This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.
Across Michigan, older adults with income or mobility challenges rely on Meals on Wheels – healthy, home-delivered meals provided free by local agencies. The number of Meals on Wheels participants rose dramatically during the COVID-19 pandemic as people found themselves homebound. And many Meals on Wheels providers report that challenges have arisen as their client lists continue to grow thanks to an aging population, even as pandemic relief funding dries up.
Meals on Wheels Western Michigan
(MOWWM) is one of those facing challenges. In 2020, MOWWM delivered more than 625,000 meals to more than 3,000 homebound older adults. Its Senior Pantry Program provided more than 1 million pounds of groceries. In all, more than 7,000 seniors benefited from its services.
Meals for Meals on Wheels Western Michigan deliveries.
"Demand for home-delivered meals has been increasing, especially over the last year," says Lisa Wideman, MOWWM president and CEO. "We know that 10,000 people a day are turning 65
in the United States. We expect this to continue past the mid-2030s."
In addition to growing demand for meals, Wideman says MOWWM's food costs have risen by 15% due to inflation — as has the cost of labor. MOWWM employs 100 staff members to prepare food, package and prepare meals, and provide services to clients like enrollment, assessment, and meal orders. A team of care coordinators visits clients every six months to assess their big-picture needs and connect them to services, if needed. MOWWM also operates 14 congregate dining sites throughout Kent and Allegan counties where older adults can meet to eat a hot meal and socialize at no cost.
Wideman notes that MOWWM will face a real challenge as federal COVID-19 funds come to an end. While new grants and fundraising might help make up some of the lost dollars, she hopes that the federal and state governments, as well as health insurance companies, will adopt policies to increase funding for home-delivered meals for older adults.
"So far, we have been able to continue to provide services without a waiting list, largely as a result of the [Kent County] senior millage, which provides almost as much funding as the state of Michigan for home-delivered meals and sustains a number of our dining sites," she says.
Voters in both Allegan and Kent counties continue to pass senior millages regularly. As of July 2023, 73 of Michigan’s 83
counties had passed a senior millage.
"We're also working to respond to the needs of seniors who may not be accessing our services right now because they may have a chronic health condition that requires a special diet or their cultural preferences may not align with some of the menus that we currently serve," Wideman says. "We are working actively to meet the demands of those populations and we see those increasing as well."
Wideman notes that Meals on Wheels' national organization
is mounting a "#SaveLunch for Seniors
" campaign to influence the federal government to increase funds allocated to address inflation's effects on the cost of meal programs for older adults. She also hopes to see improved Medicare and Medicaid coverage for meals tailored to clients' medical needs
"We’d like to see that happen and for the aid from the state of Michigan to increase, as well," she says.
This coming spring, MOWWM will formally announce its inclusion in the Food is Medicine Coalition
, an association of nonprofit medically tailored food and nutrition service providers.
"We all know food is medicine," Wideman says. "We’d like to see the insurance companies reimburse for healthy food. This would be a huge, huge benefit to our community as a whole. Healthy food prevents hospital readmissions. It helps address chronic health conditions. If you don’t have it, it’s hard to stay healthy."
Waitlists go "through the roof"
On the east side of the state, the Detroit Area Agency on Aging
(DAAA) serves home-delivered meals to older adults in Detroit and several other nearby communities. Depending on need, participants receive a hot meal daily, Monday through Friday, or five frozen meals once a week. Those unable to eat solid foods receive liquid nutrition.
DAAA Meals on Wheels driver Lamar Ellington gives Beverly Sullivan, 79, a meal for her mom, Ellen Dennis, 97.
Like MOWWM, the number of DAAA Meals on Wheels program participants rose in 2020.
"With COVID, the numbers jumped through the roof," says Gilberto Lopez, DAAA's nutrition director. "We had no idea that so many folks were on that razor's edge of needing assistance. Those individuals are still around and have aged even further, so there is still a lot of need. The Boomers are all hitting 60 and above, and so that number continues to rise."
