Older Californians Nutrition Program Stories

In March 2020, we closed 19 congregate meal sites overnight by coordinating with staff to make outbound calls to seniors and coordinate weekly deliveries, walk-up windows, or grab-n-go sites to adhere to the stay-at-home orders and safety guidelines. This logistical operation included all hands on deck. We quickly secured three different caterers and partnered with the Los Angeles Regional Food Bank to be able to serve four times as many clients. Next, we spoke with our Council Members and Los Angeles Department of Aging to assemble emergency meal delivery teams of disaster service workers to leave no senior behind. Through meal distributions, we were able to send out newsletters, facemasks, hand sanitizers, donated goods, and resource flyers to ensure our seniors had the resources necessary to keep them safe at home. Mid-way through our contract year, we served so many seniors that we ran out of funding. However, we did not stop there. We sought out private grants, sponsorships, and donations to exceed over and beyond one million meals of service as an agency in the highest ranked COVID-19 affected communities in the nation: Pacoima and Sylmar. This was a community-wide effort and took a village to accomplish the task at hand that my team and I are very proud of being a part of.

The Ramona Senior Center received a $4,000.00 grant to purchase pet food and supplies for their homebound seniors. Fifty-five seniors have a total of 96 animals including cats, dogs, 2 ponies, 4 chickens and a turkey. The nutrition program manager dedicated her whole weekend to purchasing hundreds of pounds of wet food, dry food, pet beds, litter and litter boxes, pee pads, shampoo, toys, treats, leashes, collars, and even a dog crate, for all of the seniors’ furry family members. All pet food and supplies were delivered along with the home-delivered meals. Knowing their pets’ needs are met puts the seniors at ease and improves their morale during these unprecedented times. Additionally, in response to COVID-19, the Ramona Senior Center proudly delivers nearly 2,000 home-delivered meals weekly to seniors living in very remote/rural areas of San Diego County, as well as around 400 to-go meals weekly.

San Francisco Department of Disability and Aging Services (DAS) provides funding to multiple community partners to offer congregate and home-delivered nutrition programs for older adults throughout the City. The congregate and home-delivered nutrition programs are intended to improve the dietary intake of participants and offer participants opportunities to create informal support networks. As a supporting part of the meal programs, DAS funds the Citywide Nutrition Counseling and Education program with the purpose of providing older adults, enrolled in congregate and home-delivered nutrition programs, nutrition counseling services and nutrition education workshops that promote lifestyle changes and support and encourage individuals to actively manage their health and wellness.

Leah’s Pantry is the organization that has contracted with DAS to provide citywide nutrition counseling and education services to congregate and home-delivered meal participants since FY17-18. Leah’s Pantry collaborates with nine DAS-funded congregate and home-delivered nutrition partners to provide nutrition education workshops and one-on-one nutrition counseling to older adults screened at high nutritional risk.

In a nutrition counseling session, clients can make nutrition-related goals based on the advice and guidance from the registered dietitian (RD), and have the option to meet with the RD once or on an ongoing basis either in person or over the phone. Leah’s Pantry provides nutrition counseling services to participants in any language through language interpretation services.

The nutrition education workshops consist of four classes once a week and follow a learner-centered nutrition and cooking curriculum for low-income communities. The curriculum covers topics such as recommended food groups, reading nutrition labels, cooking healthy foods in limited circumstances, and recipe demonstrations. Leah’s Pantry collaborates with congregate nutrition providers to host the workshops at congregate meal sites throughout the City, and workshops are provided in English, Spanish, and Chinese. Outcome evaluations reliably show the adoption of healthier dietary and food resource management behaviors. Based on FY20-21 data, 97% of workshop participants reported an increase in consumption of fruits and vegetables, 99% reported feeling more confident in their ability to prepare food for themselves, and 96% reported making at least one healthy change as a result of a nutrition education workshop.

During the COVID-19 pandemic, Leah’s Pantry continues to provide nutrition counseling and education services to congregate and home-delivered meal participants by hosting virtual workshops and offering nutrition counseling over the phone or through a video appointment.

The Carlsbad Senior Center had to switch gears fast when the pandemic hit. The facility had to close, but the needs of our Seniors increased, exponentially.

The Home-Delivered Meal program expanded from four routes manned by volunteers to 12 routes manned by City staff who had never had that responsibility before. The City staff stepped up in the most remarkable way - with great attitudes and a willingness and desire to assist our Seniors. They truly go above and beyond. It means the world to our recipients; the senior center often receives calls and letters of appreciation for the care that the drivers give. For example, an excerpt from a recent letter received follows:

"Since I am the caretaker of my husband and home, I sometimes am overwhelmed. Being able to pick up our dinner with my only responsibility to make a salad has been a godsend. And just as important are the smiles and laughs of the lunch crew. They are so supportive and fun during this time of isolation. It’s the joyful part of the day for my husband, my puppy, and myself."

