By NANCY HILER
At this stop, Maloney dropped off a hot dinner and cold lunch to 76-year-old Ada Avitable, a retired cashier and homemaker with various health problems whose quick wit and sunny demeanor belie her frailty and inability to care for herself. She will eat the hot dinner right away because it's difficult for her to heat things up, and save the sandwich for her evening meal.
"I get tired easily. I really can't do for myself anymore," Avitable explained. Her health issues include having survived two types of cancer, a knee replacement, a fractured shoulder that never fully healed, a heart condition that required bypass surgery, ongoing asthma and diabetes.
Maloney, who took early retirement from a high-pressure information technology position on Wall Street before starting this part-time "rewarding, pleasant job" six months ago, delivers 30 to 40 meals per day to seniors in East Meadow and Massapequa.
County subcontracts services
Catholic Charities/Diocese of Rockville Centre provided close to 190,000 Meals on Wheels last year, generally accounting for about half of the total distributed to the homebound elderly in Nassau County. "We cover communities in the entire South Shore, from Elmont to Suffolk County," said Scott Stepp, public affairs and development coordinator for the nonprofit organization. "Nassau County divides the coverage area among several agencies for Meals on Wheels and other services for the elderly."
Jolene Boden, Long Island district director of the Jewish Association of Services for the Aged, or JASA, said, "We serve 140 seniors Meals on Wheels per day, mostly in Long Beach, Point Lookout and Atlantic Beach." The county also subcontracts meal services for seniors to the Visiting Nurse Association, the Salvation Army and the Education and Assistance Corporation.
"I deliver to some people well into their 90s, and they clearly have the need, but there are all different needs and requirements," Maloney said.
Fearful of falling or experiencing chest pains or breathing problems, Avitable wears an alert signal necklace. She has never felt confident enough even to leave the 900-square-foot apartment in which she has lived for nine years to go to the community's recreation center, about 500 feet from her front door. The only time she goes anywhere is when her daughter and son-in-law help her into a car to take her to their home for a major family event or a holiday.
It became impossible for her two daughters to drop everything else they had to do to go food shopping and prepare meals for her every day, as they juggled busy work schedules and family obligations, Avitable explained.
"As a family member, I am very grateful for this program," said her daughter Diane Clerici of North Bellmore. "Without Meals on Wheels, I always had to worry that my mother might not eat. Now I don't have to worry." Her mother struggled just to stand up and to lift items to prepare a meal, she said, and began skipping meals and eating less and less because it became so difficult for her.
Now one of her daughters comes by to see her mother to make sure she has her medications, or to take her to doctor's appointments, or just to visit, but her nutrition is no longer a daily concern for either of them.
Indigence not required
"Older people are living longer, and many don't know where to go for help," Avitable said. "A lot of people don't know about Meals on Wheels." What many also may not know is that the service is not limited to the indigent.
Many homebound, like Avitable, pay at least part of the cost of the meals to the agencies that supply them. "I give them a donation of $7 a day," she said. Most nonprofit providers ask financially capable recipients to make donations for the meals they receive. This not only helps to make up for shortfalls in their funding, but also promotes psychological benefits of pride and independence among the many seniors who prefer not to take handouts.
To be eligible for Meals on Wheels in Nassau County, recipients must be 60 or older, unable to prepare their own meals and essentially homebound. Requirements include "no live-in caregiver, no regular access to grocery shopping, that they are frail and cannot get out with any kind of frequency," said Eileen Verity, administrator of senior services for Catholic Charities.
Other types of assistance are offered to the elderly homebound in Nassau. Services may range from transportation to and from senior centers, to meals and activities at those centers, to comprehensive in-home health and other care, depending on the need. Verity explained that an agency caseworker completes a 20-page assessment to determine eligibility for various services provided at no cost to those in financial need, but available to others on a sliding "ability-to-pay" scale, up to full payment.
Helpful budget developments
Asked how agencies providing Meals on Wheels in Nassau County are funded, Dr. Mary Curtis, deputy county executive for health and human services, said, "Two-thirds is provided by federal and state subsidies, and one-third by the county."
Curtis was pleased to acknowledge that two budget developments this year mean good news for the providers. A 10 percent match required of the providers was eliminated, and an added $100,000 was allocated to reduce a long waiting list for the Meals on Wheels program. "When an agency signed a contact with the county in the past, as part of it, they were expected to kick in 10 percent of the cost," JASA's Boden explained.
The match, which was in place in Nassau County for 38 years, was finally removed this year, Curtis said, because "the agencies had never really raised the issue with the administration that it was such a hardship for them before."
Catholic Charities' Stepp said, "We attended budget hearings throughout September and October, and met one on one with legislators to voice concern about our budget overruns and our financial needs. [Removing the match] means tremendous savings for our agencies, enabling us to continue to provide services where desperately needed. We worked hard to advocate for that."
"We have shifted some priorities to assist our residents who are most in need," said the county Legislature's presiding officer, Judy Jacobs, a Democrat from Woodbury, according to published reports on the eve of the budget vote.
Funding for the future
Funding is still insufficient to cover the entire cost of the program, however, according to Stepp. "The county does not recognize administrative costs" such as human resources and information technology expenses, he explained.
Verity said, "We need sustainable and equitable funding sources to nonprofit organizations necessary to meet the growing population of seniors."
Stepp added, "The issue is not going away. The senior population is growing. It is the fastest-growing segment of the population. People are living longer; their needs are more complex. As for the frail elderly, there are more and more of them."
The U.S. Census Bureau projects that the number of Americans over 65 will double by 2030 to 65 million, and that the oldest and generally most frail age group, 85 and older, will account for 19 million of those. "This is just the beginning," Verity said. "As the baby boomers age, we need to be prepared."
More than meals
"It's a long day," Avitable commented. "Sometimes Michael [Maloney] is the only person I see all day."
This points up another valuable aspect of Meals on Wheels and other programs provided to the homebound elderly. In many cases, it is not only the balanced meals delivered to their homes or made available at senior centers that make a difference, but also the friendly faces and the opportunities for social exchange that mean so much to them.
"I have a lot of nice conversations every day," Maloney concluded. "Older people have great stories."
Comments about this story? NHiler@liherald.com or (516) 569-4000 ext. 234.
