COUNTY REPORT: Confronting the Age Crisis : Agencies Struggle to Meet Rising Needs of the Elderly : Health: About 63,000 county residents are over 65. A network of care givers reaches out to those in danger of falling into a deadly downward spiral.

Social workers call it the downward spiral--a deadly syndrome that sucks too many of Ventura County’s older residents away to an early grave:

* Weary of his elderly wife’s constant coughing, a 90-year-old Fillmore man allegedly throttles the life from her.

* A depressed, 80-year-old pianist shoots his ailing spouse to death in Ventura, then kills himself.

* And a grieving, disabled Ventura woman shuts herself in, all but giving up on her health, home and life until diabetic shock throws her into the hospital.

The decline begins with failing health. And then:

“You get into that downward spiral of not being able to do for yourself,” explained Mary Leu Pappas, a county visiting public health nurse. “First thing to go is housekeeping, then you’re not able to get out and get food, and nutrition.

“And when you’re not eating properly, you’re not thinking properly, and maybe you’re forgetting to take those medications you need so badly,” added Pappas, who cares for elderly shut-ins. “That begins the spiral that we’re trying to stop.”

The powerful vortex of ill health, loneliness and corrosive depression saps the spirit of many older people in Ventura County, social workers say.

Nearly one-fourth of the 63,000 Ventura County residents over age 65 have trouble getting around or taking care of themselves, according to the Area Agency on Aging, a federally funded umbrella for elder services. Of those 63,000, one-fifth live alone--more than four out of five of them women.

A broad network of help for the aged stretches across Ventura County.

Public health nurses and in-home volunteers cook meals, prepare medication, do chores and help elderly shut-ins who might otherwise be consigned to nursing homes.

Dial-a-ride programs carry the carless from point to point. Meals-on-Wheels programs feed them. Mental health workers counsel them. And senior centers give them a place to meet and seek support ranging from computer classes and health clinics to crafts workshops and legal advice.

But Ventura County’s programs for the aged have been warned: Expect to have your state and federal funding slashed this year by anywhere from 8% to 23%. And program directors are struggling to keep a grip on what money they have left.

“What we’re pushing now and advocating is that Ventura County knows more about where we should spend our moneys that are going to be allocated to us than does Washington or Sacramento,” said John Eslick of the Area Agency on Aging.

“We can’t expect Big Mama or Big Daddy in Washington to keep sending more of this money down,” said Eslick, chairman of a countywide committee of advisors who guide the agency. “We have to ration the moneys we get [so] we get the best care for the most people.”

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As U.S. and California budget cutters consider laying waste to social programs for the aged, the elderly people of Ventura County are growing needier and more numerous each year.

The 1990 U.S. census predicted that by 2015, the number of Ventura County residents aged 75 and older will have risen by 64%. By that year, census takers predict, the number of county residents aged 85 and older will have swollen by 163%.

Elder-care agencies are scrambling to augment their programs--already shrunken by past budget cuts--with volunteers.

The county Personnel Department is launching the largest of these efforts--a new elder-help program called Volunteer Opportunity Center for Active Living, or VOCAL--with an orientation meeting Jan. 24 at the county government center.

The new program will need volunteers throughout Ventura County’s elder-care agencies to clean house for the county’s frailer residents, give rides or lend a friendly ear.

Volunteers also might be assigned a few hours a day to give a rest to older people who are all but burned out by the round-the-clock demands of caring for spouses suffering from Alzheimer’s disease.

VOCAL hopes to draft the elderly themselves, and may even let pre-screened adult and juvenile offenders work off their community service sentences by helping the aged, said program coordinator Hui Ling Tanouye.

“I don’t know how well it would work,” Tanouye said of the probation idea. “But we have to identify what all the [possible] volunteers are.”

Many agencies are running short on volunteers.

Caregivers, an 11-year-old nonprofit group that sends helpers into aged people’s homes in Ventura, Santa Paula and Fillmore, is desperate for volunteers, said Pat Meredith, its director.

“We’re limited by the number of volunteers we can recruit, and our appeals for help have risen 10% in the last year,” Meredith said. “Care for the elderly is not a glamour issue. It doesn’t have the same appeal to people as homelessness and child abuse and AIDS right now, and it’s just harder to raise money for the elderly.”

Program administrators are scrambling to keep the county’s elderly from being squeezed between the dwindling aid and their own rising numbers, said Colleen House, director of the Area Agency on Aging.

“It’s a system that is changing fast in many respects,” House said. “You’re trying to run a train and you’re laying the tracks as you go.”

As public welfare for the elderly stumbles under the increasing load, other systems are already failing Ventura County’s aged.

Affordable housing is in short supply for elderly people with limited money, who are packing the waiting lists for public housing in cities such as Thousand Oaks.

