On the cover:
by EMILY GURNON
JOY EHLERT HAS BECOME accustomed to spotting the signs of poverty among elderly people. Ehlert, the nutrition director for the Humboldt Senior Resource Center, was at the meat counter of a local market one day when she overheard an old woman telling the butcher that she didn't see what she was looking for. What was that? he asked.
"The trimmings from the bacon," the woman replied. When the butcher went in the back to look, the woman turned to Ehlert.
"I just don't know what I'm going to do," she said. "I'm taking my last pill, and it costs $100" for the prescription. In her basket was one small can of vegetables. She was buying nothing else. The butcher returned, handing the woman a small wrapped package.
"How much?" she asked.
Ehlert knows firsthand that the woman's story is not unique. More than 3,000 people in the county, or 15 percent of those over 60, are considered to be in "greatest economic need," meaning their income is at or below 125 percent of poverty level, according to a study by the Area Agency on Aging in Eureka. Thousands receive help from the many local agencies that offer services to the elderly, but those services are going to be stretched even more thinly than they are now, for one simple reason: "Baby boomers" are getting old.
"We see a huge need coming up," Ehlert said. "What we're afraid of is we're not going to be able to cover requests for services."
The sudden increase in the birth rate after World War II resulted in what became known as the "baby boom," and officially included those born between 1946 and 1964. The oldest of the boomers will hit age 60 in two years. That means that they will qualify for many state and federally funded services, such as the senior dining room program and home-delivered meals that the Senior Center provides.
"This is happening at the same time that our ability to get money from state and federal sources is declining," Ehlert said.
Providing a lifeline
Tykeshia Leschke [photo above, at right] has been working with seniors for six years, including as a driver for the home-delivered meals program at the Senior Center. One recent weekday, the 28-year-old College of the Redwoods student loaded up her Chevy Impala with 20 containers of pizza, salad, milk and cookies, and drove through Eureka to see her lunch clients, who call her "Ty." She'll make about $25 for the three-hour route, hardly enough to put a dent in what she needs to support her 3-year-old daughter. Yet she loves it.
"Doing this job has made me realize that it's the small things that really matter," Leschke said. "They're always so happy to see me. Sometimes I'm the only person they see [that day]. And sometimes that makes the biggest difference. Even if I only go in and take the lids off [the containers] or something. Something as small as that -- in their life, it's everything."
The stops on her route range from small, dingy apartments to well-kept homes with a lifetime collection of prized spoons or plates on the walls. Some clients greet Leschke from a living room recliner, hooked up to oxygen. Most are alone.
Client No. 2 on the route is Jinny Jernigan [photo at left] . Jernigan, 71, was plagued by a series of health problems earlier this year. She had fallen and shattered her shoulder, losing the use of her right arm -- that on top of brain surgery and a stroke. The combination stole her appetite and left her unable to cook; she shed 20 pounds from her already slender frame. It was at that time that her part-time care provider got her signed up for home-delivered meals.
"It was just a lifesaver," she said. "I really owe my recovery to this meal program -- I know I do."
With her children scattered outside California, Jernigan does not have family to look after her. She lives on just $620 a month, of which she donates $35 to the Senior Center for the five-day-a-week meals.
Jernigan offered Leschke and a reporter a cup of warm apple cider while she showed the driver a photo of a baby possum that had visited her porch one recent night. "I have other people in my life that are wonderfully helpful, but Ty is just a blessing," she continued. "It makes a difference seeing someone every day, and when it's someone as intelligent and pleasant as Ty," even better.
The graying boomers
The numbers of Humboldt County residents aged 65 and up are already growing much faster than the population as a whole. The 65-plus group increased by 9.2 percent between 1990 and 2000, when total population for the county grew by only 4 percent, according to the Area Agency on Aging. In the next 10-year period, to 2010, the numbers of those 65 and up is expected to grow by 12 percent. And from 2000-2020, experts project a 64 percent increase.
The impact on social services will be "huge," said Chris Martinek, planner for the Area Agency on Aging. "If we don't think we have waiting lists now..."
The baby boom generation also includes a higher percentage of poor people, Martinek said, which will mean that they may have even less retirement savings or Social Security income than the current elderly. Social Security payments are based on how much one earns in a lifetime.
The bottom line is that more people are likely to be suffering, and the agencies that work with older people will have to serve more clients with less money, Martinek said. "It is a huge challenge, and it is one that we are striving to meet. The waiting lists already exist. It's going to be finding creative ways to address these issues."
Part of what her agency is doing is trying to determine what seniors need the most. To that end, they conducted a survey in 2000 of 713 residents of Humboldt and Del Norte counties.
The top concerns among the elderly? Household chores, accidents in the home, health care, money to live on and loneliness.
The fact that chores topped the list may seem surprising -- unless you know what it's like to be old, Martinek said.
"Think about if you couldn't do your laundry, or you can't wash the floor anymore so when you spill something it stays there. When those basic parts of life can't be done, the world alters."
`What a drag it is getting old'
Two years ago, Food for People, the area's food bank, gave out monthly bags of groceries to all low-income elderly who needed it. Since then, the demand has begun to outpace the supply. Now, the organization distributes bags to 780 seniors a month -- and it's not enough. The waiting list has grown to 40, and more than 50 people ask about it every month.
