The door opened and Lily Lum smiled as she claimed the food from the tray. The women chatted before the Bennetts drove off to their next doorstep delivery.

More than 200 meals like Lum's are delivered each day on O'ahu by Meals on Wheels Hawai'i, which is celebrating its 25th anniversary this year. But as the number and average age of elderly people across the state rises, Meals on Wheels finds itself struggling to keep up with the demand.

"It's not only that there are more older elderly people, but also just the total number of elderly is increasing," said Diane Terada, executive director of Meals on Wheel Hawai'i Inc. "That's having a real major effect on Meals on Wheels programs actually throughout the country, because a large number of them are seeing great increases in their demand for services with so many more older people."

Terada also points to Hawai'i's high cost of living and the rising cost of prescription drugs as further limitations on senior citizens' ability to pay for food. "People should not have to decide if they can eat versus pay for other things like the medication they need," she said.

Irving Lauber, president of Aloha United Way, observes that those 65 and older are "the fastest growing segment of the population. Clearly it's an issue for the whole community, and we have to take care of those people. Most people would agree the objective is to keep (the elderly) in their own places as long as possible and help them maintain their self-sufficiency."

"When I started four years ago it was a really big deal when someone aged 90 called," Terada said, laughing. "But now it's like it's nothing ... over 13 percent of our clients are over age 90. So to get somebody who is 90 doesn't impress us anymore. You have to be over 100."

Eighty-year-old Annie Takemoto of McCully has been receiving food from Meals on Wheels for several years. "I have back problems so sometimes I can't get out of bed," she said. "And if I'm not home, they put (the food) in the freezer downstairs."

To qualify for Meals on Wheels a client must be either homebound and lack mobility to shop for themselves, have no access to a kitchen, be mentally or physically handicapped and not able to prepare or get the help to prepare food, be convalescing, be at risk of institutionalization if he or she doesn't receive food, or have no one to provide nutritional support. There is no age or income criteria. Clients are asked to contribute whatever they can toward the $5 cost of each meal. But whether they can pay the full cost, half or nothing at all, they will get a meal.

The standard fare is always served hot and is meant to meet a third of a person's daily dietary needs. Pureed and low-sodium meals are offered, and clients can ask for substitutes like rice instead of potatoes, or milk instead of juice.

"I enjoy people coming by," said 86-year-old Grace Sato of McCully, who uses Meals on Wheels because she is homebound. "It sure serves the purpose. And they give me nourishing food and food that I like."

Terada said, "The only time we wouldn't deliver is if a hurricane is coming in and Civil Defense says don't go out."

She said the organization also understands its volunteers provide not only food nourishment, but also the human contact that is essential for the homebound. "There is a big difference between someone who is paid to deliver a meal versus someone who really wants to be there just because they want to help other people," Terada said.

Judy Kern, program coordinator for Meals on Wheels, said, "Volunteers are the backbone of this organization." Volunteers use their own cars, pay for gas and spend at least two hours every week delivering meals.

Ken and Alice Chun began volunteering with Meals on Wheels Hawai'i when it started in 1979. "I think we're the only ones left in the program who started from the beginning," said 84-year-old Ken Chun. "As long as our health keeps up and we are able to drive and have our license renewed every two years, we should be able to continue."

The Bennetts' McCully route is one of the program's 30 routes running from Kalihi to Hawai'i Kai, Kane'ohe to Kailua, and Pearl City to 'Aiea. Two dinner routes go out to a small number of clients, and 28 lunch routes serve most clients. Two more routes, in 'Ewa and Honolulu, will be added by the end of the year.

"They're just appreciative that someone says 'Hi' and gives them a meal," said Doug Bennett, a former Punahou School football coach. "We may be benefiting more than they are. It may be cliche or awfully trite, but as you do these things, it's really rewarding."

Besides Meals on Wheels Hawai'i Inc., which is based out of Manoa Valley Church, there is an unaffiliated Lanakila Meals on Wheels, which is part of the larger Lanakila Rehabilitation Center.

"There's more demand for our service than either of us can provide," Terada said.

Meal on Wheels' approximately $500,000 annual income comes from client contributions, private donations, trusts and foundations, corporate support, government financing and in-kind support. This is the first year that the program will have a fund-raiser, in part to support the two new routes and future route expansion.

Reach Anna Weaver at aweaver@honoluluadvertiser.com or 535-2455.