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.
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.
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.
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.
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 they are 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.
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 recently, the spiral ended two more long, otherwise rich lives.
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.
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.
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.