Many older adults need care but do not receive it. Often frail from chronic conditions such as Alzheimer's disease, diabetes, or arthritis, some need help bathing, dressing, or eating, while others need help taking medications, shopping for groceries, or preparing food. Although many older adults receive help from children, spouses, neighbors, or paid home health care providers, others have few people to whom to turn in times of need.
A recent study described Monica, an older woman who lives alone and suffers from decreased mobility, painful arthritis, and fatigue. She says: "Because of my breathlessness, I can't walk any great distances. I'm slower these days. I've got a walking stick now but it's hard to manage a walking stick sometimes. It's difficult getting groceries into my house, carrying the groceries up the stairs—I have to make several trips. I can't carry too many at a time now. But I haven't really got anybody that I could ring up and ask them to come. That's where perhaps I feel isolated." Bette, a married woman who cares for herself and her increasingly disabled husband, experienced acute back pain over a recent long weekend, and spent days waiting for an appointment with her primary care physician so that she did not have to go to the emergency room and leave her husband alone. She says: "I was writing something and the phone rang and I tried to get off the chair and I couldn't. The pain was excruciating and I couldn't get to the phone. I couldn't get off the chair. We couldn't get medical attention unless I went to the hospital. It was the May Day long weekend." Bette spent the entire three days in pain.