The curbside pick-up line is our alternate to the dining room. Seniors tell us that coming through and having the 60-120 seconds is the highlight of their day. We try really hard to make every pick-up day special. One of our crew members puts out decorations every single day. We have a daily riddle or positive affirmation board. We have Music Mondays and Fun Fridays and offer other opportunities for senior engagement. It is not only about the meal, it’s about the community we have built and the smiles that we share.

We all miss having the center open, however, we have truly made lemonade out of lemons. We look forward to coming to the center each day to serve the Seniors in our community.

As an Area Agency on Aging, the San Francisco Department of Disability and Aging Services (DAS) provides funding to multiple community partners to offer congregate and home-delivered nutrition programs for older adults throughout the City. The congregate and home-delivered nutrition programs are intended to promote health and wellness, and assist individuals who are food insecure and at risk of poor nutritional health in gaining reliable access to nutritious foods and meals, and other nutrition related supportive services.

One of the community organizations that DAS partners with to provide congregate nutrition services is Project Open Hand. Project Open Hand has provided congregate meals to older adults since 1998, and prior to the COVID-19 pandemic provided hot congregate breakfast and lunches to older adults at 16 locations throughout the City. In response to the shelter-in-place orders put in place in March 2020, Project Open Hand has implemented many operational changes in order to continue to meet the needs of older adults in San Francisco.

Project Open Hand transitioned from hot meals to distributing "meal packs" to participants, containing seven frozen congregate meals. This allowed participants to remain sheltering-in-place, except for a single weekly pickup, without having to forego receiving nutritious meals. Project Open Hand was able to supply six of their sites with a freezer to hold the meals prior to pick up. Due to safety reasons, one of their congregate meal site locations decided to close until the pandemic was over. To continue to serve the fifty clients that went to this meal site, Project Open Hand deployed a refrigerated mobile van and set up the distribution of meals outside of the building.

These innovative strategies have had a tremendous impact in older adults accessing nutritious foods during the pandemic. From April 2020 to February 2021, Project Open Hand has distributed over 372,000 meals to older adults throughout San Francisco, which is a 60 percent increase in meals compared to what was provided the year prior.

During Older Americans month, we celebrate the strength of older adults and the aging network. The following stories share the perspective of older adults receiving meals through the Older Americans Act Nutrition Program.

Norma and Barbara - North Seal Beach Senior Center

Sisters Norma, 94, and Barbara, 92 miss the pre-pandemic "good ol’ days" when they hopped on a bus destined for a local senior center and enjoyed a hot meal at our Lunch Café, the popular Meals on Wheels OC lunch program enjoyed by thousands each year at 23 partnering senior centers. Going to the Lunch Café was a weekday excursion for the sisters that was as much about meeting with friends as it was about having a good meal. Sadly, COVID-19 necessitated the suspension of these special gatherings. Instead, Meals on Wheels OC worked diligently to convert this program to a Grab & Go frozen meal service that offers curbside pick-up or delivery of a week’s worth of meals. Surrogates, such as family or friends, may pick up meals for an older adult. For those who are unable to get to their closest participating location and do not have someone who can do so for them, meals are delivered similar to our traditional home-delivered Meals on Wheels. Now, many folks like Norma and Barbara are enjoying access to nutritious food while they limit exposure to this life-threatening virus by having the meals delivered. And like Norma and Barbara, we’re all anxious to return to the "good ol’ days" of meeting together to share laughs and connect over a delicious meal. In the meantime, we’re making sure at-risk older adults are as safe and healthy as they can be!

Corazon – Meals on Wheels Orange County & Fullerton Community Center

Corazon is a 75-year-old participant enrolled in the Grab & Go Meal Program at the Fullerton Community Center. She learned about the Lunch Café/Grab & Go Meals Program through a newsletter providing details and has been participating throughout the COVID-19 stay-at-home orders. This program has helped Corazon and her husband immensely, physically, nutritionally, and financially. Corazon is extremely grateful for this program as it has been difficult for her to buy groceries and prepare meals during the pandemic. The program has helped limit her exposure to COVID-19 and she picks up meals at the Fullerton Community Center every week. Both Corazon and her husband love the food stating that it is well prepared, very nutritious, and sanitary. She routinely thanks the employees at Meals on Wheels OC and at the site for offering the Lunch Café/Grab & Go Meals Program.

