Each day, North Tonawanda Meals on Wheels volunteers bring more than a hot meal to Jean Elinski’s home.

They bring comfort — to both Elinski and her children. Elinski, 83, is independent and able to get around, but she can be forgetful. So her children asked her long ago not to cook for herself, for fear that she might put something on the stove and forget about it.

Elinski has been taking Meals on Wheels almost every day since 1983, when she was diagnosed with cancer. Later, she suffered back problems that required surgery.

For Elinski, North Tonawanda Meals on Wheels has been a “God send.”

“If I didn’t have Meals on Wheels, I don’t know what I’d do,” she said. “I wouldn’t be as healthy as I am, that’s for sure.”

Elinski is one of approximately 115 clients the North Tonawanda agency serves each day, according to coordinator Joy Welch. Right now, the group is able to meet that demand.

But in the years to come, as the region’s aging population continues to increase in numbers, more and more senior citizens will require the assistance of Meals on Wheels and a multitude of other services, which likely will stretch some agencies thinner than they are now. Moreover, senior centers across the region are offering more programs than ever.

North Tonawanda Meals on Wheels is serving more people above age 90 than it ever used to, Welch said. The agency anticipates delivering its one millionth meal next year.

Currently, there are nine routes. Welch said it will be difficult to add another route — or more — in the years to come.

On that possibility, Welch’s husband, Bill, said, “I wouldn’t be surprised, but we can only go so much further.”

Growing demand in tough times

Last fall, two economists with the Buffalo Branch of the Federal Reserve Bank of New York released a study projecting that the state’s population of senior citizens — people aged 65 and older — will increase by 40 percent over the next 20 years.

Upstate New York already has a higher concentration of seniors 75 and older than in the rest of the country, according to economists Richard Deitz and Ramon Garcia.

Their study on the growing demand for local services for the aging appeared in a 2007 issue of the Upstate New York Regional Review.

The growing demand for health care and support services for the aging comes at a time when local governments and social service agencies are experiencing difficult financial times. The economists note that the demand for those services is higher in upstate New York than in the rest of the nation. U.S. Census Bureau data reveals that Western New York has the largest population of seniors in the state.

Deitz and Garcia conclude that the increased demand for services isn’t likely to create a significant rise in local public expenditures. It will, however force some tough choices on how to spend ever-thinning resources.

“However, in many upstate New York communities, where the increasing demand for services and infrastructure takes place in an environment of fiscal stress, local governments will likely face difficult decisions,” the report states.

“Moreover,” according to Deitz and Garcia, “many community-based organizations that serve the region’s older population may find it hard to satisfy demand because they often rely on local governments for resources. Some local governments and institutions in the region therefore may face significant challenges meeting the growing needs of an aging population.”

‘Stretched to capacity’

Christopher Richbart, director of Niagara County’s Office for the Aging, agrees with that assessment. Niagara County’s senior population — the county characterizes people 60 and over as seniors — is hovering around 45,000 now and is expected to grow well beyond that in the years to come, as members of the Baby Boomer generation leave the workforce and enter their golden years.

Of course, in a region that has seen population rates remain flat — in the good years — it lends to a shift in demographics that will have profound effects for legislators, taxpayers and families.

There already are shortages in the number of caregivers and home care aides in the county, the senior care expert said.

“Our home delivery meals program is stretched to capacity,” Richbart said. “All of our routes are full. We’re constantly looking for more volunteers to make those services available.”

As for home care aides, “There’s already a major shortage there, and that’s projected to get worse,” he said.

There’s more bad news. Richbart’s office is among dozens whose state aid will be slashed 6 percent as state lawmakers, at Gov. David Paterson’s urging, make cuts to curtail New York’s soaring deficit.

That means agencies such the Office for the Aging will have to continue to offer their current services with less money.

While Niagara County’s senior population is comparable to much of the rest of the country, it does have a higher concentration of the “frail elderly” — people 85 and older who have serious medical conditions.

There are 5.7 caregivers available for each member of that most vulnerable group of seniors. With the overall population remaining steady, but getting older, that number is expected to drop to 4.7 caregivers per senior over the next decade.

“That’s a major drop-off,” Richbart said.

North Tonawanda’s DeGraff Memorial Hospital has always provided programs and services for the elderly, including an adult day care facility, said DeGraff President Tammy Owen.

“Are we ramping up what we’re doing (for seniors)? No. But I certainly think that because of the age of the population, it makes the demand for this hospital increase and the services to the community that this hospital provides even more vital,” Owen said.

Care at home and hospital

There’s yet another dynamic to the region’s graying population. While area Baby Boomers are aging locally, larger numbers of their children are fleeing the area in pursuit of better jobs. That creates a situation where there’s no one to provide day-to-day care when seniors are released after a stay in a hospital.

“It has an effect on our length of stay,” said Mary Hoffman, president of Kenmore Mercy Hospital.

In addition, the aging population makes it difficult for local hospitals to attract young workers.

“It impacts the pool of people we have in the community to work,” Hoffman said, adding that the average age of the nursing staff at Kenmore Mercy hovers around 50.

That’s about eight years older than the average age a decade ago.

“We’re working vigorously to recruit new nurses, who are typically younger,” she said.

With so many twenty-somethings leaving the area, “we absolutely feel the burden of that,” said Owen, of DeGraff. To manage that, DeGraff has worked toward creating partnerships with local social agencies to assist seniors once they are discharged from the hospital.

Nursing homes full

Skilled nursing facilities in Erie and Niagara counties are approaching full capacity, according to data compiled by the Community Health Foundation of Western and Central New York, which is working on a significant study on the aging of the region’s population called “Creating Options for Dignified Aging” in Erie and Niagara counties.

The Community Health Foundation’s survey of skilled nursing facilities in both counties revealed that the facilities’ occupancy rates are 96 percent in Erie County and 98 percent in Niagara County as of January.

The reduced capacity to accept new residents at skilled nursing homes creates a “push back” effect in which local hospitals take in the clients for an extended period of time because there’s nowhere else for them to go.

Hoffman, of Kenmore Mercy, says the solution isn’t simply to build more nursing homes. Instead, the Catholic Health System is looking toward services such as the Program of All-Inclusive Care for the Elderly, or PACE.

Housed in a former hospital in Lackawanna, Catholic Health System’s PACE provides low-income senior housing. Residents receive the services they would get in a nursing home, but they’re living more independently.

Highlighting the need

Jean Elinski, the North Tonawanda Meals on Wheels recipient, is able to live independently in her own home, but she has taken some risks as a result.

For example, two years ago Elinski climbed up onto a ladder in her home. “I didn’t like the way the pleats looked on the curtains,” she explained. After making the necessary adjustments, Elinski leaned back and tumbled off the ladder, breaking her pelvic bone.

The injury required two pins be put in her back. Elinski is now able to move around just fine without a walker or cane.

Last year, Elinski’s blood pressure dropped significantly, as did her pulse. Rather than calling an ambulance, she drove herself — with a pulse of four — to nearby DeGraff, where she was quickly treated before anything serious happened.

Still, it’s things like that that have forced Elinski to at least rely on someone else for her meals, and she’s grateful Meals on Wheels is around.

“The meals are terrific,” she said. “Today I had chicken, vegetables, sweet potatoes and applesauce. I wouldn’t be cooking all these vegetables and all that stuff when (I’m) lucky to get around.”