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Wholesome Beginnings' first order, intended to feed a home of five residents three healthy meals each day for a week (Courtesy/Sarah Short)

Sarah Short was chatting with a friend who worked in a group disability home last year when he mentioned that the residents in his company’s care often end up eating less-than-nutritious meals. The rotation he described included a lot of French fries and frozen pizza, she recalled.

In the weeks afterward, she couldn’t get the conversation out of her head.

“My love language is food,” said Short, who studied dietetics and public health at Oregon State University and later went on to work with the state’s Supplemental Nutrition Assistance Program office, as well as the OSU gardening program Food Hero. “It really bugged me as a person who’s always worried about people being fed. I couldn’t stop thinking about it.”

Short decided to take matters into her own hands and create a delivery meal kit service specifically for group disability homes. In June 2021, Wholesome Beginnings officially launched.

Using her background in nutrition, she works with house managers in the greater Willamette Valley area to ascertain the dietary needs and medical conditions of each individual resident. 

Her main clients are disability group homes, where three to five disabled adults live in residential houses along with their caretakers. While she founded the business in Corvallis, she said most of her clients have been based in Salem.

Salem has a particularly high concentration of these homes because the city used to house the Fairview Training Center, a state-run asylum for people with developmental disabilities that shuttered in 2000.

According to the Oregon Department of Human Services Aging and People with Disabilities office, there are currently 432 such residences — licensed as Adult Foster Homes — operating within 25 miles of Salem. The homes include live-in support services provided by the property owner, with no more than five residents per house, said office spokeswoman Elisa Williams. More homes still are registered under the OHS’ Developmental Disabilities office and the Oregon Health Authority’s Behavioral Health Services, she added. 

Unlike larger institutions like hospitals or nursing homes, these houses don’t typically include on-staff nutrition directors solely responsible for addressing dietary needs, Short said. Instead, a caretaker will go on a grocery run, similar to how any ordinary family’s household would usually operate.

While the staff are highly trained in caregiving, there’s often no formal process to address the residents' nutrition needs, she added. 

“A lot of the people who were there, the residents, had special dietary needs and they weren’t being met,” Short said. “It just seemed like something the companies were overlooking, as something anyone could take care of.”

Wholesome Beginnings' cherry crisp, a "fan favorite" meal according to founder Sarah Short (Courtesy/Sarah Short)

Working out of commercial kitchen she rents by the hour, Short puts together meal service kits - a specialized version of the home cooking kits that already exist for the general population.

“I love meal kit subscriptions like HelloFresh and Blue Apron, and I thought, wouldn’t it be cool if we had something like that customized for group homes?” Short said.

She delivers kits to clients once per week. Short said she uses the opportunity to touch base with the house staff and find out what worked, what didn’t, and what adjustments she’ll need to make to the menu going forward. 

“Have that kind of individual touch where the person who delivers the home every week knows the staff, knows the manager, knows the work of the house,” Short said.

While Short can offer anecdotal evidence indicating that Wholesome Beginnings provides a needed service, there isn’t a very robust body of research into how well group disability homes currently meet the nutritional needs of their residents. The studies that do exist tend to pull from small sample sizes bound within specific regions.

“Research on the nutrition knowledge of carers is limited,” stated one 2018 survey that compared the dietary expertise of 40 Australian caretakers with that of the country’s general public.

But the study, which was published in the Journal of Intellectual Disability Research, found that understanding of dietary guidelines, nutrient sources, healthy food choices and diet-disease relationships among caretakers was “significantly lower.”

“Limited carer nutrition knowledge may compromise their ability to plan and adapt meals to support a healthy and appropriate diet” for residents with intellectual disabilities, the study concluded

In 2020, the same group of researchers tackled the other side of the coin, tracking the nutritional intake of 33 residents with intellectual disabilities living in group homes. The team found that the residents ate less than half of the recommended amount of vegetables and failed to consume enough calcium, magnesium, iodine and zinc.

“Nutrient intake and diet quality of the participants in the group homes studied was poor,” stated the study, published in the academic journal Nutrients. “Education and policy to support healthier diets is required to improve dietary intake of people with intellectual disability, living in group homes.”

Short said her number of clients has fluctuated over the last 10 months. In her opinion, nutritional expertise is undervalued, she added. That makes it frustrating to pitch the owners and operators of the group homes who may not necessarily regard nutrition as a topic that requires a whole other specialist on top of existing household care staff.

“In these homes, if a furnace breaks or a pipe leaks, they get an expert in to take care of it,” Short said. “I believe nutrition should be outsourced in the same way. It’s not ‘women’s work,’ it's not something anyone can do. It’s really important and vital for health.”

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Meet the Editor: Les Zaitz is nationally-acclaimed journalist with nearly five decades of experience, including more than 25 years as a reporter and editor at The Oregonian.