Understanding Senior Citizen Centers and Senior Nutrition Programs

August 21, 2018 | by the National Care Planning Council

Senior Citizen Centers

The first Senior Center in the country opened in 1943 in the Bronx, New York and was called the William Hodson Community Center. By 1961 about 218 senior centers had opened all across the country. The first community senior centers were operated by cities or nonprofit or religious organizations. Funding came from government, community donations and fees from people using the facilities. In the early days, some federal funding came from Title XX of the Social Security act but funding for Title XX has been decreasing and much of that money today is being used for other programs. In 1972, the Older Americans Act was amended to provide funding for senior centers as this was considered to be an important piece of the aging network.

Today, there are estimated to be about 15,000 senior centers across the country serving about 10 million older Americans annually. About 6,000 of these centers receive part or all of their funding through the Older Americans Act.

Senior centers act as a focal point for older Americans to receive many aging services. They are a vital part of the aging network. For Area Agencies on Aging, the senior center has become a place where many AAA services can be provided, where outreach and targeting can occur and where feedback can be received from the elderly. The most common services offered at a senior center are:

• Health and wellness programs
• Arts and humanities activities
• Intergenerational programs
• Employment assistance
• Community action opportunities and social networking opportunities
• Transportation services
• Volunteer opportunities
• Educational opportunities information and referral
• Financial assistance
• Senior rights counseling and legal services
• Meal and nutrition programs
• Leisure travel programs

Larger senior centers in major cities may offer additional specific services because they serve a large and diverse group of patrons. Here are some examples:

• Education classes, perhaps through a local college
• Foot care
• Health clinics
• Haircuts
• Daily exercise
• Telephone friends
• Support groups for Alzheimer's caregivers
• Support for Parkinson's disease
• Low vision and diabetes services
• Weekly health speakers
• Grocery shopping
• Many and varied classes for personal growth and learning
• Special events and fundraisers such as auctions, raffles, sales, bazaars, rummage sales, bingo, special meals and parties, fashion shows and facility rentals

Most elderly people are aware of senior centers in their neighborhoods but for those who are not familiar with the program, senior centers are listed under that title through an online search.

Nutrition Services for Seniors

Federal funding for these services represents 52% of the total federal budget for aging services and represents 56.7% of state direct title grants. This also includes some money for nutrition counseling and other nutrition service programs. Also a large block of this money comes from the Department of Agriculture in the form of cash or commodities.

At the state and local level these programs also represent the greatest part of matching funds and the largest share of volunteer hours. And a great number of volunteers who help area agencies on aging are also involved in the meal program. In addition, state and local governments, direct public contributions and the United Way may provide additional money to run nutritional programs. The meal program is one of the most important and largest components of senior aging support services.

It is felt by all who serve elderly Americans that providing at least one meal a day, which is equivalent to at least a third of the daily recommended caloric intake and nutritional needs, is important in helping the elderly remain independent in the community. Just making sure that older Americans receive proper nutrition and nutrition counseling has probably kept a large number of people out of long term care institutions. Also the congregate or community served meal program, which is designed for people who are not homebound, is an incentive for the elderly to get together in groups for not only a daily meal but also for social stimulation, awareness of the other aging programs, caregiver training and input from other supportive programs. Some programs can afford to offer more than one meal a day and also offer meals on weekends as well.

Area agencies on aging aren't the only programs providing nutritional service to elderly Americans. A diverse number of organizations from local government, church groups or nonprofit groups serve meals every day to a large number of elderly Americans all over this country. Some of these groups may accept money from area agencies but many do not. Although the number of meals served by other groups may exceed that provided directly through area agencies, Older Americans Act meal services are by far the largest single program in the United States. Since the meal program's authorization in the Older Americans Act in 1972, approximately 7 billion meals have been served.

Congregate (Community) Meals

This meal program is usually offered in senior centers which may be sponsored by area agencies on aging or sponsored by other community organizations, counties or cities or churches. Area agencies may also make arrangements with religious groups or other providers of gathering places for the elderly to serve these meals in places other than senior centers. Organizations not receiving funds from area agencies might be offering meals in churches, non-OAA senior centers, local government and community gathering places and so forth.

The Older Americans Act does not allow providers receiving its funds to charge for these meals, although voluntary donations are encouraged and often received. This creates a dilemma for organizations that may want to use these funds but typically charge for meals on a sliding scale fee, based on income. Even by charging, most of these organizations only receive about a third of the cost of the meal from cost sharing. Some of the organizations providing meals will accept money from area agencies but have to segregate their programs into voluntary contribution meals and cost sharing meals. In order for area agencies to have a greater impact on the congregate meal programs in the United States, the rules must change to allow for cost sharing.

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 of 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 are able to 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.

The majority of 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.