Long before the coronavirus emerged, nutrition programs serving the country’s older adults were struggling to keep up with growing demand. Often they couldn’t.

For example, in Charlotte, NC and nine surrounding counties, the waiting list for meals on wheels averaged 1,200 people. However, Linda Miller, director of the Centralina Area Agency on Aging, who coordinates the program, always assumed the real need was greater.

She knew that some customers were skipping meals because they couldn’t travel to a senior center for a hot lunch every weekday. Some shared a single homemade meal that served for both lunch and dinner.

Some never asked for help. “Just like with food stamps that are under-used,” Ms. Miller said, “people are embarrassed:” I’ve worked hard all my life; I don’t want charity. ‘”

In northern Arizona, budget cuts combined with only modest increases in the federal dollar under the Older Americans Act also resulted in waiting lists.

“We get a lump sum and say: ‘Thank you! We weren’t cut! “, Said Mary Beals-Luedtka, director of the regional agency for aging, which supplies four largely rural districts there. “But flat-rate financing is like a decline. It is not sufficient. “

Covid-19 made the task immeasurably more difficult. Across the country, senior centers and church halls serving meals to healthier, more mobile seniors have been closed. Then those closings, as well as on-site housing guidelines and fear of exposure, have dramatically increased the number of elderly people who have had to eat.

Many volunteers, who were also at risk from age, stayed away. Sometimes family members who had been involved in shopping and cooking also became concerned about infecting their elders.

The Arizona team struggled last year to serve 150 percent more meals at home than last year. “My staff wavered,” said Ms. Beals-Luedtka. “It was crazy.” She still has around 70 people on a waiting list.

Help has come, however. For the convenience of administrators and advocates, the first three federal Covid recovery packages included a significant increase in funding for the Older Americans Act, which supports both community meals and group meals (which serve the majority of attendees) and meals on wheels.

The fourth and by far the largest infusion, $ 750 million, will come from the American rescue plan that President Biden signed last month. That brings the total increase for senior nutritional services to $ 1.6 billion. They received $ 907 million in fiscal 2019.

“It is a victory and an endorsement of the value of this program,” said Bob Blancato, executive director of the National Association of Nutrition and Aging Services Programs. “Malnutrition among older adults is an ongoing problem.”

Regardless, a 15 percent increase for those who qualify for grocery brands, specifically the Supplemental Nutrition Assistance Program, will benefit an estimated 5.4 million elderly recipients.

For years, lawyers for older adults have been campaigning for more significant federal aid. Although the Elderly Americans Bill was supported by both parties, 5,000 local organizations were consistently lagging behind in their ability to feed the elderly due to small annual increases in funding.

From 2001 to 2019, funding for the Older Americans Act rose an average of 1.1 percent a year – a 22 percent increase in nearly two decades, according to an analysis by the AARP Public Policy Institute. Adjusted for inflation, however, funds for food services fell by 8 percent. State and local matching funds, endowment grants, and private donations helped keep the kitchens open and the drivers deliver, but many programs still failed to fill their budget gaps.

At the same time, the number of Americans over 60 – the age at which they are eligible for OAA nutrition and other services – rose 63 percent. About a quarter of low-income seniors were “food unsafe”, which means that they had limited or unsafe access to adequate food.

And that shortage was before the pandemic. After the programs hastily closed community meetings last spring, a survey by Meals on Wheels America found that nearly 80 percent of programs said new requests for self-delivered meals had at least doubled. Waiting lists grew by 26 percent.

Together with the money, the Covid relief legislation gave these local programs the flexibility they needed. To qualify for Meals On Wheels, domestic customers must typically require assistance with daily living activities. The emergency funds allowed administrators to service less frail seniors who were completing home stay orders and transfer money free from community centers for home delivery.

Even so, some administrators were faced with dire decisions due to the increased number of cases from people who had never applied for a meal before.

In northern Arizona, approximately 800 customers were served homemade meals as of February 2020. By June, that number had risen to 1,265, including new applicants as well as those who had previously dined at the program’s 18 now-closed senior centers. Customers received 14 meals each week.

By the summer, Ms. Beals-Luedtka had “no more money” despite government aid. She was faced with the grim task of telling 342 seniors who had been on the list for three emergency months that she had to remove them. “People were crying on the phone,” she recalled. “I literally had a man say he was going to commit suicide.” (She restored it.) Even those who stayed got five meals a week instead of 14.

Now Ms. Beals-Luedtka is waiting for an estimated $ 1.34 million from the rescue plan, which will largely remove the waiting list, increase the number of meals for each recipient, and help local vendors reopen senior centers with the procurement and repair of kitchen appliances .

In North Carolina, the Centralina agency last month began delivering boxes of groceries – containing produce, canned foods, and other staples – to low-income seniors using federal funds from last year’s CARES Act, in partnership with a grocery bank. “You are a huge success,” said Ms. Miller. “I could never do that.”

It may seem unnecessary for senior nutrition programs to accomplish anything other than feed hungry elderly people, but research has shown that they have a broader impact.

“Addressing nutritional needs isn’t just good for people’s quality of life,” said Kali Thomas, a researcher at Brown University whose studies have shown that meals on wheels have several benefits. “It improves your health.” These programs reduce loneliness and help keep seniors away from expensive nursing homes. They can also help reduce falls, although these results were based on a small sample and did not reach statistical significance.

Interestingly, Dr. Thomas suggested that daily food deliveries had a greater impact than weekly or twice-monthly frozen food deliveries, a practice many local organizations have used to save money.

Frail or forgetful customers may have trouble storing, preparing, and remembering frozen meals. The main reason daily deliveries pay off is because of their regular chats with drivers, according to their study.

“They build relationships with their customers,” said Dr. Thomas. “You could come back later to fix a rickety handrail. If you are concerned about a client’s health, let the program know. The drivers are often the only people they see all day, so these relationships are very important. “

Congregant meals also contribute to the wellbeing of participants by preventing food insecurity and providing socialization and healthier nutrition. This resulted in a prepandemic assessment.

While program administrators enjoy a rare opportunity to expand their reach, they fear that the aid money will be spent and waiting lists will reappear if Congress does not maintain this increased budget.

“There will be a cliff,” said Ms. Beals-Luedtka. “What will happen next time? I don’t want to have to call people and say, “We’re done with you now.” These are our grandparents. “