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 week ago.

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 center.

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 illiterate.

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.