Ezekiel and Irma - Meals on Wheels Orange County

Since 83-year-old Irma suffered a stroke last year, her husband Ezekiel has been her loving caregiver. Ezekiel considers himself an "excellent dishwasher," but much less competent preparing meals when it comes to time in the kitchen. Since the threat of COVID-19, the couple stays home, restricting their outings to doctor appointments. "It is limiting," said Ezekiel, "but no one is exempt from this virus." When trips to the grocery store were no longer safe for the couple, their niece suggested they contact Meals on Wheels Orange County. Since joining the program six months ago, Irma and Ezekiel are no longer concerned about getting the nutrition they need. Without Meals on Wheels, Ezekiel knows they would be struggling to meet their dietary needs. "We would be eating badly," he said. The pandemic has resulted in isolation and loneliness for many older adults. Knowing someone will arrive at the door with meals is a comfort. Irma and Ezekiel look forward to receiving physically distant check-ins from their Meals on Wheels driver. Irma said, "It’s so nice to have someone come over and say hello."

Norma - H. Louis Lake Senior Center

Meals on Wheels client, Lorna, is legally blind. Before COVID-19 hit, she travelled with her service animal to the local grocery store, sometimes navigating the streets on foot and other times taking public transportation. Lorna’s purchases were restricted to whatever she could carry home, which eliminated heavy items like milk. Her limited sight made the trip to the store and the task of shopping enormously challenging. "Every aisle looked like the cereal aisle, and I made a lot of mistakes," she said. Since Lorna’s groceries were minimal and she could not safely use the stove, her menu options were few. When her crockpot became inoperable, Lorna’s choices were even more constrained. "I just ate whatever came my way," she said. When COVID-19 hit and it was no longer safe to travel to the store, Lorna knew the time had come to call Meals on Wheels Orange County for help. Now, Lorna is thrilled to receive nutrition-packed meals while in the safety of her home and is thankful to be independent. The Meals on Wheels prepared meals make life easier and much less "messy" for Lorna. "I’m not knocking things over and breaking glass when I go to make a meal anymore," she said. Lorna appreciates the variety of entrees, and especially enjoys one special item included with every delivery that was always missing from her shopping list: Milk!

The shut-down began in March 2020. Like so many programs and services affected by COVID 19, the El Dorado County Senior Nutrition Program closed eight community dining centers and lost many home-delivered meal (HDM) volunteers. While this moment was unprecedented, it was met with the resilience of many new volunteers who stepped forward to offer their help and support.

As the overnight transition was made from sit down dining to "take-out" meal service, small teams of volunteers have continued to arrive at 7:30 am Monday through Friday to help our West Slope kitchen staff wrap more than 700 cold packs that accompany the hot entree being served each day. In addition to wrapping cold packs, volunteers assembled 350 grocery boxes for weekly distribution to take-out meal and HDM participants, totaling more than 17,000 grocery boxes between May 2020 - April 2021.

The small, rural communities of El Dorado County have been served by five take-out meal locations on the western slope of the Sierras, and one location in the city of South Lake Tahoe. The participation was overwhelmingly positive. During the first week of the closure in March 2020, 449 take-out meals were provided to 122 unduplicated seniors. A year later, during the week of March 22, 2021, 1,721 take-out meals were provided to 423 unduplicated seniors.

By continuing to provide meals through take-out and HDM service, Nutrition staff and HDM volunteers have been able to maintain a vital social connection with our senior community to help assure their continued health, wellness and safety. Take-out meal service was also enhanced by the valuable opportunity to collaborate with Senior Information and Assistance staff, Home Energy and Assistance (HEAP) program staff, and regional food banks to provide additional resources and services to seniors in need.

The results of a recent survey helped affirm the importance of nutrition programs when asked, "What do you feel is the best part of the Senior Nutrition Program?":

• "We eat much healthier, plus it is an excellent value for our limited income."
• "Ease of getting meals and seeing other seniors."
• "Ensures a healthy and tasty meal."
• "Provides healthy, affordable variety of meals."
• "It helps me provide a healthy, more varied diet for my mom – and an additional benefit, I eat a healthier more varied diet too."

In March 2020, as a result of closing all in-person programming due to COVID-19, ONEgeneration shifted the focus and delivery of all social service programs to address the immediate and evolving needs of quarantined older adults, family caregivers, and unemployed adults. Our programs have converted to home-based, drive-through, or virtual engagements responding to the increasing food insecurity and need for social services among the disadvantaged populations we serve. ONEgeneration is feeding an average of 2500 households each month. We pick up daily and deliver perishable and nonperishable food items from over ten local markets to our most frail, homebound community, including those grandparents who care for grandchildren and cannot get to the market on their own. ONEgeneration is delivering over 200,000 pounds of food each month, including over 32,000 meals to homebound adults. Our goal is to keep seniors and families in need healthy and to prevent hunger, homelessness, and hospitalization due to chronic illness.

