By Danielle Renwick
When an unprecedented Heat wave Heading into Portland, Oregon, in June 2021, Jonna Papaefthimiou, the city’s resilience manager, immediately thought of the city’s most vulnerable populations: the suffocating elderly, often alone, in their homes.
She called Suzanne Washington, who runs the local chapter of Meals on Wheels. “That overlap of their demographics and the demographics that face great heat risk are almost identical,” Papaefthimiou said.
Over the next two days, Washington and a group of employees identified their most vulnerable customers, recruited volunteers and began making calls. “We were like, ‘Do you have a fan? Do you know this heat is coming? Are you ready? Could you go to a cooling center? Do you know where is (nearest)? said Washington.
She and her team collected donated fans and air conditioners, which drivers took with them on their food delivery routes. They conducted wellness checks over the phone and helped customers find routes to chill centers.
Washington remembers calling an octogenarian who told him she had just passed out, had a headache and wasn’t feeling well. “We sent help,” she said. “This person was in the heat exhaustion phase and was heading into the next phase” – heatstroke, a life-threatening condition. Their quick actions and persistent awareness have most certainly saved lives.
Meals on Wheels, which originated in the UK during World War II, is not a climate organization – or even an emergency response organization in the traditional sense. These programs are best known for delivering hot meals to low-income seniors.
But in recent years, as climate disasters increase in frequency and intensity, the broader mission – to “improve health and quality of lifeof seniors served by these programs — has taken on new urgency.
Climate-related disasters, such as extreme heat, hurricanes and wildfires, do not affect all populations equally. If you are black or poor, you are more likely to live in a urban heat island which can become dangerously hot during a heat wave. You are also more likely live in a low-lying area prone to hurricane damage and flooding.
Elderly, disabled and isolated people are among the the most vulnerable during climate emergencies. In Multnomah County, which includes Portland, 56 of the 69 people whose deaths were attributed to heat event were over 60 years old. Forty-eight of the dead had lived alone.
There are more than 5,000 meals-on-wheels programs across the country serving more than 2.4 million people, according to Meals on Wheels America, the governing organization that supports local branches. These programs, which often long waiting listshave been shown to be effective in improving the diet and nutritional intake of older Americans, but their benefits go beyond food security.
Heat kills about 12,000 Americans each year, and about 80% of those deaths occur in adults over 60. When Hurricane Ian killed 148 people last year most of those who died were over 60. When the campfire engulfed the California town of Paradise, killing 85 people, the middle age of the dead was 72 years, according to a Cal account analysis.
“Whenever you face a natural disaster or climate change event, you face events that cause morbidity and mortality and ultimately lead to people succumbing to their chronic medical conditions,” said said David Dosa, geriatrician and researcher at Brown University.
Older people are more likely to have mobility difficulties, making it more difficult to evacuate from a flooded area or in the path of a wildfire. They are also more likely to have health conditions that require electrical devices, such as oxygen tanks or refrigerators for medication, which makes power outages life-threatening. And they are more likely to suffer from chronic diseases exacerbated by stress.
“When ‘Mrs. Smith’ dies in her apartment a week after a heatwave, she’s dying of COPD (chronic obstructive pulmonary disease) or heart failure. She’s not necessarily ‘in dying from the heat wave, ‘even though there’s a good chance she was destabilized by the heat,” Dosa said. “The actual body count ends up being much higher” than the official count, he added.
Residents of assisted living facilities do not necessarily fare better in an emergency. According to a Senate Report released in February, extreme weather events in 17 states forced evacuations or led to injuries and deaths in long-term care facilities. In Florida, nine residents of a single nursing home died from heat exposure in 2017 after Hurricane Irma knocked out the facility’s air conditioning.
What protects people is contact with others and emergency plans – like having an emergency contact list on the fridge and enough food, water and medicine on hand to last several days, Dosa said.
As Hurricane Ian approached South Florida last year, Stefanie Ink-Edwards, CEO of Community Cooperative and manager of Fort Myers’ Meals on Wheels, rushed to distribute hundreds of hurricane kits with water, non-perishable food, flashlights and batteries. Staff and volunteers provided rides to shelters and ensured clients had these emergency numbers on the fridge.
The storm hit Fort Myers on Wednesday, September 28. That night, Ink-Edwards could barely sleep. “I was so worried for all of our homebound elders, some of whom were living in very low areas,” she said. “That’s the scariest part for us, not so much the preparation for the storm but: what is it going to be like during the storm and after? Will we be able to reach them?
The next morning, Ink-Edwards inspected the organization’s kitchen and was relieved to find that it had sustained minimal damage. “Friday we were delivering meals and supplies again,” she said.
The roads were strewn with debris and customers had a litany of requests: bottled water, a generator for an oxygen tank, help removing a branch that had hit a roof. “We are doing everything we can,” she said. “We will eventually find a roofer, but in the meantime, to put the band-aid on, it is my volunteers and my staff who are sheeting the roofs.”
Researchers have found that non-profit meal delivery programs can reduce loneliness, risk of falling and the need for institutional care. An economic analysis of the model revealed that a 1% increase in the number of people using the service was associated with a $109 million reduction in Medicaid spending.
“What sets these programs apart is the daily interaction – the informal feel-good check-in and socialization that recipients inherently receive from these meals appearing at lunchtime, every day, multiple days a week. week,” said Brown researcher Kali Thomas. University that has authored several studies on meal delivery programs.
In New York, the Covid-19 pandemic has exacerbated one of the most dangerous hazards of old age: isolation. “There are still so many who are afraid to go out, afraid to shop,” said Beth Shapiro, executive director of Citymeals on Wheels. “The meal and check-in at their doorstep is truly a lifesaver.”
Jackie, a 73-year-old Queens resident and Citymeals customer who asked that her surname be withheld, said she looked forward to her deliveries six days a week. Two volunteers, Pablo and Veronica, take it in turns to drop off the meals at her home. “It’s like a niece and a nephew visiting him every day,” she says.
Jackie, who suffers from shortness of breath, heart palpitations and poor vision, has lived alone since her mother passed away several years ago. “I hibernate when it’s hot because of my respiratory issues,” she said. During the summer, she relies on a single air conditioner in her living room and deliveries from her local pharmacy and deli to keep out of the heat. “I’m lucky to have people like that because when you’re on your own — no family, no siblings — you have to be independent,” she said.
She said Citymeals had the phone number of a friend of hers, who lives down the street. “If for some reason I don’t answer the phone, they’ll call her to make sure she knows I was okay. If they can’t reach (me or) her, they’ll call 911 to make sure I’m not dead or unconscious on the floor,” she said. (Cities, including New York, have adopted buddy system programs to ensure the safety of vulnerable residents during heat waves.)
In the first two years of the pandemic, Citymeals on Wheels more than doubled its annual deliveries and began replacing in-person visits with feel-good calls. Volunteers have largely resumed making in-person visits, but Shapiro said his organization is investing in expanding its check-in call program.
Citymeals also trains volunteers to identify the signs of heat-related illnesses. “The people we feed live on extremely fixed incomes,” she said. “They make the decision – if they have an air conditioner – whether to turn it on or not. So we have to be very aware of what is going on and check,” she said.
For Shapiro, the climate crisis has not so much changed Citymeals’ mission as it has focused it. After Hurricane Sandy, the organization purchased a 25,000 square foot building in the Bronx to use as an operations center. Shapiro never thought they’d use the whole building. “And then came COVID and we were filled to the gills,” she said.
She added: ‘A lot of our planning now is for emergencies.
Republished with permission from Nexus Media News.