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Commentary : When Elderly Outlive Relatives and Friends, Who Is There to Help?

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<i> Sallie C. Russell of Costa Mesa is a community volunteer who works with the elderly. </i>

She wears the same dusty rose sweater in the chill of winter and the heat of summer. Her small apartment is cluttered with a lifetime of “treasures.” She can’t bear to discard anything. Old newspapers compete for space with piles of grocery coupons, junk mail from years past and carefully rinsed and stacked food trays and milk cartons.

The only bare space is in her refrigerator, which except for the food we deliver, is always empty. She used to be a bookkeeper and sometimes thinks that she still is, but the mention of anything related to money--overdue utility bills, checking account balance, health care costs--causes her great distress. Even though I see her once a week, she doesn’t really remember who I am but makes a brave attempt to appear “in control.” She is proudly independent, always optimistic, a beautiful senior in her twilight years. And she is completely alone.

For the past year I have had the privilege of working as a volunteer for a nonprofit organization that provides home services to seniors who are disabled or temporarily incapacitated. Their goal is to help the elderly remain in their own homes for as long as possible, thereby providing the opportunity for them to live with dignity and independence.

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Home meals are one service provided by this organization. Buying groceries, and planning and preparing meals are often beyond the capabilities of the frail and elderly. Lunches and dinners, personally delivered to their homes on a daily basis, help to alleviate this major problem. But what of the other problems? What happens to people like Sarah who have no one to assume responsibility, to assist in making decisions, or simply to be there when explanations or encouragement are needed?

On one of my recent weekly visits to deliver Sarah’s meal, I was met at the door by a social worker representative from one of the county agencies that provide aid to seniors. She also was making a routine visit and had determined that Sarah needed to see a doctor. But there was no one to take her.

Sarah sat quietly listening to our conversation. It did not appear to be an emergency so I volunteered to drive her as soon as I finished delivering the other meals on my route. However, I later found that she had been taken to the hospital by ambulance. A matter of expedience, since this was a holiday eve, her doctor wasn’t available and everyone’s schedule was quite rushed.

Later that week I went to the hospital and was greeted by the discharge nurse who was very relieved to find someone visiting Sarah. She had been discharged several hours earlier but the nurse could find no one to take her home and help her get settled in.

I was glad I was there but wondered what would have happened if I hadn’t been. Sarah didn’t have the money for a taxi and the stress probably would have caused another crisis for her.

Since that day, by default, I have become a contact person for Sarah, a name and number on her file. I have had discussions with the hospital social worker, the administrator of our program and a representative from the county agency. I have sat with one of her caring neighbors trying to help get her “final notice” electric bill paid and then learned that someone at her church was supposed to be handling her finances.

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All of the traditional support groups are involved: government, nonprofit, church, health care organization and neighbors. Each is providing some service, doing what they can. But the programs are not integrated. Well-meaning efforts are often duplicated, while other needs go unidentified. Meanwhile, Sarah sits alone, bewildered by and often oblivious to her environment.

She and others like her are falling through society’s safety nets for lack of a central individual, someone who can coordinate the various social services provided by these support groups. Someone who can speak for Sarah. For the more fortunate seniors, this central role is provided by a daughter, a grandson, a younger sister or nephew, or maybe just a lifelong friend.

But how many are out there who have outlived their friends and relatives, who have no one to help in managing their finances, evaluating their health needs, maintaining their homes and especially, coordinating the available services?

Who is willing and qualified to fill the role, compassionately providing assistance without invading an individual’s privacy? Who will make the really difficult decisions when an individual can no longer live alone, and what criteria will be used?

Who will speak for Sarah?

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