The square meals that the elderly can't live without

It's 11.30 a.m. in the bright cheerful canteen of the Little Flower Centre in Dublin's Meath Street, and the day's delivery of…

It's 11.30 a.m. in the bright cheerful canteen of the Little Flower Centre in Dublin's Meath Street, and the day's delivery of "meals on wheels" to some 40 people is being put into foil containers. The drivers are standing by, waiting to carry the meals out to the parish van, where they'll make an hour-long circuit of the area. On the menu today is chicken drumsticks, with beans and mash, and apple crumble and custard.

Cooks Deirdre Flynn and Marie Claxton get paid by the centre, but the three drivers who work on rotas from Monday to Friday are volunteers. Since the runs are at mid-day, volunteers tend to be retired people, who can be available at that time of day. Finding reliable people who are consistent time-keepers is an essential part of the equation: if they don't turn up in time, the meals will either get cold or run the risk of not being delivered.

In the Eastern Health Board's 10 Year Action Plan for Services for Older Persons 1999-2008, the section on meals on wheels notes that among areas of concern are: "Recruitment of volunteers. Most of the volunteers are more than 60 years old and it is not uncommon to have a volunteer in their mid70s delivering meals to much younger clients. Availability of drivers to deliver the meals is more of a problem than finding volunteers to prepare or cook meals."

Sister Bridget Phelan is the manager of the Little Flower. "If someone drops out, I'll do the driving myself," she says. Drivers Con O'Connor and Willie Redmond are in the centre, and both are modest and candid about their reasons for volunteering. "The day's too long, you might as well be doing something," O'Connor says. Redmond adds: "I'd be bored sitting at home all day." While they're waiting for the meals to be boxed, they're obviously thinking again about why they volunteer to drive twice a week, since O'Connor turns around, shrugs, and simply says, "Especially in this day and age . . . " (This is the same week that George Redmond is telling the Flood Tribunal a few streets away that he cannot afford to eat lunch in town.)

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The meals from this centre are delivered Monday to Friday. Sometimes it happens that the people delivering the meals do not get a reply to their knock on the door. They then call back to the centre and someone goes on foot to see if there is anything amiss. Occasionally, people are found dead. More often, they have fallen and cannot get up, and the people who deliver meals on wheels are the first to notice. Sister Phelan reckons that 80 per cent of the people who receive meals on wheels in their area are living on their own.

In Britain, various local bodies are currently experimenting with a new tack on providing meals for the home-bound elderly. Devon County Council has a scheme in which a month's supply of frozen meals is delivered in one go. Microwaves are provided. The argument is that people will then be able to eat at whatever time of the day suits them, and it cuts down on the logistics of rotas for cooking and delivery.

Silverton parish councillor Jean Roach has organised a petition of protest, saying that old people do not like change and that they would lose the regular human contact the old system involved. A similar frozen-food delivery system is in place in the north-east of England, and there are also plans to introduce it in Scotland. At the Little Flower, cook Marie Claxton doesn't like the sound of frozen meals delivered monthly. "This might be the only contact people would have with anyone else," she points out. "They could possibly not see anyone for the rest of the month."

In the Republic, meals on wheels is provided by a number of different organisations. The health boards provide some, but not all, of the meals. A jigsaw network of local groups do the rest of the work, mainly on a voluntary basis. This ad hoc network varies from county to county, hence accurate figures for the number of meals being delivered is difficult to ascertain.

The Midland Health Board, for example, delivered some 99,994 meals last year, in 13 different areas of its region, to 486 people, but was unable to supply a complete set of figures for volunteer workers. The largest area was Co Longford, which had 180 people in receipt of meals, and the smallest was Mountrath, which had just one person receiving a meal. Elsewhere, the South Eastern Health Board delivered some 155,000 meals; the Southern Health Board delivered 293,392 meals; the Eastern Health Board some 1.2 million meals; the Western Health Board 6,610 under its community nursing scheme; and the North Eastern Health Board 89,000. No figures were available for the North Western Health Board.

Once the meals have been loaded into the parish van, Sister Phelan and myself go on foot to the Oliver Bond Flats to meet some of those who are expecting meals.

May Coulter, who does not go out any more and is very hard of hearing, has been getting meals for two years. She sits at the table, the foil containers arranged neatly in front of her. Her favourite meals are beef, cabbage and potatoes. When she hears it's chicken today, she rubs her hands together happily. "Lovely! Lovely chicken," she croons, looking down at the as-yet-unopened foil container.

Tommy Grogan, who will be 82 this year, has been living in his current flat for 68 years. He, too, has been getting meals for some two years, ever since spending a six-week stint in hospital with a disorder connected with malnutrition. He had not been eating properly, got double pneumonia, and spent 11 hours lying on the floor of his flat before being found.

"I'd be lost without the meals," he says, perching on the couch of his tidy little livingroom. He doesn't have a particular favourite, because he likes everything. Usually, he eats the meal as soon as it arrives. When he hears about the microwave system in use in parts of Britain, he grimaces politely. "I'd miss the people coming every day, the jolly people. Of course I would." He also says that he wouldn't be sure of his ability to use a microwave. "I don't use the big part of the cooker - the oven - ever. I just use the top bit, the rings," he offers.

At present, people pay a subsidy of 65p for their meal every day. The EHB's 10 Year Action Plan makes the point that "all of the organisations considered that the current subsidy of 65p per meal is insufficient". Yet the organisations still manage to prepare simple meals which are nutritious and varied. On the weekly menu at Little Flower recently, in which each day's meal is different, was: ham, sprouts, mash; chicken Kiev, carrots and mash; roast beef, turnips, mash; coddle, mixed vegetables, mash; corned beef, cabbage, mash. Desserts included apple tart, rice pudding, and trifle. According to Rita Fitzsimons, who has been delivering meals on wheels for all of 23 years, stew and coddle are the long-term favourites.

The meals on wheels service is available to all older people, regardless of their means, but it is usually availed of only by those who are less well off, according to Regina Buckley, who is the director of public health nursing in the Eastern Health Board.

She's aware of the microwave policy in parts of Britain, but sees problems with it. "Would people defrost the meals properly? Would they cook the meals for the right length of time? There would need to be a lot of education given about that.

"I think meals on wheels is an invaluable service, and I'd like to see it extended to seven days a week," she says. While the service runs Monday to Friday in most urban areas, in rural areas, it's often less. Buckley sees challenging times ahead for the meals on wheels service here. "It's getting harder and harder to recruit volunteers," she points out regretfully.

For information about volunteering with meals on wheels, con- tact local health boards