July 13, 2008

Central Virginia Area Agency on Aging Dining Center Looks for Best Way to Reach Elderly

By Cynthia Pegram, The News & Advance, Lynchburg, Va.

Jul. 13--MADISON HEIGHTS -- In the early morning, even Dixie Airport Road is quiet, but Mary Mathisen is already busy in the fellowship hall of Emmanuel Church of the Nazarene.

It's well before 8 a.m. and with hands encased in transparent plastic gloves, she puts canned orange slices into small Styrofoam cups with covers. Slices of frozen bread are slipped into per-person sized wrappers.

Mathisen is site manager for the Madison Heights dining center established by the Lynchburg-based Central Virginia Area Agency on Aging.

The average client is 84 -- ages range from 70s to 90s.

"They call me the junior senior," said Mathisen, 70, with amusement in her brown eyes.

Frozen veal Parmesan, seasoned mixed vegetables, and mashed potatoes will take an hour and a half to cook. Steaming hot, the meals will be bundled into bright blue insulated carriers and whisked off for delivery to 33 frail senior citizens who may live as much as an hour away. They'll also get milk, bread and the oranges.

Soon popping sounds come from the kitchen as Mathisen jabs a knife into the clear wrap over each frozen meal before she puts it in a convection oven designed to heat 36 meals at a time.

She makes sure everything runs like clockwork on Mondays, Wednesdays and Fridays for 10 to 15 clients who will be picked up at their homes by the CVAAA van drivers and brought to the church, the dining site.

They'll arrive around 10 a.m. Drivers then load the waiting hot meals and begin deliveries to those too unwell to share the meal and fun at the dining site.

To participate in the center, a person must be healthy, alert and over 60. Even regulars must be re-evaluated after a bout of bad health. If things have changed, they go on the home-delivered meal roster.

The agency has eight sites throughout Central Virginia, said RoseAnn Richards, director of nutrition services.

When she first came to the agency years ago, Richards said she mistakenly assumed the sites would all be the same -- but like the seniors themselves, "They're all different."

"Each has unique ownership of their site. They make it their own."

The Madison Heights site is in Emmanuel Church of the Nazarene's fellowship hall, which has space in its kitchen for CVAAA's convection oven, two freezers, and metal storage cabinet.

The agency and the church have worked together for about 15 years. The church is reimbursed for utilities, but gives up space -- and options for other uses -- during site hours so seniors can be served.

Pastor Peter Migner said the church works with CVAAA because "they serve a valid purpose in the community" as one of the few reaching out to older citizens.

Emmanuel's congregation is young, so allowing the seniors to use the facilities is a welcome complement to it, Migner said.

Getting the site ready for the seniors and tidied afterward is part of the time challenge for the agency staff. Meals must meet federal temperature standards and some clients live an hour away.

Fifteen is a full roster for those eating at the dining site, but it's seldom they're all present at once, Mathisen said. Two new clients will come Friday, and there's no waiting list.

Menus are cycled and activities vary. But some things are regular -- health checks, movies, crafts, and monthly birthday celebrations.

In the fellowship hall, rectangular tables are set up in a "U" pattern.

Two vans arrive with a group of 11 ladies. They file in and usually opt to sit in the same seat each time.

One lady distributes a folder of sheet music. The women begin to sing hymns unaccompanied, having lost their 97-year-old piano player when she entered a nursing home. A prayer for a liver transplant patient follows a reading from Proverbs. They give thanks for being able to come to the site.

In unison, the soft voices recite the Lord's Prayer.

In the kitchen, van drivers John Philbrook and David Carter pack the hot meals for home deliveries.

Philbrook, a retired New Jersey law enforcement officer, said the older folks "appreciate what we do for them."

There's no charge for the meals. "That's part of our service," Richards said. "We do ask for donations -- it helps increase the number of clients served."

Drivers know the homebound clients, and if no one answers the door they leave a doorknob sign saying they've been there but haven't left the meal. Then Richards is notified. The emergency contact number kept by the agency is called to report the lack of response.

Van drivers, Richards said, "are our first line of defense."

The agency is planning to develop a central kitchen in which meals would be prepared, cooked, quick-chilled, and then taken to site. The chilled -- not frozen -- meals could be quickly reheated and served family style at the

congregate sites. Home-delivered meals could be warmed to the right temperature in two minutes, Richards said.

That would free the agency from federal temperature standards, which is a limiting factor for home-delivered meals.

It would also mean the ability to provide more meals at more sites, at lower cost, in part because the freezers, convection ovens, and hour-and-a-half frozen meal cooking times would not be needed. The agency could also contract with other organizations to provide their meals from the central kitchen, Richards said.

The first step is to find a Lynchburg site for the central kitchen.

The old style continues.

Today in the dining center, the meals cook while the group does a craft project with Judy Spencer, outreach librarian for the Madison Heights Branch of the Amherst County Library. She's brought DVDs, books and shells.

Spencer teases the group into saying, "She sells sea shells by the seashore." They try with laughter with pretty good results.

She holds up what looks like a charcoal-colored, elongated clamshell. The seniors will fill the shells with small fabric flowers and moss. It will become a glued-on magnet with a refrigerator door decoration.

"We take old things, make new things out of them," Spencer said.

Several of the women have looked through the collection of library materials, selecting several to check out and take home.

This is a group with many losses over long lifetimes, yet Mary A. Sandidge, 77, is a cheerful figure in brilliant yellow and red. She also comes for the opportunity to get out and meet people, she said.

Lucille Miles has come to the agency's program since 1986. Sophie Brown started out in 1987 at what was then the Clifford Dining Site.

Brown, who doesn't drive, can get a ride to the doctor and a lift to the grocery store through CVAAA.

The ladies help set the table, and lunch is served.

They are a congenial group, chatting as they eat together. After the meal, they clear the table, clean placemats, and talk as they anticipate the van drivers' return at 12:30 p.m.

When all is tidy and the paperwork done, Mary Mathisen's site manager's day will come to a close.


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