Gaps in the public transportation network often force older people without cars or licenses to pay for cab fare or beg rides from friends to get to specific destinations. Some just stay home.

Minibus and dial-a-ride services carry elderly passengers around in most of the county’s large cities, but elder-care administrators complain that they are inadequate, and that there are few city-to-city runs.

And although a network of Meals on Wheels programs serves hot meals to homebound older people across Ventura County for a suggested $2.50 donation per meal, it can reach only about 1,300 people, five days a week, one meal a day.

The kitchen at the Ventura County Senior Nutrition Program prepares lunches in its Camarillo facility and trucks them to senior centers in Camarillo, Fillmore, Oxnard, Moorpark and Ventura.

The centers then heat up the meals for about 500 walk-in diners; 400 more lunches are trucked out hot to elderly recipients by volunteer drivers, and the remainder are dispersed through other Meals on Wheels programs in cities such as Thousand Oaks, Ojai and Simi Valley.

In the early 1990s, said program administrator Violet Henry, budget cuts forced Meals on Wheels to stop feeding everyone who asked for it.

Now, she said, folks who cannot fix their own meals at home can receive Meals on Wheels for up to two weeks after getting out of the hospital--but only until case- workers rule that theyare able to fend for themselves.

Food does not always reach the people it was meant to feed, she said: Many older people are too proud to reach out for help, and others simply do not know the Meals on Wheels program is there.

And with Congress contemplating fobbing off many public welfare programs to the states, such administrators as Henry worry that not enough money will filter down to the neediest in Ventura County.

“It’s up to the seniors to lobby for it, and tell them that we need it,” she said. “I’m concerned that we’ll have to have waiting lists or we’ll have to deny people. You know, it’s like playing God--’You can have a meal, and you can’t.’ We’ve been really lucky that we haven’t had to do that.”

Finally, there is the safety net, a loose collection of county agencies charged with rescuing elderly people who are already trapped in the downward spiral.

Nurses, counselors and caseworkers fan out from the departments of public and mental health and the Public Social Services Agency, hoping to catch people suffering from failing health or crushing depression before they hit bottom.

But the caretakers say they can treat only those they know about--those whose doctors urge firm intervention, the ones who are hospitalized because of their own self-neglect, or the ones who try to kill themselves.

This year, two of the county’s more tragic cases of the downward spiral completely eluded the safety net:

In September, police say, Alfred Pohlmeier got fed up with his wife’s constant coughing and complaints.

He put his hands around her neck, they said, and strangled her for close to 10 minutes until she stopped moving. Then he called 911. Barely two hours later, staff at Santa Paula Hospital ordered the comatose Ludwina Pohlmeier, 86, disconnected from a respirator that was keeping her alive. Her husband, now 91, faces trial on charges of murder.

And two weeks ago, the spiral ended two more long, otherwise rich lives.

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Irving G. Babcock, apparently depressed over his own back pain and his wife’s deteriorating health after a stroke, wrote down his burial wishes in a note telling authorities how to contact his kin.

The 80-year-old retired accountant and piano player pointed a gun at 77-year-old Jessie M. Babcock, his wife of 50 years, and shot her in the head. Then he killed himself.

“When I read about [the Babcocks’ deaths] I purposely went back and looked through our files,” said Pappas, the public health nurse in charge of cases for the county health department. “No one has ever made a referral on either of these cases.”

The ills and infirmities of old age are hard enough to bear, say elder-care workers: Joints fail, hearts clog up, senses dull and thoughts cloud over, making caring for oneself a chore at best.

But depression can prove the deadliest symptom of all, and it hits an estimated 15% of Ventura County’s elderly.

Depression can be triggered by a stroke or by several drugs used to treat other age-related disorders such as arthritis, lupus or serious infection, said Barbara Kurtz, head of the Older Adult Services Team for the county Department of Mental Health.

Or it can be brought on by tragedy--the death of a spouse or a child, or the last of a series of deaths of elderly friends.

“Sometimes, things just catch up with them,” said Kurtz. “Maybe that last one is the straw that broke the camel’s back, and they sink into a clinical depression.

“Depression can make life not worth living, to where you actually put the gun to your head and pull the trigger,” Kurtz said. “The elderly just don’t do that on a whim. It’s not spontaneous. If you talk to a lot of your elderly people, they talk about it. It’s a lifeboat. It’s there: ‘If things don’t work out . . ..’ It actually makes them feel better.”

Therapists view elderly suicides as people who were either too fearful, too proud, or too ill-informed to seek counseling.

Many are proud, the elder members of a self-reliant generation raised during the Great Depression who shun charity, shrug off pity and prefer to look after themselves.

“These are the people who pull themselves up by their bootstraps,” Pappas said. “When you’re losing control over your life, you will hang on to any shred of control you can. And if that means independence, you’re not going to ask for that help even though it might make your life less difficult.”

