David Friedman / NBC News

Kathleen Campbell, 85, stays with her daughter's family in Hawthorne, N.Y., while she is displaced from her home in Breezy Point. Campbell's daughter Ann Marie Pawlowicz, and granddaughters Kalina, 16, and Julia, 8, play with the family dog in the background.

Kathleen Campbell has had a bad night. It’s nothing a cup of fresh brewed tea won’t fix, but Campbell, 85, likely faces many more less-than-comfortable nights on her daughter’s living room sofa.

Just three months ago, Campbell was riding her three-wheeled cycle on the smooth and level streets of Breezy Point, a cheerful and close-knit community at the far end of the islands called the Rockaways in Queens. Now she is shuttling among three houses – her daughter Ann Marie Pawlowicz’s 1890s home in Westchester, N.Y., another daughter in New Jersey and her sister’s home near Philadelphia.

Campbell’s lifestyle is one of the many casualties of Superstorm Sandy, which sent floodwaters surging through homes when it hit Oct. 29, damaging more than 2,000 homes and starting a fire that burned more than 100 houses to the ground. The beachfront village, whose population plummeted from 12,000 in the summer to around 4,000 the rest of the year, provided a way of life not often seen in the sprawling suburbs of most cities. Generations of the same family jealously guarded their modest homes, and they took care of their own.

Like so many other elderly residents there, Campbell could “age in place”, living alone after her husband died in 2009, despite a heart condition and the onset of what might be dementia. It’s a concept that many communities have embraced, and that groups like the AARP and the National Council of State Legislatures are encouraging.  When people age in place, they stay in their homes, perhaps adapting them for more limited mobility, rather than moving to elder care facilities. And it’s a way of life that seems to have just evolved naturally in Breezy Point.

“It’s not uncommon to have three generations living within blocks of each other. It did offer that kind of stability and smalltown closeness,”says Msgr. Michael Curran of St. Thomas More Catholic Church, the main church on Breezy Point’s main drag and one of the places residents sheltered during the height of the storm.

Campbell’s house on Reid Avenue was completely flooded when Sandy hit. “It was like the ocean meeting the bay in your living room,” says Pawlowicz.

The house, which Campbell's late husband, Charlie, built in 1990, is on the first road to the left as you enter Breezy Point. Shelves at her house, filled with carefully catalogued photo albums, were soaked when the floodwaters filled the home. Campbell lost almost everything but the small suitcase she took with her when she fled to Pawlowicz’s home to wait out the storm.

Courtesy of Ann Marie Pawlowicz

Kathleen Campbell rides her tricycle in Breezy Point, N.Y., on Sept. 27, 2012.

Campbell was once a fixture of the community as she rode up and down the narrow alleys on her tricycle. Now it sits rusting in her empty, mudstained house.

The Westchester hamlet of Hawthorne where Pawlowicz lives doesn’t have many level streets. Its Victorian, Craftsman and Care Cod homes are tiered one above another along streets built into a steep, rocky hillside.

“I miss riding my tricycle,” says Campbell in a soft Irish accent. “I was on it twice a day.”

Although Campbell is clearly enveloped in the loving arms of her family, her independence is gone. “She felt safe,” Pawlowicz says. “Even though she has a touch of memory issues.” She sleeps on the sofa because she is uncomfortable with stairs.

Within walking distance to many Breezy Point homes in the 500-acre cooperative were a bank, auto repair shop, the Blarney Castle pub and Deirdre Maeve's Supermarket and, perhaps most important for Campbell, St. Thomas More Church. Most remain damaged and closed months after the disaster.

Breezy Point had naturally what states like Georgia and New Jersey have been spending money to develop – safe, walkable neighborhoods with homes friendly to arthritic bodies.

A survey AARP did in 2008 of Americans over age 50 showed more than half would like to walk, bike or use public transportation, but nearly 40 percent complained about a lack of sidewalks and safe crossings, bicycle lanes or safe places to catch the bus near their homes.

'A hidden little gem'
At Breezy Point, three of Campbell's cousins and a neighbor used to regularly look in on her, making sure she ate her meals and keeping her company. Now they're all displaced too.

David Friedman / NBC News file

Veets Pawlowicz, second from right, is aided by a gang of family, friends and even volunteering strangers as they clean up his mother-in-law Kathleen Campbell's house on Nov. 2, 2012, in Breezy Point.

“I feel like a lot of the neighbors looked out for each other. It was a very simple life. It was great,” Pawlowicz adds as she sets a cup of tea in front of her mother. “It’s all gone now.”

Pawlowicz, 41 and the mother of two girls aged 8 and 16, finds herself a member of the “sandwich generation” – trying to juggle her job as a nurse with raising children and caring for an elderly parent. On weekends she and her husband, Witold, make the hour-long drive to Breezy Point to try to rip out drywall and salvage what belongings they can in Campbell’s home. It’s not clear what it will take to rebuild.

“We have pumped out the basement like 35 times. Whatever happened with this storm, it shifted everything. Now it’s like it’s on a spring,” Pawlowicz says. Getting insurance sorted out has been a chore for many Breezy Point owners.

“I haven’t been back to see it yet. Please, God, let’s get back there,” Campbell says.

“Not now, Mom,” Pawlowicz answers gently. “It’s a ghost town.”

