Rose D'Agostino can still tackle a sink full of dishes at age 100. It's the bathtub that scares her.
Climbing inside is dangerous; cleaning it is impossible.
"I would like somebody to help me bathe, because I'm afraid of falling," said the Spring Hill resident, who stopped cutting her own lawn only two months ago. "They have a waiting list, but in the meantime they would find me dead in the tub."
Social workers in Hernando County are deluged with requests for help from a growing number of elderly residents such as D'Agostino _ people clinging to their independence even as simple household chores become perilous.
The number of people older than 75 in Hernando soared during the past decade _ from 9,736 in 1990 to 18,981 in 2000 _ one of the fastest rates of growth in Florida for the oldest age categories, according to figures released recently by the U.S. Census Bureau.
The percentage of older residents is climbing: People 75 and older jumped from 9.6 percent of the county's total population in 1990 to 14.5 percent in 2000, census numbers show.
But county social services cannot keep up to ease the problems of elderly residents. A shortage of funds and workers to help seniors in their homes leaves them vulnerable to self-neglect or accidents that land them in hospitals and nursing homes.
"People have no idea what (seniors) out there are living with," said Francine Ward, director of programs and operations for Mid-Florida Community Services Inc., a non-profit agency that handles a large share of programs for the elderly in the county.
That includes respite care for spouses taking care of sick loved ones, transportation assistance, meals, home care and personal care. But seniors have to qualify financially to receive public aid for some of the help, and waiting lists for some services hold several hundred people.
"We're stretched," Ward said.
"I think the situation with the older elders is that many times they have lost any support they may have had through (the death) of neighbors or friends," she said.
"The amount of help you provide in a home with someone who is 65 with minimal health problems is not going to be enough with someone who is 88. . . . Any kind of chronic health problem worsens with age, and there's a much higher percentage of people experiencing dementia. That puts them at risk if they are alone or isolated. Falling is a big deal; it's a real danger."
Alone for the first time
Like D'Agostino, other retirees moved to Hernando County in droves during the past 30 years. Plots were cheap, and housing was plentiful. They made new friends and honed their golf and tennis games.
But as the years passed, spouses fell ill and died. So did friends and neighbors. Nest eggs dwindled in the face of high prescription drug costs and medical bills. Vision failed, and bones began breaking.
Now hundreds, possibly thousands, of residents face life alone for the first time, sometimes unable to cook for themselves, cut the grass or drive to the store. Children live miles away or out of state. Help is hard to find or too expensive.
D'Agostino counts herself lucky. Despite her age, the white-haired widow takes no medications. But it's getting harder to care for the house she bought 31 years ago when she followed friends here from Long Island, N.Y., years after her husband died.
The proud native of Italy dotes on the marigolds and roses that dot her lawn but pays for workers to cut the grass and fix broken sprinklers. A social worker visits once a week for two hours to run the sweeper or clean the tub. D'Agostino appreciates it, but it's not enough, she says. And no one is available to help her bathe.
Determined to stay active, she fixes her hair and puts on dancing heels once a week for a trip to the Enrichment Centers Inc. at Oak Hill Hospital. But if her health gets worse, she doesn't know how she would pay to move into an assisted living facility. Meanwhile, she makes do on her own, hoping to avoid a repeat of a few years ago, when she fell while picking up the morning newspaper. She crawled back into her house and called for help.
"A lot of people I met here 31 years ago are gone. They either moved or died," she said. "Sometimes I wonder if I belong here anymore. But where can I go?"
Who will help?
The caller was frantic. The woman from Tennessee worried about her father, an 85-year-old resident of Hernando County living by himself with no one to care for him.
"Who do I call? What do I do?" she asked Jean Rags, the county's social services coordinator.
These types of calls, from children checking on their aging parents, continue to increase, officials say, reaching between 25 and 40 a week at the Enrichment Centers Inc. at Oak Hill Hospital.
Left on their own, many seniors make too much money through pensions or Social Security to qualify for public aid, but not enough to afford personalized care in the home. Often, when one spouse dies, the other can no longer afford the mortgage or upkeep on the house, Rags said.
Also, spouses caring for loved ones with Alzheimer's disease or other illnesses often become sick from stress or fatigue and need help themselves.
"If they don't get the services, they are going to get worse and they're going to die," she said.
Children of seniors should not be the only ones worrying, Rags added. The entire county pays the bill when seniors end up in the hospital or nursing homes, both of which are far more expensive than home care or assisted living facilities.
