Ruth M. Jones doesn't know what she'd do without hot meals delivered daily to her home. The 81-year-old Charleston widow can't walk or drive since a car wreck nine years ago left her stricken by arthritis.

"A lot of times I can't even get into the kitchen," said Jones, who relies on her Social Security check to cover the soaring costs of food and utilities.

Those same costs are squeezing the estimated 20,000 senior nutrition programs across the country that serve Jones and millions of elderly and frail Americans.

While most needs are still being met, advocates from California to New York worry that seniors will go hungry. They blame a nearly 20 percent increase in fuel and food prices over the past year, flat or reduced government funding, and an ailing economy that yields fewer donations.

"All of that is generating a lot of anxiety," said Bob Anderson, associate director of the Metropolitan Area Agency on Aging in Minneapolis-St. Paul.

Across the country, nearly 60 percent of the estimated 5,000 programs that belong to the Meals on Wheels Association of America have lost volunteers who can't afford gas, said Enid A. Borden, president and CEO of the program that has been providing meals to Americans in need since 1954.

Nearly half the programs have eliminated routes or consolidated meal services. Some 38 percent have switched to delivering frozen rather than hot meals, while about 30 percent are cutting personal visits from five days a week to one.

"We're in a crisis and it's just getting worse and worse," said Borden, who is urging Congress to increase money for senior nutrition programs by at least 10 percent.

Two pending bills don't come close to that amount, said Peggy Ingraham, the association's senior vice president for public policy. A House subcommittee is considering a 6.5 percent increase for senior nutrition programs for the fiscal year that begins Oct. 1, while a Senate subcommittee is considering a 5.7 percent increase. The federal earmark for the current fiscal year is $758 million.

Cuts are already inevitable in New York City , said Marcia Stein, executive director of Citymeals on Wheels, where meetings are under way this week to work out details such as who will no longer receive meals.

"We have no choice," she said. "It's like trying to take a size 10 foot and putting it into a size 7 shoe."

In California , senior programs face a proposed 10 percent cut in state funding, said Donna Anderson, adult services division chief for San Joaquin County Department of Aging in Stockton .

In West Virginia , where about 15 percent of the population is over 60 and more than two-thirds live in rural areas, lawmakers last week provided an additional $1 million to help county agencies pay for food and gas.

Without it, the West Virginia Bureau of Senior Services would have had to cut 113,000 meals and make 100,000 fewer trips to and from doctor's appointments, the pharmacy and other places seniors need to go to remain independent, officials said. The bureau provided 848,000 round trips and 2.5 million meals last year.

"We're the only transportation they've got," said Sandra K. Vanin, the agency's commissioner.

In South Carolina , lawmakers added $2.9 million to next year's budget for a home-delivered meals program, sparing 5,400 of more than 29,000 clients from being cut off, said Frank Adams, spokesman for Lt. Gov. Andre Bauer, who oversees the state's Office on Aging.

Preparing meals and visiting the doctor are especially difficult for 91-year-old Mary Elliott of Charleston since she returned from the hospital last fall.

"I couldn't do nothing when I came home," said Elliott, who has lived alone since her husband died 15 years ago.

Her sons live in New York and Cleveland . The retired caterer has a fairly new stove, but hasn't learned how to use it. She said she doesn't trust herself to ride the bus because she might fall. And while her appetite isn't always what it should be, she said having meals delivered to her door is a blessing.

Photo by Jeff Gentner

It's people like her who worry retired firefighter Matt Jackson. He travels 50 miles every day as he distributes 93 meals to some of the most vulnerable residents of West Virginia 's capital city.

"Sometimes I'm the only person these people see," Jackson said. "Without this food program, a lot of people would suffer immensely."