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As we continue to age, there are a number of ailments that develop and health issues that we are forced to address and adapt to. While we anticipate problems such as achy joints and the occasional stiff legs, we do often forget about the continued upkeep associated with dental hygiene. Dental checkups are easy to forget about and avoid, especially when you do not feel like anything is wrong, however, as soon as something starts to ache, the check up can turn into a very expensive visit. Many elderly individuals avoid going to the dentist due to the associated fear of costs and lack of coverage.

Medicare does not provide dental care coverage for their insured beneficiaries, which leads many to either go without coverage or to retain an independent plan that could cost them more than they can afford in their budget. Millions of elderly Americans rely on Social Security and Medicaid or Medicare to support them in their old age, however, these programs continue to shrink in size and will not be able to provide for all of those soon to be retirees. Medicare does provide dental care for some chronic medical conditions such as reconstruction following an accidental injury, or extraction due to radiation exposure for neoplastic diseases of the jaw, a very specific list. Even with those exceptions, the reimbursement rate is so low that some doctors will not accept Medicare coverage in their offices because they know how difficult it becomes to get paid.
The National Center for Health Statistics has found that 20% of Americans over 65 years old have cavities that are currently going untreated, with the numbers steadily increasing with old age. With teeth becoming more brittle and procedures performed decades earlier needing maintenance, many elders find themselves in the Emergency Room due to the pain. There are a number of nonprofits however across the nation that offer free or discounted dental cleanings for elderly patients that do not have dental coverage and cannot afford it. Additionally, many universities offer discounted cleanings as well as procedures by having elderly patients be seen by their class of graduating dentists. They will offer up front costs of services as well as payment plans in an effort to avoid having the individual rack up debt.

Meals on Wheels is a government program that started in the 1950s that has assisted elderly citizens by delivering food to them when in need, either by providing the meals in the elderly individual’s home or in a community senior center. They not only provide the meal but also provide safety checks and visit with the senior, critical actions that have been shown to help elders live longer. There are over 5,000 independent organizations across America that help administer the program, and it has for decades, had much success. In order to receive funding local communities as well as the Older Americans Act help to keep the program afloat.

As the new budget is proposed, many programs are in jeopardy of being cut. One program that is may see a threat to funding is Meals on Wheels, due to the program not providing results. However, the nature of the program is not a results oriented initiative. The program services 2.4 million Americans, a number that will undoubtedly grow in the coming decades due to the large number of baby boomers beginning the retirement age. These cuts are the result of discretionary spending decisions related to the Community Development Block Grant that allocates a portion of the block grant money to elderly through Meals on Wheels. There have been numerous studies conducted that have showed the effectiveness of Meals on Wheels decreasing loneliness scores and also decreasing reliance on traditional care, while allowing elderly individuals to remain in their homes longer.

However, there are conflicting opinions about how much influence this will actually have on the institution. From financial statements released last year, only about 3% of the total funding was made from the block grant. On a local level, there is much more monetary influence, with federal funds accounting for 30% of the expenses relating to the home delivered meals. While the program’s costs and returns are currently being debated, it is evident that although it may not be the most lucrative on it’s face, Meals on Wheels can provide a number of benefits. One study even found that if there was a 1% increase in elderly individuals receiving Meals on Wheels, states would saved over $109 million, due to reductions in need for nursing home care.