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

Visit my webpage: http://www.kajikitscorner.com
Allergyfree Eating Recipe Swap: http://groups.yahoo.com/group/Allergyfree_Eating
Ample Aussies Mailing List: http://groups.yahoo.com/group/ampleaussies/

Kajikit > wrote in message >. ..
>
> 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!