Lifestyle

When an older neighbor recedes from view, is calling the authorities moral — or meddling?

 Nahant letter carrier John Uva regularly checks in with Tom Loftus. He called 911 once when Loftus didn’t recognize him

Kieran Kesner for The Boston Globe

Nahant letter carrier John Uva regularly checks in with Tom Loftus. He called 911 once when Loftus didn’t recognize him

Billerica police Officer Ivonne Osgood works as a liaison to the town’s Council on Aging, and when she’s sent out to check on the well-being of an older resident in town her first thought is: “I hope they’re not dead.”

That’s a fear familiar to everyday residents, too, when an older neighbor recedes from view. Neighbors begin to wonder if calling the authorities is a moral imperative — or meddling.

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“We have a society where people live pretty independently, and there may be times where people don’t want to step on others’ toes,” said Emily Shea, Boston’s commissioner of elderly affairs. “Taking that responsibility can be a scary thing.”

To call or not to call is typically a quandary people wrestle with privately. But the issue became news recently when the corpse of a woman in her mid-60s was found under her kitchen table in a dilapidated house in Brookline.

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Lynda Waldman, 74, and her younger sister, Sheryl, who later went by the name Hope Wheaton, had lived a reclusive life for decades in their 4,000-square-foot home. Last year, concerned neighbors began calling the authorities, but by the time anyone got inside the house, the younger sister may have been dead for a year.

An autopsy report is pending, and no charges have been filed against Waldman. Meanwhile, the house at 122 Clinton Road has been condemned.

About 2,300 cases of elder abuse are reported every month to the Protective Services Division of the state’s Executive Office of Elder Affairs.

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That includes reports of self-neglect — when a person stops bathing or eating or taking care of medical conditions — along with physical and financial abuse by others, said Mike Festa, AARP’s Massachusetts state director and a secretary of elder affairs under former governor Deval Patrick.

Festa and other experts fear that problem will only grow as the population ages, and societal factors — including a growing push to keep people out of nursing homes and in the community, far-flung families, and less contact with neighbors — further isolate vulnerable people.

Festa used himself as an example to illustrate the challenge of motivating concerned neighbors to look for signs of trouble.

“I’m a very social animal,” he said, “but the truth of the matter is that unless I work at it, I don’t know enough about my neighbors.”

Len Fishman, director of the Gerontology Institute at University of Massachusetts Boston, says the best way for society to help faltering elders who live alone is to connect them with each other and with community programs. “But as hard as we may try,” he said, “there are certainly folks who fall through the cracks.”

Even so, he and Festa said, Massachusetts compares well with other states. Massachusetts offers more subsidized housing for seniors, spends more to help frail older adults continue to live in their homes, and offers a strong network of services.

Fishman noted that Massachusetts is fifth in the nation in Medicaid spending on aged adults ($21,129 per enrollee compared with the national average of $13,249), according to a federal fiscal year 2011 report by the Kaiser Family Foundation, the most recent available.

Additionally, Fishman said, MassHealth spends two-thirds of its budget on home- and community-based services and one-third on nursing home care compared with a national average of approximately 50-50.

But, he emphasized, “much more progress is possible — and necessary.”

Many seniors, of course, take matters into their own hands, working to ensure they have an informal support network. In Lexington, Patty Maier, 82, a retired high school English teacher, made a plan with another woman to call each other every morning.

“We said, ‘How are you?’ ‘Fine.’ ‘Nice talking to you,’ and that was it,” she said.

The calls lasted for about nine months but then stopped.

“One goes in and out of moods — now it doesn’t seem like anything that I’d worry about,” said Maier, a member of Lexington at Home, a social support network that helps members age in place.

One problem is that neighbors who might want to take action because a house or its occupant looks increasingly run down aren’t always sure what to do. The AARP’s Festa spelled out options clearly.

“The first thing you have to address,” he said, “is what is the nature of the concern?”

If you haven’t seen your neighbor in a very long time but know she hasn’t left town, he said, “that is a potentially an emergency.” Call the police.

If it’s an ongoing situation and the place is getting run down and it doesn’t look as if the person is taking care of herself, call the state’s elder abuse hot line. That’s 800-922-2275.

“If you suspect financial harm — if your neighbor says something like ‘I just lost money,’ or ‘I don’t have any money,’ that is also a hot line call,” Festa said.

What does it feel like to make a call? In Natick, Maura Gaughan felt so uncomfortable that she left work and used her cellphone in her car so colleagues wouldn’t overhear her.

She was calling about a man across the street. Mail piled up on his front steps, trash filled his yard, birds flew into holes in his roof. Word in the neighborhood was that someone had gone to check on him but he didn’t answer the door.

“I didn’t want to seem like I was judging his lifestyle,” said Gaughan. But not calling also felt wrong. “Maybe he was inside in distress.”

By the time she took action, the man had already been hospitalized. “Fortunately he survived,” she said. “But it was very stressful.”

The sad situation of a frail or sickly person living alone and faltering puts emotional strain on everyone involved, including the people sent to knock on the door.

In Billerica, it makes Officer Osgood think about the particular sadness of dying not surrounded by friends and family. “If you’re dead and no one misses you for a week, then what kind of life did you have when you were alive?”

In Nahant, letter carrier John Uva feels the weight of his duties. Before delivering mail on a recent morning, he recalled a situation with a 94-year-old man on his route. He regularly checks in, but one day the man didn’t recognize Uva.

“Tom, you’re scaring me,” Uva told him.

He called 911. The man had had a small stroke and recovered quickly.

“Now I joke with him,” Uva said. “I tell him, ‘Tom, if I come in here someday and you’re dead, I’m going to kill you.”

Where to report concerns about elders

Concerns about elder abuse or neglect can be reported statewide to the Elder Abuse Hotline 24 hours a day: 800-922-2275

Regarding elders residing in the city of Boston, one can also file a report with Central Boston Elder Services during business hours: 617-442-4200º

For questions regarding elder services, other than reports of abuse or neglect, call 800-AGE-INFO (243-4636)

If you fear an emergency, call the police: 911

Uva looks out for the elderly residents on his route in Nahant.

Kieran Kesner for The Boston Globe

Uva looks out for the elderly residents on his route in Nahant.

Beth Teitell can be reached at beth.teitell@globe.com. Follow her on Twitter @bethteitell.
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