The loneliest lunch (meals on wheels)

Discussion in 'Food and nutrition' started by Kajikit, Mar 7, 2004.

  1. Kajikit

    Kajikit Guest

    March 7, 2004 The Loneliest Lunch: A Party of One By N. R.
    KLEINFIELD

    The meals come one a day, Monday through Friday, with an
    extra frozen meal for the weekend. One day it is a pork
    chop with broccoli and mashed potatoes. The next it is
    meatballs and macaroni. Then lemon chicken with baked
    potato and spinach.

    To Marge Marcone, who lives in the Fordham section of the
    Bronx, the doorbell signaling the arrival of her food is
    often the highlight of her day. She is 76, and recently
    deteriorating health has largely confined her to her
    apartment. She had a heart attack, and her vision has been
    failing, making her leery of using the stove. She is
    legally blind and too unsure of herself to venture out
    other than to visit a doctor. She qualified for the city's
    Meals on Wheels program that brings a hot meal to her door
    five afternoons a week.

    The deliverer is also a welcome dose of socialization to
    spice up her solitary existence. "I don't have anybody visit
    me," she said. "No one comes knocking at my door. I like
    having someone knock at the door, even if it's only a few
    minutes. You don't think you're living a hermit's life. You
    don't like to feel like you were running a race and you
    suddenly stopped. After all, do you want to talk to yourself
    day after day? I'm bored with me already."

    The confined elderly like Ms. Marcone, perhaps the city's
    most delicate and invisible population, are having qualms
    about a new experiment coming to the Bronx that may
    foreshadow a fundamental reshaping of the city's meal
    delivery system. A yearlong pilot program by the city's
    Department for the Aging, set to begin in July, is causing
    considerable debate over what is meant by a daily hot meal,
    delivered to the fragile and isolated.

    The ranks of New York's elderly are growing quicker than the
    resources available to serve them, and so the city wants to
    save costs by reducing the frequency of some food
    deliveries. This prospect alarms advocates for the elderly
    because, among other things, it will curtail the often all-too-
    brief human contact that these infirm people experience, and
    they fear it could threaten their well-being.

    To cope with the mushrooming elderly population, the city
    intends to reduce the number of deliveries, though not the
    number of meals, for a proportion of elderly people in the
    Bronx to once or twice a week from five days, giving them a
    stack of frozen meals to store instead of hot meals.
    Depending on the results of the program, it could be
    expanded throughout the city.

    Meals on Wheels, which exists around the country, has been
    feeding the shut-in elderly in New York since 1979. Since
    then, the number of meals it delivers has grown by more
    than 300 percent, to some 14,600 meals a day, making it a
    familiar and vital part of the city's infrastructure.
    Beyond its aid to nutrition, the service has become an
    important anchor that allows the frail elderly to remain in
    their own homes.

    But the city's Department for the Aging insists that
    changes in the meals system are essential to accommodate
    changing demographics. Projections are that the number of
    people 85 and older in the city alone will grow by 28
    percent over the next 15 years, straining the resources
    available to serve them.

    Under the new plan, the department is consolidating the
    Bronx program to three separate programs from 17. Meals are
    to be furnished at an average cost of $5 a meal, compared
    with the current average of about $6. About 2,200 homebound
    elderly people get the meals in the Bronx. They receive a
    daily hot meal near the lunch hour, with extra weekend meals
    dropped off on Friday or over the weekend. Many weekend
    meals are frozen.

    The Department for the Aging originally proposed that 60
    percent of the recipients would get frozen meals. After that
    was denounced by advocates, the city reduced the test group
    to 30 percent. The per-meal cost was raised to $5 from $3.

    But many agencies that serve the elderly are dubious that
    30 percent can safely deal with frozen meals, or have the
    storage capacity for that much food. Moreover, they argue
    that considerably more than a meal arrives each day - a
    needed and welcome brush with humanity. The deliverer, even
    in the fleeting encounter, can check that feeble people
    with scant contact with the outside bustle of the city are
    all right.

    The Bronx Jewish Community Council, one of the Meals on
    Wheels providers in the Bronx, asked its staff members for
    recent incidents illustrating this function. Some that were
    listed in an e-mail message:

    "2/26/03: [Client] was very confused again and would not
    answer the door. We called her son and he came with the key.
    This occurs frequently."

    "11/10/03: [Client] was on the floor in the apartment when
    meals deliverer arrived. Called 911. Police broke down door
    and ambulance took her to the hospital."

    Another provider, the Riverdale Y.M.-Y.W.H.A., produced
    similar examples:

    "8/13/03: Deliverer observed that client had large gash on
    head - dried blood on head and face. She got his son who
    lived in the same building and they called 911."

    11/03/03: Deliverer smelled strong odor of gas when entered
    client's apartment. Found that client had left
    stove on. Turned stove off and opened windows."

