Empty Plates: The Quiet Crisis Facing America’s Elderly

Budget battles in Congress leave 2.2 million seniors in limbo as local Meals on Wheels programs ration aid and stretch donations to feed the frail.

As Washington lawmakers hash out which programs will emerge victorious in the congressional budget battles, it is not clear how one program that touches some 2.2 million older adults, many of whom are homebound, will ultimately fare. While the program is not directly in jeopardy as the budget bill goes, cuts in Medicaid and in SNAP will likely impact  seniors and   increase food insecurity if the massive cuts go into effect.

So far Meals on Wheels America, established in the 1970s in the wake of President Lyndon Johnson’s Great Society, the Older American’s Act , the Meals on Wheels network’s nutrition program, the Meals On Wheels Network’ primary source of public funding is on track for flat funding. That means its appropriation from the federal government of about $1.059 billion will stay the same for the next fiscal year with no increase reflecting growing demand or rising costs. One in three Meals on Wheels providers has a wait list with an average wait time of nearly four months and some even up to two years. 

I have covered this story since the 1990s, interviewing  seniors who had little or nothing to eat and asking each time: Why in America, one of the richest countries in the world, do we allow our oldest and most frail citizens to wait in a queue for a meal?  A 79-year-old woman I interviewed in San Francisco was blind and probably hadn’t eaten in days. She said she would “eat something” but didn’t know exactly what when I asked her what she was having for dinner.  “Maybe an apple and some nuts,” she replied.  An issue of “Cooking Light” in braille was on the table next to her chair. She was hungry, but could not get help from Meals on Wheels anytime soon. She had been on a waiting list for six months.  

A woman in Pine Bluff, Arkansas, used her refrigerator to store old cosmetics; she had no food to put there. A 64-year-old Atlanta woman with a monthly income of $848 and $68 in food stamps was No. 27 on the waiting list when I met her in April; in November she still had not gotten meals. Her daughter finally found another program. A Nebraska man in one of the state’s most rural counties could not get a meal because the food program was not able to deliver across the county line. Near Baltimore a couple aged 89 and 91 shared one meal a day. When I later checked back with the family, the husband said they still could not pay the small amount for food from Meals on Wheels. “We’re not eating much of anything at all,” he said.

Stories like these can be told everywhere in the country today as homebound seniors wait for a hot meal. Program officials estimate the waiting list averages about four months. “The number of seniors with one or more chronic conditions has increased, so the numbers needing support have gone up,” says Ellie Hollander, president and CEO of the national leading organization. One-third of Meals on Wheels providers don’t have the funding to cover the needs of America’s growing numbers of homebound elderly. 

“The revenue has never kept pace with the growth of the senior population,” she says. “The gap is growing with 12,000 people turning 65 every day. Such numbers never have risen to a high priority in congressional budget battles. This year is no exception. The program is on track for flat funding this year. We’re talking lives here,” Hollander says. “Lives that are lonely, hungry, homebound and in desperate need  for food.” 

Betty Bradley knows the plight of hungry seniors. She runs the Meals on Wheels program in Abilene, Texas, and has seen the program in her area grow from serving 80 to 85 people a day, five days a week, to 1,738 a day. “So many people are struggling to meet their basic needs for food for a whole month,” she says. 

To supplement the funding from the federal government’s social services block grant, Bradley has to do additional fundraising in the community. She has spoken to local churches but says they are struggling, too, because of declining membership. When she talked to her congressional representative, Republican U.S. Rep. Jodey Arrington, about the grant she needs to fund her program, “He was primarily talking about budgets that had to be cut. He had sympathy for the program but couldn’t make any promises,” she said.

The Meals on Wheels program in Central Maryland had a recent visit from Health and Human Services Secretary Robert F. Kennedy Jr., who participated in a meal delivery and met with program officials about the needs of the homebound elderly. He said President Trump had asked “us at HHS to continue supporting Meals on Wheels so that no American in their twilight years feels forgotten.”   

Time will tell whether the visit will translate into more federal revenue for seniors needing food

Some years ago I met a woman named Ellen who lived in a trailer in a tiny, dusty town at the edge of western Nebraska, a stone’s throw from the Wyoming state line. She mostly existed on rice and biscuits with gravy. “The country doesn’t want to admit there’s poverty,” she said. “We can feed the world, but not our own.” 

Trudy Lieberman, a past president of the Association of Health Care Journalists, has had a long career in journalism, specializing in health care in recent years. She has written for many publications including Consumer Reports, Columbia Journalism Review, The Nation, Harper's Magazine, and the Center for Health Journalism. She has won many awards for her work including two National Magazine Awards, several National Press Club Awards, and a James Beard Award.