Professional counselors will be eligible to serve Medicare beneficiaries as of January 1, 2024, and Medicare is the primary health insurance program for older adults in the United States. This population is rapidly increasing, and growth is accompanied by increased mental health concerns such as suicide. Older adults who receive home-delivered meals (HDM) may be at risk due to isolation, especially throughout the coronavirus pandemic. Grounded in the interpersonal theory of suicide, we sought to understand the relationships between proximal (thwarted belongingness; TB, perceived burdensomeness; PB) and distal (chronic pain, loneliness, and perceived social support) risk factors among older adults who receive HDM. TB and PB were correlated with pain, loneliness, and perceived social support, and these variables predicted TB and PB. Understanding relationships between proximal and distal suicide risk factors may inform interventions for counselors to address loneliness, enhance social support, and identify suicide risk among older adults.