prepare balanced meals (n = 5, 45%). Eight participants described caregiver involvement as supporting regular ONS use, while others discontinued supplements once home alone. Conclusions: Despite receiving individualized ICU-based nutrition support, many older trauma patients struggled to maintain dietary improvements after discharge. Social context influenced both diet quality and adherence to prescribed supplements. We hypothesize that post-discharge strategies incorporating caregiver or peer support may improve long-term nutrition adherence following ICU care in this population.
Haines et al. (Sun,) studied this question.