This year, the state requires the county to pick up $750,000 in shared Medicaid expenses for hospital and nursing home patients, the majority of which goes for care of seniors, Rags said. That amount is expected to increase by $100,000 next year.
"Is there going to be a drain on the system? Yes," she said.
The other option is for young families to move ailing parents into their homes, she said.
"It's a growing concern of my generation," she said. "There aren't a lot of people that have the ability to quit work to sort that out. That's a very difficult decision for anyone to make."
Cost of care is excessive
The fall was the final straw. When Rose O'Dell slipped and hit her head three years ago at age 97, her family began looking at assisted living facilities.
What they found were prices topping $1,000 a month, said O'Dell's daughter, Marjorie Luccarelli.
Only the veterans benefits O'Dell receives because of her late husband's and deceased son's service in the military enabled the family to afford Forest Oaks Care Center in Spring Hill, which charges $1,100 a month, Luccarelli said.
Now 100, O'Dell, once known as the "shuffleboard queen" at Clover Leaf Farms in Brooksville, has near-constant care.
Luccarelli thinks she and her husband, both in their 70s, would have had to move her mother into their home if not for the military benefits because of the high costs of assisted living. But they are busy raising and racing horses, and would have struggled.
"If I had gotten up to do something for the animals, she would have followed me. Before I knew it, she would be outside, and we have steps," she said. "She would have fallen.
"I'm positive she would not be alive today if I had not been able to put her in assisted living."
Catering to the growing population of elderly residents, the number of state-licensed assisted living facilities in Hernando County has doubled since 1996, from six to 12, according to the Florida Agency for Health Care Administration.
Also growing is the number of people who cannot afford to live in them, said Jamie Dees, marketing director of Forest Oaks and whose parents own the center. They opened the center in 1988 when Dees' grandparents needed more assistance.
Their charges usually run between $1,350 and $2,500 a month, Dees said. The reason for the high prices in the industry is the surge in liability insurance, which costs the center $400,000 a year _ up from $40,000 just two years ago, he said. A British native, he is shocked that more is not done by the government to help this generation of senior citizens.
"We're a European family and used to socialized programs," he said. "We've always perceived that this is a generation that was asked to sacrifice the most when we needed it the most, and now it's our obligation as a society to come through.
"You see a lot of people living longer than their moms and dads, thanks to modern medicine, and living beyond their means. This has got to be addressed."
An emotional, financial drain
In fact, major initiatives are under way by the Hernando County Commission's Elder Affairs Committee to obtain a national grant of up to $200,000 to help establish an adult day care center locally.
The center would provide care and congregate meals for seniors who need more attention than those involved in social activities available at hospital-sponsored enrichment centers.
"What you could look at is a person taking their loved one to an adult care program and then going to the enrichment center to play cards," said county Commissioner Betty Whitehouse, who spearheaded the committee.
Also in the works are plans for a bus transportation system, Whitehouse said, and a booklet informing seniors where they can obtain reliable services.
"As you look at these statistics, what we need is the community to be involved," she said.
Social services officials say Hernando needs more volunteer programs or companion services from neighbors, churches and other groups to help seniors remain active and happy in their own homes for as long as possible.
A family friend was the salvation for Charles Fontana, 83, of Spring Hill while his wife suffered with Alzheimer's disease for 12 years. June Fontana died in February. During her illness, social workers, paid for by public aid and brought in through Mid-Florida Community Services, helped bathe and feed his wife. Though the assistance preserved his sanity, Fontana said, a family friend staved off his heartache.
"It can be a very lonely time," he said.
When Fontana endured quadruple bypass surgery, he had to hire full-time help, draining him of $10,000.
"In addition to losing her companionship and everything else that goes with it, we had the financial drain as well," he said.
Fontana said he agrees that more help in the homes of seniors is necessary, including a companion service to help the elderly avoid becoming depressed during ordeals like his.
"When you talk about being alone," he said, "that defines it."
_ Staff writer Saundra Amrhein covers business and development in Hernando County and can be reached at 848-1434.
Counting the County Census 2000
Hernando County's elderly population grew at a faster rate than any other age group in the county during the past 10 years. In fact, the Hernando growth rates for the 75-84 nad 85+ age groups ranked fifth and fourtho respectively among Florida's 67 counties.
Age group 1990 2000 % Change
75-84 8,193 15,547 +89.9%
85+ 1,543 3,434 +122.6%