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Others cannot see past pop culture’s cartoonish view of mental health care, sensationalized in movies such as “The Snake Pit” and “One Flew Over the Cuckoo’s Nest.”

To these people, said therapist James Sheldon, counseling is not a boon to average folk with normal troubles. It is the front door of the loony bin.

Sheldon runs a coping group where aged people can offer each other advice and support in facing daily problems.

“They complain of bad health, they complain of the lack of money, they complain of not being given enough attention by their children. They complain of being lonely,” Sheldon said. “Oftentimes, they’re feeling useless.”

And they suffer from fear: “Fear of aging, fear of dying, fear of having a slow and painful death, being kept alive beyond the time that you want to be--that comes up a lot.”

Yet although counseling can help stave off depression and restore stability to daily life, Sheldon and other counselors say, it may take more strength to admit you need help than to go on suffering in private.

Too often it takes a crisis to push someone past their pride, to throw a spiraling elder into the arms of people who can help.

When Eleanor Chavez’s 34-year-old son died of cancer in 1977, she was wracked with grief. That was only the start of her troubles.

In 1979, the Ventura native was diagnosed with diabetes and had to start giving herself daily shots of insulin.

Osteoarthritis that had struck her at age 30 had eaten away some of her joints so badly that she could not walk. Surgeries in 1987 and 1988 replaced both her knee joints, but she still had to rely on an aluminum walker to get around.

Getting to the doctor’s office--barely two blocks away at the county medical center--was so painful that she began calling a cab for every visit.

By 1993, she had sunk into deep depression. She shut her family out, ashamed to admit her sadness, and she considered just giving up.

“I stopped taking my insulin, and I stopped taking my pills. I was just tired of the whole thing,” recalled Chavez, now 72. “I was thinking of just going to bed and staying there . . . There was a time when I closed the drapes and I wouldn’t answer the phone. I was thinking of ways that maybe I could . . ..”

She broke off in tears at the unbearable memory.

One day, in the kitchen, she recalled, it all caught up with her. Dizziness struck. She gripped the counter for support, then fainted to the floor in a diabetic shock.

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After a friend had Chavez rushed to the hospital, her doctors stabilized her, put her back on insulin, and got help through the county Public Health Department.

A counselor began coaching her to shoulder past her embarrassment at needing help, sort through her troubles and defuse her depression.

A public health nurse began visiting every morning to prepare her insulin shots and her meals. People came in to help with housekeeping and rides to the doctor. And all she had to do was ask.

Now Chavez takes more joy in life, in visits with her children and grandchildren. She gets out more, taking rides to the mall or the bank or to Ventura Community College to watch her grandson play football.

“I found out there is a lot of help out there,” she said brightly. “I have learned that even though you have had a tragedy in your life and you’ve lost your only son, that there is help there for you . . .. If I see someone, I tell them, ‘I’m doing so much better.’ ”

County social workers reach out to dozens of older people who are circling the rim of the vortex, and snatch them just before they get sucked in.

And despite increasingly difficult obstacles, dozens more agencies in Ventura County are willing to help older people, who need only ask.

“It’s a guarantee that if you have someone case-managing the person, they will not fall into the hospital and the emergency room nearly so often,” Pappas said. “Once you’re isolated and society goes on beyond you, you have no knowledge of where to even seek the help.”

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Agencies Helping the Elderly

These are some of the agencies that provide help for the elderly in Ventura County:

* For general information on any type of help, call the Area Agency on Aging, 652-7560.

* To report mistreatment of the elderly, call Adult Protective Services, 654-3270.

* If you are depressed, call Ventura County Senior Adult Services--West county, 652-7820; East county, 371-8300.

* For information on Alzheimer’s disease, call the Alzheimer’s Disease and Related Disorders Assn. of Ventura County, 643-2614.

* To volunteer help of any kind, call Betty Krause, the Vocational Opportunity Center for Active Living, 654-3361.

* If you want to work as a senior-to-senior counselor (nondenominational), call Aliza Berk, Jewish Family Services, 659-5144.

BY THE NUMBERS / Statistics that reflect on Ventura County’s elderly population:

Residents Over 65: More than 63,000

Residents Over 75: More than 20,000 (Projected 64% increase by 2015.)

Residents Over 85: More than 5,700 (Projected 163% increase by 2015.)

Elderly Who Live Alone: 11,711 Women

Elderly Who Live Alone: 2,638 Men

Self-Care Problems: 15,947

Severe Depression: 15%

Nursing Home Costs: $1,400 to $5,000 (per month)

Home Nursing Costs: $30 to $100 (per day)

Below Poverty Level: 7,700

Sources: 1990 U.S. Census, Area Agency on Aging, Alzheimer’s Disease and Related Disorders Assn. of Ventura County, Ventura County Department of Mental Health.