The seaside neighborhoods in the Rockaways are among the last to recover from Sandy. Breezy Point is nowhere close to being back to normal. Empty foundations yawn open on the blocks that burned. Elsewhere, houses remain shifted off their foundations. There is still no electricity, so almost everyone clears out as the sun sets. Breezy Point is the last New York neighborhood left without clean water.

Like Campbell, many long to go back home. But for seniors, that will be especially hard, even with family support. “It is going to be tough for an elderly person living alone in a badly damaged home to get that home restored,” says New York’s health commissioner, Dr. Thomas Farley.

Curran tries to remain in touch with the seniors who are now scattered to new homes. They're resilient, he says, but "late in life it’s a big adjustment that folks are making.”

Just as they found their own solution when the community was whole, the elderly of Breezy Point have found their own solutions to being homeless. “Most people were able to find a family member or a friend they could move in with and have their needs met,” says Curran, who now commutes himself to attend to his duties at St. Thomas More.

Many families don’t want to talk publicly any more about their situations – a man who moved his elderly father to Dallas, a family who brought their aging parents to Long Island. “I was just talking to a couple – they took their parents in, they are safe,” says Curran. “But they are 85-plus and this is the first time they have ever lived in an apartment.”

Campbell misses the beach, but she doesn’t complain. “We’re on top of the hill,” she says, smiling as she gazes around her daughter’s antique-filled home. “It’s beautiful.” But she mentions again that she misses her tricycle.

“I always say everyone should have a touch of dementia during a disaster,” says Pawlowicz. “The best thing about dementia – my mother laughs. We have been able to cry a little bit, but nobody died.”

Related stories:

• Sandy-struck Breezy Point facing 'greatest historical challenge'
• Confusion in the storm: Alzheimer's patient refused to evacuate
• Elderly sisters find time to laugh after Sandy
• Temporary housing will never be the same post-Sandy

By Maggie Fox

The Supreme Court upheld President Barack Obama’s health reform law on Thursday, with conservative Chief Justice John Roberts making up the surprise swing vote and writing out a road map for making the law work.

It is of course a big victory for the Obama administration. But it’s not the end of the story, not by a long shot. Even if everything goes smoothly, many important provisions don’t go into effect until 2014 and later. And Republicans, from presidential hopeful Mitt Romney through to members of Congress and governors of close to half the states, renewed their promised on Thursday to fight tooth and nail to either repeal the law or at least chip away at it.

"Today's decision makes one thing clear: Congress must act to repeal this misguided law,” Senate Minority Leader Mitch McConnell, a Kentucky Republican, said Thursday.

More than half the states have been gambling that the law would be struck down and have done little or nothing to put into effect one of the law’s main provisions – the exchanges, where people are supposed to be able to go online and get enough good information to choose a health insurance policy. They’re scheduled to be up and running by 2014. The Health and Human Services Department says 34 states have taken money to set up exchanges.

And HHS hasn’t finished making all the rules clear for how to put the full law into effect, and doesn’t have all the money and staff it needs to do that work. The November elections will be very important for determining whether Congress helps or hinders this effort.

Plenty of provisions look set to move ahead. They include changes meant to make doctors provide more effective care. Starting in 2015, doctors will get paid for keeping patients well, not necessarily for every test or procedure. That means, in theory, that a doctor will get paid the same by Medicare or Medicaid whether she gets a patient’s blood pressure down by prescribing drugs or by persuading him to lose weight and exercise.

Accountable Care Organizations will also continue to be created. These new organizations are meant to encourage cooperation by grouping independent care providers such as doctors with hospitals. And the trend toward consolidation is likely to continue no matter what happens with the health reform law – something that, in theory, will make it easier to connect patients with specialists, for instance.

Rules that stop insurers from what the government considers abusive practices also stay in place. “Insurance companies can no longer impose lifetime limits on the amount of care you receive. They can no longer discriminate against children with preexisting conditions,” Obama said in Thursday in response to the ruling. “They can no longer drop your coverage if you get sick. They can no longer jack up your premiums without reason. They are required to provide free preventive care like check-ups and mammograms -- a provision that's already helped 54 million Americans with private insurance,” Obama added.

“And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses, and not enough on your health care.” The Health and Human Services Department checks insurance plans to make sure they spend at least 80 percent of premiums on direct health care.

Small businesses will still get tax credits to help pay for health insurance for workers and people who retired at age 55 can get special insurance to hold them until they turn 65 and become eligible for Medicare.

Poll: Do you agree with the Supreme Court ruling on health care?

The controversial requirement that insurers and employers pay for all contraceptive care free of charge to women will also stand.

One group has an uncertain future – poor people without children. The Supreme Court ruling struck down the requirement that states expand Medicaid to about 16 million people who make less than 133 percent of the federal poverty level, or about $30,700 for a family of four. Many states currently offer Medicaid mostly to pregnant women and children, but poor adults are often not eligible. The health care law did require states to broaden that and the federal government was going to pay for almost all of it starting in 2014 and would pay more than 90 percent through 2022.

The ruling says states can’t be forced to do this, and now it’s not clear which states might decide not to.

 More on health care ruling:

Supreme Court upholds health care law

Thrilled and relieved, sick patients cheer court ruling

Health reform is legal, but is it moral? Bioethicist weighs in