Case Study #1: Mr Raffi Hagopian
Baltimore, Maryland: The winter sun strained to enter through the
grimy window of the eleventh floor studio apartment where Raffi
Hagopian, seventy-nine, was beginning to awaken underneath the broken
acrylic electric blanket which barely insulates him from the fifty-five
degree temperature in the room.
For Mr. Hagopian and millions of
other elderly poor who survive on meager social security checks, this
is the most risky time of the month--the week before the next check
arrives and when this month’s money is completely gone.
Until the next check arrives in
five days, Mr. Hagopian has no clean underwear or shirt or pants to
change into. His towels and sheets are also soiled, rendering them
unusable for the moment. His coins for the laundry were used up a
His only food is packets of fast
food condiments—mayonnaise and mustard and cellophane wrapped hot
sauce. His only appliance is a used one-burner hot plate. There is
no stove or refrigerator in the room. Down the hall, the sink and
toilet and single shower are shared, in turn, by his neighbors who
are mostly young couples with small children. Dressing quickly, he
knows that the cold air in the room will further irritate his sore
throat and watering eyes. He is embarrassed by his need to go to the
neighborhood dining room where he will receive yet another donated
meal and have to ask the volunteers for permission to use the bathroom’s
hot water, hand soap, and paper towels in order to clean himself.
An introvert by nature, Mr. Hagopian
is a prisoner of his own shyness, who has survived adversity with
a tenacious independence. His only socializing is intermittent and
casual with the teenage volunteers and members of their parents’ generation
at the neighborhood church dining hall. Yet, there has never been
an occasion when he has felt comfortable asking these well-intentioned
volunteers to help him problem-solve his basic need for services and
information. And his only occasional appearance at the dining hall
makes the church’s outreach more difficult to achieve.
Ironically, Mr. Hagopian worked
his entire adult life, supporting a wife and son (both of whom died
in the 1970s) until a work-related disability forced his retirement
at age sixty-seven. He rarely received health benefits from his employers,
and since his retirement he is unfamiliar with how to access medical
services, including physical therapy needed for his disability. He
has not had his eyes examined, his teeth cleaned, or a physical examination
for more than fifteen years. He is reluctant to use the city bus system
for fear of becoming lost or disoriented if he leaves these familiar
surroundings. He fears for his safety when ever he goes out at night.
Like many of his generation, Mr.
Hagopian’s isolation is a result of several factors, including a rugged
individualism honed by years of blue collar work ethic and an aversion
to asking for public assistance of any kind. Yet, his current living
situation is unmanageable without some intervention that will provide
medical, nutritional, and other essential services to which he is
entitled but is not currently receiving.
Case Study #2: Mrs. Laura Templeton
Vallejo, California: In the “gray
ghetto” of the largely deserted town center, the seventy-three year
old former employee of the C & H Sugar refinery worries that her
meager pension will not keep up with the rent increase she expects
for her hotel room. Mrs. Templeton is a recently widowed retiree whose
savings were depleted along with her home equity in order to keep
her husband, who suffered from Alzheimer’s disease, at home in her
care until his death.
Hoping to find at least part-time
work to supplement her income, she moved from the company town of
Crockett, CA, to nearby Vallejo in the late 1980s. However, the city’s
economic prosperity was critically depressed with the closure of its
principal employer—Mare Island Naval Shipyard—a San Francisco Bay
Area naval installation which had employed thousands of skilled workers
on a 24-hour schedule. Its closure closely coincided with her relocation
and eliminated her prospects of finding work as a housekeeper or child
care provider for one of the many two-income Mare Island families
with small children. Now, she is stuck in a downtown area that has
lost many of its small businesses to which Mrs. Templeton could walk
from her apartment.
She faces a whole new set of challenges:
the unpredictability of this place and a lack of knowledge of how
to access the services that might guide her through this time of transition
toward independence. In fact, the city has moved its offices away
from the center of the downtown in order to meet the needs of families
in neighborhoods to the east of the interstate highway that divides
old town from new developments. There is public transportation; however,
Mrs. Templeton is confused by the system and afraid of becoming lost
in one of the more volatile neighborhoods to the north of the town
She often skips meals rather than
going out alone at night. The prices and quality of food in the neighborhood
convenience markets limit her ability to shop for a balanced diet
and to budget her money for other purposes. Mrs. Templeton is isolated
and invisible to those who might have services to address at least
some of her needs.
Case Study #3: Mr. Jose Flores
Chimayo, New Mexico: As a young
child in the 1920s, Mr. Flores emigrated from the Philippines along
with his father, uncle, and two older brothers. Although he has a
working knowledge of English, Mr. Flores never received formal schooling
in either Tagalog or English; therefore, he is reluctant to sign anything
he cannot read or to reveal to strangers the extent to which he is
Instead of attending school, Mr.
Flores worked in the agriculture fields of the American Southwest,
moving constantly from rural farm to orchard across six states in
a seasonal cycle that made one year blend seamlessly with the next.
Over the years, he has picked everything from tomatoes and strawberries
to pecans and cotton.
Due to the Asian exclusion acts
and other discriminatory practices in the 19th and 20th centuries
that forbade Filipino workers from marrying outside of their own culture
and the immigration policies which made it nearly impossible to unite
separated families or to allow for unmarried females to enter the
country, Mr. Flores never married. In fact, he lost contact with many
relatives due to his lack of formal education and the missed opportunities
for written communication.
The years of abusive working conditions—the
lack of sanitation and nutritious food, the rigors of stoop labor,
and the exposure to pesticides in the field—have taken their toll
on Mr. Flores’ overall health and sense of well-being.
He is reclusive, living alone on
land that is physically near an urban center, but the layout of Santa
Fe is just too confusing for him to access. His small savings will
not keep him warm and fed for more than another year.