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Services Available for Orange County Families in Need of Help : Private counselors and county agencies can help guide people through a difficult time.

May 20, 1990|LYNN SMITH | TIMES STAFF WRITER

At 87, Charlie Hinton was the state shuffleboard champion; at 98, he was still a contender. Now 102, his vitality mainly shines through his eyes, which twinkle up at strangers he can barely hear.

His main caretaker is his wife Dorothy, who is 83. She cooks his meals, helps him into his walker and writes important reminders on a chalkboard. She also works three days a week to keep active and to bring in a few needed dollars. On those days, Charlie happily takes the bus by himself to adult day care.

With a little luck and a lot of gumption, the Garden Grove couple have managed to attain the goal of most older Americans: independence. Dorothy will tell you candidly that it isn't easy. For others, it can be much rougher.

In Orange County, as elsewhere, the older elder population (sometimes called the "old old") is mushrooming. In the 1980s, it is estimated the number of people over 60 grew from 221,584, or 11.5% of the county population, to 325,125, or 14.3%. The largest increase, 31%, was found among those 75 and older--the ones most likely to need outside assistance, according to the County of Orange Area Agency on Aging.

Only an estimated 5% are in nursing homes or board-and-care homes, while 15% are living alone but need social services, such as meals, housekeeping or transportation, or help with eating, dressing and bathing. About 65% live independently and 15% are living--almost always reluctantly--with one of their adult children, according to Le Ann Donaldson, director of community outreach at St. Joseph Hospital, which sponsors Project PACE, a psychological counseling agency for Orange County's elders and their families.

The county draws affluent retirees to the Leisure Worlds in Laguna Hills and Seal Beach, and to a proliferating new breed of full-service retirement hotels. But about half the senior population struggles to make ends meet with monthly Social Security checks of $550, social workers said. There are waiting lists up to six years for federally subsidized housing projects, although some non-subsidized apartments accept federally subsidized housing vouchers. Nearly every county program that assists the elderly, including nutrition services, is strained, often hindering people from doing what they want most: to grow older with dignity, in their own homes.

"People do best in their own environment," Donaldson said. But typically, she counsels adults with a parent--usually a mother--who can no longer live alone at home. Typically, the parent lives far away, has suffered a stroke or other health crisis, and is unable return home from the hospital.

"They sell her apartment and move her out here. She's mad. She wants to go back home, but there's no home to go back to."

Project PACE trains adult children to help their parents remain as independent as possible and offers support groups for them to deal with their own anger that may be lingering from childhood.

For the elderly who live alone--whose children are elsewhere, or the few who have been abandoned--a conservator such as geriatric social worker Maria Estrada may be appointed by the court. Founder of a Tustin firm, Senior Support Services, Estrada is sometimes called on to make decisions for people being kept alive on respirators and feeding tubes.

"Now people go on living and living," Estrada said. "They have all these antibiotics, cures, open-heart surgery. We don't let them go naturally with dignity."

People should specify in advance details such as whether they want doctors to take heroic measures or whether they prefer no care at home to a nursing home, she said.

"Every family has to face it. It's a rough question. But people need to think and talk about it," Estrada said.

Confronted with sudden debilitating illness, families are often bewildered by the maze of legal, financial and emotional problems of old age.

For fees ranging from $22 to $65 an hour, Estrada's counselors assess an elder's situation, including health, bills, transportation, social involvement and property; counsel families on role reversals and legal options; design a custom plan of care, and monitor the new situation--whether the elders remain at home with a nurse's aide, in a board-and-care facility, a specialized home for Alzheimer's patients or a nursing home.

Registries and agencies providing in-home care can be found in the Yellow Pages at fees ranging from $6 to $13 an hour, but non-medical custodial care is not covered by insurance. Low-income seniors may qualify for in-home support services from the county.

Resource, referral and monitoring are also available free from the Orange County Council on Aging's ombudsman, Pamala cq McGovern. She will provide background information--including citations and deficiencies found by state licensing officials--on board-and-care homes or nursing homes.

Although few of them probably chose it, 16,000 people are being cared for in 68 nursing homes and 375 board-and-care homes in the county.

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