National Care Planning Council
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Books for Care Planning

    Long Term Care BooksFind books provided by the National Care Planning Council written to help the public plan for Long Term Care. Learn More...

Eldercare Articles

    Eldercare ArticlesThe NCPC publishes periodic articles under the title "Planning for Eldercare". Each article is written to help families recognize the need for long term care planning and to help implement that planning. All elderly people, regardless of current health, should have a long term care plan. Learn More...

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Guide to LTC Planning

    Guide to Long Term Care PlanningFrom its inception, the goal of the National Care Planning Council has been to educate the public on the importance of planning for long term care. With that goal in mind, we have created the largest and most comprehensive source of long term care planning material available anywhere. This material -- "Guide to Long Term Care Planning" -- is free to the public for downloading and printing on all of our web sites. Learn More...

Meals On Wheels

Home Delivered Meals

Home Delivered Meals

The first American home-delivered meal program in the United States began in Philadelphia, Pennsylvania, in January of 1954. With help from a local grant, Margaret Toy, a social worker, started providing meals for homebound elderly people and other "shut-ins" who were in dire need of nutritional support. She solicited local high school students to volunteer to prepare and deliver meals to the needy homebound people. These young volunteers were called "Platter Angels." Platter angels were so reliable in their duties that the people receiving meals often jokingly chided them if they were but a few minutes late.

Older people living by themselves at home often have a tendency to deprive themselves of proper nutrition. Perhaps because of depression, loneliness or a medical condition, many older people lose their appetites and do not eat properly. In addition a large number of older people are living in poverty and cannot afford to buy nutritious food. They may also not have transportation to get out and go shopping or they may not have the desire to prepare meals for themselves. Additionally, many older people, because of frailty or because of fear, cannot leave their homes and are often trapped at home for days or weeks at a time without ever seeing anyone else. All these problems can lead to a situation where because of improper nutrition, older people will decline in health and mobility. Proper nutrition is essential in helping people remain independent in the community.

There is great demand for home delivered meals and, in some cases, people are put on waiting lists for months before they can receive the services. There is typically not enough money and not enough volunteers to go around. And with chronic budget shortages, increased insurance premiums and higher fuel costs it is becoming more and more difficult to provide meals to those who want them. As with community served meals, home served meals through area agencies on aging cannot require cost sharing. And this creates a dilemma for organizations wanting to receive money through the Older Americans Act. And as with community served meals many of the organizations providing home-based nutritional services are not associated with area agencies on aging.

Meals on Wheels

The "Meals on Wheels" name is well recognized across the nation as a provider of home delivered meals for the elderly. The name does not represent a specific organization or a business but is simply a way of identifying meal services. "Meals On Wheels" derived its name during World War II in England. A woman's volunteer organization would deliver snacks and other treats to servicemen on duty and this service became affectionately dubbed by the soldiers as "Meals on Wheels."

Many cities, area agencies on aging, church groups and nonprofit organizations that provide nutritional services have adopted the name, "Meals on Wheels," to afford the public a recognition of trusted services provided by volunteers and community donations. People dealing with Meals on Wheels programs have the assurance of knowing from the name what is provided and how it is going to be administered.

There is also a national association called the Meals on Wheels Association of America that coordinates efforts and provides training for over 900 meal programs across the country. Any entity can use the name and does not have to be a member of the Association and some members of the Association do not even use the name "Meals on Wheels". And of course, not all organizations providing meals are members of the National Association. It should also be noted that many local nutritional services may use another name and not the Meals on Wheels moniker.

Over the past 50 years government organizations as well as religious communities and private nonprofit groups have all recognized the need for providing meals for homebound elderly people or younger people who can take care of themselves at home but are disabled and unable to get out. Incorporation of meal services into the Older Americans Act in 1972 has given some administrative and national organization to meal programs. And many of these programs, as a result, receive a portion of their funding through the Older Americans Act.

Most individuals receiving home delivered meals are elderly, single women with chronic health conditions. These women are often confined to their homes because of lack of transportation or their own inability to walk very far. A noon meal delivered by a volunteer, five days a week not only provides these shut-ins a nutritious meal, but also provides them contact with another person. And many of these people cherish the attention from the volunteer much more than the availability of a hot meal.

Meals are typically delivered between 11 a.m. and noon, five days a week. They are typically prepared in community kitchens or by catering companies. They are likely to be designed by nutritionists to offer at least one third of the daily recommended nutritional intake. If a recipient is not at home the meal is returned to the kitchen. Some organizations will allow seniors to order extra meals for the weekend when that service is not provided. Many providers are now delivering frozen meals as well and these can be used on weekends or at other times of the day.

Volunteerism and public contributions are an essential cornerstone of Meals on Wheels programs. With the exception of the cost of food, transportation, key kitchen workers preparing the meals and administrators, all other services are provided by volunteers. These can be older individuals themselves who have a desire to serve in the community or oftentimes teenagers especially enjoy serving the elderly or in many cases volunteers come from employer-sponsored volunteer programs.

Perhaps more than any other form of volunteering, hand delivering meals to a needy person at home can be the most satisfying public service a healthy person can perform. Many companies recognize the power and compassion of this form of service and they readily embrace programs for their employees to provide volunteer hours. Many other organizations seeking employer supported volunteers may have a more difficult time receiving the attention of corporate decision-makers because their services are not as profound as home delivered meals to the elderly. Companies are also often generous in providing funds for the cost of administration, transportation and meal preparation.

Funding for Meals on Wheels programs typically comes from a variety of different sources. Cities and local governments may provide funds and as has been mentioned before, money can also be provided under the Older Americans Act. In fact, some area agencies on aging support home delivered meals entirely under their agency administration. In some cases home delivered meals may not have any connection with government programs. Many funds come from community donations either directly or through programs such as United Way or Red Cross.

Fundraisers are also a large part of some programs. With the exception of programs provided with Older Americans Act funds, most Meals on Wheels organizations charge the recipients for their meals. The cost is based on income. If a person receiving a meal is impoverished, generally no money is charged. Otherwise, costs are almost always based on a sliding scale based on a person's income. Depending on a person's income, the cost of a meal could vary from $.80 to $4.00. Due to a chronic lack of funding, over 40% of all home delivered meal programs have waiting lists. Much more government and community support is required to reach those in need.

In recent years many Meals on Wheels organizations have been providing other services to the elderly at home. This is because many homebound older people have needs in addition to proper nutrition and because of contact through the nutrition service, the Meals on Wheels program has been able to identify those people in greatest need. Case managers may come into the home and make an assessment of the needs and coordinate in-home services from other community programs. Visiting nurses and home health aides may be provided to help with medical problems or with activities of daily living. Arrangements for the installation of emergency response systems or GPS location bracelets for those who might wander can also be made.