Meals on Wheels (MOW) of Santa Cruz County staff and volunteers have stepped up during the COVID-19 pandemic to provide home-delivered meals (HDM) with love and comfort to the seniors in our community. When congregate sites closed due to the shelter in place orders, MOW quickly adapted to an all HDM delivery system, with congregate site managers becoming meal delivery drivers. Staff stepped up to become COVID-19 safety protocol experts, implementing temperature checks and safety protocols for all essential staff at the main kitchen. As the pandemic grew, MOW saw a need for additional meals for their senior clients and began packing and delivering a week's worth of breakfast foods to all HDM clients. At its height, MOW was delivering 700 HDM lunch and breakfast meals per week and continue to deliver 600 lunches and breakfasts per week currently. MOW of Santa Cruz has gone above and beyond for its senior clients; staff personally called each participant who met vaccination age requirements and helped them navigate the vaccination process. Their love and caring for each senior participant at MOW Santa Cruz is amazing, and all staff deserves a standing ovation!!

To keep Sacramento County older adults safe during the COVID-19 pandemic, Agency on Aging\Area 4 (AAA4) partnered with the County of Sacramento to provide fresh meals to over 1000 people in the community. At least twice a week,15 local restaurants deliver freshly prepared meals to older adults who shelter-in-place. The Dine At Home Sacramento program participants receive two meals per day, either breakfast and lunch or lunch and dinner, and they can select from meat, vegetarian or diabetic menu options. The program has served over 260,000 restaurant-quality meals and has helped to save over 80 jobs is Sacramento County. The program has become so popular that the AAA4 created the Dine at Home Yolo and Dine at Home Yuba Sutter programs. Other counties have also followed the same service model to increase their reach to older adults in their community.

Prior to the pandemic, the San Marcos Senior Activity Center (SAC) served one hot meal a day at our Discovery Cafe. We served our last congregate meal Friday, March 13, 2020 and on the following Monday, we transitioned to a home delivered frozen meal program. We have three staff delivering over 300 meals per week across the southern California city of San Marcos. Due to the duration of the pandemic and the state mandate that seniors over 65 years of age continue to isolate, we decided to offer a fresh produce and various other items food box to all 60 participants in our home delivered meal program. We partnered with a local church that supplemented the box with pasta, dry beans, canned fruits, vegetables, soups, oatmeal and a healthy variety of snacks. In addition, the SAC purchased fresh greens for salads, carrots, celery, spinach, squash, tomatoes, berries, tuna, chicken, salmon, cottage cheese, cheese, deli meat and peanut butter. The boxes are distributed every other month to approximately 50 homebound seniors. Each box provides at least an additional 10 meals per month.

As an Area Agency on Aging, the San Francisco Department of Disability and Aging Services (DAS) provides funding to multiple community partners to offer congregate nutrition programs for older adults throughout the City. The congregate nutrition programs are intended to promote health and wellness, and assist individuals who are food insecure and at risk of poor nutritional health in gaining reliable access to nutritious foods and meals, and other nutrition related supportive services.

One of the community organizations that DAS partners with to provide congregate nutrition services is Bayview Senior Services. For over 40 years, Bayview Senior Services has provided programs designed to enhance and retain the health, quality of life, and culture of African American older adults in San Francisco. Bayview Senior Services offers an American-Southern style congregate lunch to older adults at 4 sites throughout San Francisco.

In response to the shelter-in-place orders put in place in March, 2020, Bayview Senior Services transitioned to take-out congregate meals to continue serving its participants. However, Bayview Senior Services saw an increased need for additional food resources. Based on consumer intake information, 68% of their congregate meal participants are low income and 40% are at high risk for poor nutritional health. To meet the increased need from their participants, Bayview Senior Services piloted a new program at two of their meal sites in conjunction with the San-Francisco Marin Food bank (SFMFB) and the San Francisco Produce Market. On a weekly basis, Bayview Senior Services receives 125 grocery bags from the SFMFB, and supplements the grocery bags with culturally appropriate produce tailored to their population. Examples of additional produce include cabbage, sweet potatoes, corn, bok choy, pineapple, and green beans. When older adults come to the site to pick up their congregate meal, they are given the supplemental grocery bag as well. The program’s success not only acknowledges the importance of providing cultural foods that support good health, but also limits the participant’s COVID-19 risk by providing meals and groceries at one location.