The loneliest lunch (meals on wheels)



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

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

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

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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Tony Lew

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!