Unlike West Michigan, the DAAA program has not been able to keep up with demand. While steadily decreasing, DAAA's waitlist stands at 285 older adults.
"That's actually pretty darn good. In the past, it was much higher," Lopez says. "[DAAA President and CEO Ronald] Taylor has really been focusing on getting individuals off the list. Our in-home assessors have really done a bang-up job making sure to get as many folks off the waitlist as we can."
Taylor agrees with Wideman that the federal government needs to allocate more money to meal programs for older adults. He’d also like to see more dollars to address the social determinants of health that drive older adults into food insecurity.
"As far as some of the reimbursement models being proposed by [the federal Centers for Medicare and Medicaid Services] and some of the others out there, there's a strong recognition that social care needs to match up with the medical care of individuals," Taylor says. "If the individual is receiving that nutritious meal, but they don't have a manner to warm the meal, or they don't have electricity or things of that nature, that type of support is required to ensure that we can meet the holistic needs of those individuals."
In Muskegon, Oceana, and Ottawa counties, Agewell Services
’ Meals on Wheels program is also struggling to catch up to demand for meals. Despite senior millages in the counties it serves, about 680 people are currently on Agewell's Meals on Wheels waitlist, most of them for more than 31 days. A Dec. 26 freezer malfunction
that spoiled thousands of meals and required costly repairs didn’t help matters.
Agewell uses a priority scoring system to make sure those who are most in need of home-delivered meals are served first.
"We assess their nutritional risk, their mobility, caregiver support, and any physical and mental concerns that they have," says Kris Collee, Agewell Services executive director. "A priority-one client would receive up to three meals per day because of all those risk factors. A lower priority to score might be an individual that needs five meals a week. They just need lunch while their loved ones are working. In terms of equity, we really try to meet people where they are and based on what their needs are specifically."
Area Agency on Aging 1-B
(AAA 1-B) serves Livingston, Macomb, Monroe, Oakland, St. Clair, and Washtenaw counties. Federal American Rescue Plan Act funding for its nutrition services will end in September 2024.
"The majority of those seniors continue to meet the eligibility criteria and remain on the program," says Angela Patten, AAA1B nutrition services program manager.
Volunteers are the heartbeat of Meals on Wheels programs — and one more way programs can address rising costs. They not only help prepare, serve, and deliver meals, but also extend a vital lifeline to the clients they serve.
Abigail Finn, nutrition programs manager for Senior Services Southwest Michigan, prepares meals for delivery.
"Our contracting partners are continuously looking for committed volunteers," Patten says. "You don't have to commit every week or every day. You can volunteer once a month."
Delivery volunteers build friendships with clients and provide an important safety check.
"Every [client] that does not come to the door gets reported through a hotline. We follow up to make sure they're safe," Wideman says. "The volunteers also are a key set of eyes for changes in conditions. They, a lot of times, will notice problems before family members do. Social isolation combined with an inability to access healthy food really puts your health in a downward spiral."
"It's that daily knock on the door, that social interaction for that individual. and it's that extra set of eyes, seeing those things that may not be noticed — the leaky roof, the porch falling," Lopez adds. "Those observations can lead to referrals being made to other resources that the DAAA can help provide."
A Meals on Wheels Western Michigan volunteer makes a delivery.
Michigan’s Meals on Wheels program leaders hope to find both the funding and volunteer support needed to eliminate waitlists and provide nourishing food and friendships to Michigan’s older adults.
"We're helping provide seniors with two things: access to healthy food and social connections," Wideman says. "These are vital to older adults remaining healthy and independent as long as possible. We’re a key part of that."
Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at [email protected] or www.constellations.biz.
MOWWM photos courtesy of MOWWM. Ronald Taylor photo by Nick Hagen. DAAA photo by Steve Koss. Senior Services Southwest Michigan photo by Susan Andress.