    The commissioner of the Department for the Aging, Edwin Mendez-
    Santiago, acknowledged that the deliverers serve this
    unintended role, but said that no one who is unable to
    handle frozen meals or is at risk will be included in the
    test population. Case managers are to make the selections,
    under criteria still being established. He said that two
    very small test runs of less-frequent frozen meal
    deliveries, one in Queens and another in Brooklyn, worked
    well, and that programs elsewhere in the country do it this
    way, sometimes with everyone getting frozen meals just once
    or twice a week.

    When the meal program began in the city, Mr. Mendez-Santiago
    said, he delivered meals himself in East New York, Brooklyn.
    He said, "For some seniors, the burden of waiting for the
    meal and the anxiety of missing a delivery is awful. I know
    for the appropriate senior this will contribute to an
    enhanced quality of life."

    He said that he was intent on offering the homebound elderly
    more contact, through other visiting programs and telephone
    reassurance services, though it was unclear to advocacy
    groups where resources for these will come from in an
    already overburdened system.

    The Dorot agency operates a long-standing frozen kosher meal
    delivery program for 200 elderly people on the Upper West
    Side and Upper East Side of Manhattan, bringing them up to
    seven meals once a week. But Dorot has extensive support
    programs that assure frequent contact with these recipients
    that do not exist in a systematic way throughout the city.
    And Dorot has 60 people on a waiting list because it does
    not have the resources to serve them.

    Opponents of the Bronx experiment worry that the department
    has not done a sophisticated enough assessment of the
    homebound. "This is not a well understood population," said
    Bobbie Sackman, director of public policy for the Council of
    Senior Centers and Services, a New York advocacy group,
    which speaks for many agencies opposed to the plan. She
    described a situation in which many people live without
    working appliances or have a fear of ovens, where people
    forget to eat unless a person reminds them, where one meal a
    day and one scant brush with a person assumes magnified
    importance.

    Deliverers sometimes find that a frozen weekend meal sits
    untouched for weeks, that people use questionable heating
    methods like dropping a frozen meal into boiling water and
    that a recipient's competence can change overnight.

    Ms. Sackman worries that once the experiment is under way,
    it cannot be stopped. "It's Humpty Dumpty," she said.
    "You take it apart, you can't put it back together."

    The executive vice president of the Bronx Jewish Community
    Council, Brad Silver, said: "Some of the seniors will be
    fine. Some of the seniors will be unhappy. Some of the
    seniors will be more than unhappy. They will be hurt by this
    process. It's inevitable."

    Diane Rubin, executive vice president of the Riverdale Y.M.-
    Y.W.H.A., which delivers meals in the Bronx, said she was
    convinced that the pilot program "is very detrimental to the
    community."

    Advocates organized a protest drive in which they estimate
    more than 5,000 postcards have been sent from elderly people
    to Mayor Michael R. Bloomberg and another 5,000 to City
    Council Speaker Gifford Miller in the last few weeks.

    The fight persists. The meals go on the trucks, the
    doorbells ring. Esther Grodman, 85, has been receiving
    the meals at her Bronx home for nearly two years. She
    moves about gingerly, with a four-wheeled walker equipped
    with a seat. "I look forward to getting my meal
    delivered," she said. "At least I see a live person who
    talks to me. What if I fall and nobody knows? I live
    alone and I refuse to leave."

    There is not much time to speak with the deliverer, but the
    small patter matters to her. "Sometimes I say a word or two
    about my daughter," she said. "My son died in May, so I
    can't talk about him anymore. I'll mention that my daughter
    has been begging me for 30 years to move to Louisiana. I
    can't see living there."

    Rosemary Taco has been driving a meals delivery van for 13
    years in the Bronx, seeing 63 clients a day. She drives and
    delivers, working for the Tolentine-Zeiser Community Life
    Center, and is accompanied by another deliverer.

    Her job is to give the food and go. But she augments her
    role for those without other help. Three of them like to see
    the daily newspaper, so she picks up copies for them. A few
    have modest grocery needs. They give her a list. "I go home
    at night and tell my daughter, 'Come on, we're going to the
    supermarket to get a few things,' " she said.

    At one apartment, the woman said her phone had been
    disconnected. Ms. Taco called the phone company and
    straightened it out.

    "These people need somebody," she said. "And someday I'll be
    in their shoes, so I hope there will be somebody like me
    there for me." ~Karen AKA Kajikit Lover of shiny things...

    Made as of 5 March 2004 - 36 cards, 22 SB pages (plus 2
    small giftbooks), 35 decos

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  2. Tony Lew

    Tony Lew Guest

    Kajikit <[email protected]> wrote in message news:<[email protected]>...
    >
    > Rosemary Taco has been driving a meals delivery van for 13
    > years in the Bronx, seeing 63 clients a day. She drives
    > and delivers, working for the Tolentine-Zeiser Community
    > Life Center, and is accompanied by another deliverer.

    Rosemary Taco?? You don't put rosemary in tacos!
     
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