Meals on Wheels

Definition

Meals on Wheels is the name of community programs that deliver meals to homebound seniors. Many are actually called Meals on Wheels, but the name has become a generic term for other home-delivered meal programs for seniors.

Description

Background

Meals on Wheels began in the United Kingdom during World War II when many civilians were displaced by the German Luftwaffe's bombing of London and other large cities in southern England. The Women's Volunteer Service for Civil Defense responded to the needs of those who could no longer cook for themselves by preparing and delivering meals. They also took refreshments to servicemen in canteens during the war; it was from these canteens that the term “Meals on Wheels” originated.

After the war ended, a group of people in Philadelphia experimented with a home-delivered meal service for seven seniors in January 1954. The program was so successful that Margaret Toy, a social worker in Philadelphia's Lighthouse Community Center, asked a local foundation for a grant to extend the program across the city. As is the case in the late 2000s, the seniors who were served in the 1950s did not require hospitalization or skilled nursing care, but only some help with meal preparation in order to maintain their independence . The first Meals on Wheels program charged 40 to 80 cents per day (according to ability to pay) for the meals, which consisted of a hot lunch plus a serving of milk, a sandwich, and a side dish to be eaten as a cold supper in the evening. The fee was intended to maintain the seniors' sense of dignity as well as to partially defray the expenses of the program. By 1955, the Philadelphia Meals on Wheels program was introduced in Columbus, Ohio, and Rochester, New York; it then spread rapidly across the United States and Canada.

As of 2008, Meals on Wheels programs in both countries are still financed and operated at the local level. They vary widely in size, services provided, method of operation, and funding. Some are funded by religious groups or other charitable organizations; some programs in the United States receive funding from the federal government. The Meals on Wheels Association of America (MOWAA) is a national umbrella organization that assists local programs in meeting the specific needs of their communities, which vary considerably in terms of demographics, geographical area covered, climate, and other factors. As of early 2008, MOWAA worked with 78 different regional Meals on Wheels programs in Canada and the United States and held an annual conference on senior nutrition . Its official (trademarked) motto is:“So No Senior Goes Hungry.”

How it works

To receive Meals on Wheels, the senior (or family member) should call the closest regional group and ask about eligibility (seniors must be 60 years of age or older to be eligible for federally funded meal delivery programs); cost (some programs charge between $2 and $5 per meal; some are free; and federally funded programs may only ask for a voluntary contribution); and whether there is a waiting list. As MOWAA notes on its Web site, the rapidly growing senior population in North America means that Meals on Wheels programs in some large cities have waiting lists.

Meals are delivered to home of seniors by a driver, who may be either paid or a volunteer. In many areas, Meals on Wheels drivers are recent retirees who can take the time to chat for a few minutes with the senior as well as drop off the hot lunch and brown-bag supper (a few programs offer deep-frozen meals as an option). Many local programs also train their drivers to be alert for signs of health or safety problems in the senior's house.

There are also a few Meals on Wheels programs in the larger cities that offer kosher meals for Jewish seniors.

Congregate senior meal programs

Congregate senior meal programs (sometimes called congregate dining) are hot-lunch programs for seniors who are ambulatory (able to walk and move around) and who can get to the community center, church or synagogue, adult day-care center, senior center, or other location where the meal is served. Most congregate senior meal programs are open to all elderly in the community served by the program; some also provide transportation to and from their location.

The hot lunches served in these programs meet federal nutrition guidelines; most congregate meals programs do not charge anything, although some request a voluntary contribution based on income. Many seniors enjoy congregate meals programs for the social contact as well as for the nutritious lunch. The Web site MealCall (http://www.mealcall.org/) to help people locate both Meals on Wheels and congregate senior meals programs in their state or province. The index for United States locations can be found online at http://www.mealcall.org/meals-on-wheels/index.htm; for Canada, http://www.mealcall.org/canada/index.htm.

We All Love Our Pets (WALOP) program

WALOP is a resource program offered by MOWAAto help local Meals on Wheels programs that are getting involved with pet food delivery for seniors whose cats or dogs need supplemental food. WALOP was formed in 2005, after an article in the Ladies' Home Journal about pet food services for seniors sparked nationwide interest. According to MOWAA, WALOP is not a national pet food programas such but rather “a resource for all Meals On Wheels programs serving their clients' pets [that] enables them to share their challenges and successes with one another.”

Viewpoints

Benefits

According to such professional organizations as the American Dietetic Association (ADA) as well as medical researchers, Meals on Wheels programs are effective in significantly reducing the risk of malnutrition in homebound and low-income elderly. Several groups of researchers reported in 2006 and 2007 that most Meals on Wheels recipients were pleased with the taste and overall quality of their meals and that the social contacts as well as the food itself lowered their risk of depression as well as improving their overall quality of life.

Critical needs

Meals on Wheels and congregate senior meal services face significant long-term challenges over the next several decades, as the population of homebound seniors continues to grow. The first challenge is the simple size of the elderly population: as MOWAA notes, the number of people over 65 grew eleven-fold over the course of the twentieth century, compared to a threefold increase for the general population. The elderly population in the United States is expected to double between 2008 and 2050, to 80 million people.

The rise in numbers has been most rapid among those over 85—the population most often served by Meals on Wheels programs. Between 1960 and 1994, the number of seniors over 85 rose 274 percent, compared to a 100 percent rise among seniors below the age of 85, and a 45 percent rise in the general U.S. population. Numbering 3 million in 1994, the oldest age group may include 19 million Americans by 2050.

KEY TERMS

Canteen —An informal social club, cafeteria, or snack bar, often for a particular group of people, such as soldiers, teenagers, or college students.

Congregate senior meal programs —Hot-lunch programs for groups of seniors served in such community settings as churches, synagogues, senior centers, or general community centers.

Other challenges include the rising cost of gasoline, which affects home delivery of meals, and the growing proportion of low-income elderly among the seniors served by Meals on Wheels programs. The American Dietetic Association as of the late 2000s recommends that programs serving low-income communities consider adding breakfast to the traditional lunch and supper included in home-delivered meals in order to improve the nutritional status of homebound seniors.

Resources

PERIODICALS

Keller, H. H. “Meal Programs Improve Nutritional Risk: A Longitudinal Analysis of Community-Living Seniors.” Journal of the American Dietetic Association 106 (July 2006): 1042–1048.

Lirette, T., J. Podovennikoff, W. Wismer, et al. “Food Preferences and Meal Satisfaction of Meals on Wheels Recipients.” Canadian Journal of Dietetic Practice and Research 68 (Winter 2007): 214–217.

Rosenzweig, L. Y. “Kosher Meal Services in the Community: Need, Availability, and Limitations.” Journal of Nutrition for the Elderly 24 (2005): 73–82.

Roy, M. A., and H. Payette. “Meals-on-Wheels Improves Energy and Nutrient Intake in a Frail Free-Living Elderly Population.” Journal of Nutrition, Health, and Aging 10 (November/December 2006): 554–560.

OTHER

Position Paper of the American Dietetic Association. “Nutrition across the Spectrum of Aging.” Journal of the American Dietetic Association 105 (April 2005):616–633.

ORGANIZATIONS

American Dietetic Association (ADA), 120 South Riverside Plaza, Suite 2000, Chicago, IL, 60606, (800) 877-1600, http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/index.html.

Meals on Wheels Association of America (MOWAA), 203 S. Union Street, Alexandria, VA, 22314, (703) 548 5558, (703) 548-8024, http://www.mowaa.org/.

Rebecca J. Frey Ph.D.