"What we're seeing are increased requests for help," said Anne Holcomb, Food for People's executive director. "As the cost of living goes up but these folks are still trying to live on a fixed income, it just really puts the squeeze on."
The fact that the baby boomers will soon move into old age worries her, Holcomb said. "If the economy doesn't get radically better, we're very concerned about how these seniors are going to be able to survive."
The elderly make up a big chunk of the people who come in to the food bank for other food assistance as well, Holcomb said. In order to try to meet the increased demand, especially around the holidays, the organization is holding its annual Holiday Spirit Food and Fund Drive, encouraging residents to fill grocery bags with nonperishable foods and drop them at Food for People collection barrels throughout the county.
One bag or box of food a month may not seem like much when the need is so great. But many elderly can make a little go a long way -- and every little bit helps them retain the independence that they guard so fiercely.
"If they're not able to obtain adequate nutrition, their health declines and they lose their independence," Holcomb said. "Then, the burden to the taxpayer and to the family is much more significant."
The Senior Center serves 40,000 meals each year at its dining centers in Eureka, Fortuna and Arcata. It also delivers more than 52,000 meals a year -- to 225 people a day -- through its home delivery program, which extends from Trinidad to Fortuna. Recipients are asked to donate whatever they can afford, but the money doesn't ever cover the costs, said Ehlert, the nutrition director. There are 10 to 15 people on the waiting list at any given time, and about 30 new people are referred for the home meals each month. The Rotary Club of Eureka has contributed $30,000 to help expand the program, but more donations from individuals are needed.
Food or pills?
For seniors on a limited income, the costs of rent or home maintenance and insurance, plus utilities, transportation and medical care, add up fast. Food then becomes "the one sort of negotiable item" in elderly people's budgets, as Holcomb put it. And like the woman Ehlert saw at the grocery store who was trying to live off bacon trimmings, many seniors feel they are forced to choose between eating and buying expensive prescription drugs.
Jerry Voorhees [photo at left] has worked as a pharmacist in Humboldt County for 34 years, and is now pharmacist in charge at Henderson Center Pharmacy in Eureka.
He said he often sees customers who are visibly distressed at the cost of their medications. "Happens almost every day. Especially if there's no insurance involved. If they have no insurance and it costs them right straight out of pocket, they're very concerned," he said.
The most pricey are the new drugs. "They're all outrageously expensive," Voorhees said. And they may be only marginally better than an older, vastly cheaper drug.
Voorhees said he counsels his customers to start questioning their doctors, to ask what the benefit of the drug is, whether there are alternatives or generics, and what's it going to cost.
The problem is, many people of the older generation are not accustomed to doing anything that might be construed as challenging the medical experts, he said.
"I'm 63. People my age and a little older were always told the doctor was God, and we don't question him. I just see so many older folks, in their 70s or 80s, who have never asked a question of a doctor in their life. They've gone to the doctor, they've gotten the diagnosis, they've gotten the prescription, they've come and gotten it filled and they've gone home.
"As the baby boomer population gets grayer, the people in this generation are more bold, they've been given more freedoms, they've had better choices, and they know how to ask for those choices. The younger people know they can ask questions and aren't afraid to."
Coping with it all
In addition to the physical and financial challenges many elderly face, growing old can carry with it a host of emotional difficulties, said Laura Holmes, a licensed clinical social worker who coordinates Humboldt County's Older Adults Program.
"We see people who have functioned well, worked, raised families and been successful, but when they reach old age, there are the common challenges of aging -- illness, loss of a spouse -- that can sometimes cause depression," Holmes said.
In Humboldt County, Holmes has also seen elderly people who moved here upon retirement, underestimating how difficult it could be to leave behind the social supports they may have had back home and connect with a new community.
The baby boomers will not be as reluctant, as a whole, to seek help, Holmes said. But those who are now 70 and older "grew up at a time when they were supposed to be very independent and self-sufficient, and mental illness of any kind, even depression, was seen as a sign of weakness, or something to be ashamed of," she said. "The idea that it could even be treated is a newer idea to many of these older adults."
Those who can get past the stigma of seeing a therapist or psychiatrist may have transportation problems that make it difficult to do, Holmes said.
Having too little money can limit an elderly person's options for mental health treatment. And, of course, "if you're really worried about how to put groceries on the table, it can contribute to increased anxiety and depression," Holmes said. "In any case, poverty just makes it more stressful and difficult."
`Behind the facade'
Joy Ehlert's encounter with the old woman at the meat counter didn't end with the woman's confession that she was destitute. Ehlert asked if she would come to one of the dining centers; the woman explained that her husband was disabled and couldn't get out of the house. Ehlert then suggested the home-delivered meals program. The woman shook her head.
"We don't need it yet," she said.
That was the hardest part, Ehlert said. "She wouldn't let me help her. People are unaware that help is available, and when it's offered, they still don't feel they're needy enough yet. There are more people who need it than we realize.
"To me, it's the hidden ones, the seniors who are hidden behind the facade of being OK, when really they're not -- it breaks my heart."
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