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:

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• Elderly sisters find time to laugh after Sandy
• Temporary housing will never be the same post-Sandy

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By Judith Graham
Kaiser Health News

Large numbers of seniors aren’t receiving recommended interventions that could help forestall medical problems and improve their health, according to a new survey from the John A. Hartford Foundation.

Notably, one-third of older adults said doctors didn’t review all their medications, even though problems with prescription and over-the-counter drugs are common among the elderly, leading to over 177,000 emergency room visits every year.

Falls cause over 2 million injuries in people age 65 and older annually, but more than two-thirds of the time doctors and nurses didn’t ask older patients whether they’d taken a tumble or provide advice about how to avoid tripping on carpets or slipping on the stairs, the Hartford poll found.

Similarly, depression can cause people to become socially isolated, suicidal, or stop taking care of themselves, but 62 percent of seniors said doctors and nurses hadn’t inquired about whether they were sad, depressed or anxious.

The results, which cover a period of 12 months, speak to doctors’ and nurses’ lack of training in geriatric medicine.  Providers need to recognize that “care of an 80 year old differs from that of a 50 year old,” said Dr. Rosanne Leipzig, professor of geriatrics at the Mount Sinai School of Medicine in New York. But too often, this doesn’t happen.

Seven interventions examined in the Hartford study are part of Medicare’s annual wellness visit, which became a no-cost benefit available to all seniors in the government health program in January 2011.  Yet 54 percent of older people surveyed by the foundation had never heard of the Medicare wellness visit while another 14 percent weren’t sure if they had.

Only 2.3 million seniors out of a total 35 million with traditional Medicare coverage took advantage of wellness visits last year, according to government data.  Medicare pays doctors about three times their ordinary office visit rate for asking about older adults’ ability to function, evaluating their mood, recommending preventive services, and connecting them with community resources during wellness visits.

“These are low tech, low cost interventions that are easy to do and that can have a huge impact on an older person’s medical care and their quality of life and function.  But too many providers and older adults don’t realize they’re important,” said Dr. Sharon Brangman, chairwoman of the board of directors of the American Geriatrics Society and professor of medicine at SUNY Upstate Medical University.

Christopher Langston, program director at the Hartford Foundation, said older adults should schedule a Medicare wellness visit and talk to their doctors about recommended preventive care.  The Rand Corp. has found that only 30 percent of older adults get care supported by medical evidence, compared to 55 percent of the general population, he noted.

Still, despite gaps in care uncovered, 97 percent of respondents reported being satisfied with their primary care providers.

The mission of the Hartford Foundation is to improve the health of older adults.  Its survey, released Tuesday, asked 1,028 people age 65 and older between February 29 and March 3 about their experiences with care. The study was conducted online by Lake Research Partners and had a margin of error of +/- 3.1 percentage points.

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Seniors do just fine catching their zzzz's, a new study reports. In fact, compared to seniors over the age of 80, men between 18 and 24 are twice as likely to report sleeping problems.

Contrary to popular belief, healthy seniors have no problem getting a good night’s rest, a large new study shows.

In fact, researchers found that many seniors actually report better sleep than your average 20- and 30-somethings, according to the study published Thursday in the journal Sleep.

The bottom line is that sleep problems aren’t a part of normal aging and can be a sign of health problems,  said the study’s lead author Michael Grandner, a research associate at the Center for Sleep and Circadian Neurobiology at the Perelman School of Medicine at the University of Pennsylvania.

“This study shows that older people are not more likely to complain of sleep problems or daytime tiredness, relative to younger people, if you take demographics, socioeconomics, health, access to care, and depressed mood out of the equation,” Grandner said.

When an older person complains of sleep issues, it could be a sign of health issues, he said. "Sleep is a vital part of overall health, and ignoring sleep problems, especially in older people, is placing them at increased risk for poor health and outcomes down the road.”

Grandner and his colleagues questioned 155,877 randomly chosen adults in a phone survey that asked about sleep disturbances, daytime tiredness, as well as race, income, education, depressed mood, general health and date of last medical check-up.

To get a handle on how folks were sleeping, the researchers asked: “Over the last 2 weeks, how many days have you had trouble falling asleep or staying asleep or sleeping too much?” and “Over the last 2 weeks how many days have you felt tired or had little energy?”

When the researchers took health and depressed mood into account they found that people reported increasingly better sleep as they grew older – except for a brief decline in mid-life. That mid-life decline was worse for women than men. Grandner suspects menopause may be behind women's mid-life sleep issues but noted that since sleep started to worsen even before then, the stress of work and raising children may be partially to blame. "For men, workplace issues may also be a likely culprit, as that age is associated with peaks in heart disease risk, stress, and sleep apea," he said.

Compared to seniors over 80 years old, men between the ages of 18 and 24 were twice as likely to report problems sleeping. Among women the differences weren’t as large. Compared to seniors over 80, women between 18 and 24 were 1.61 times as likely to report problems sleeping.

This doesn’t prove that seniors are sleeping better, Grandner said. It’s just as likely that sleep problems bother them less. “In my mind, the most likely reason is that actual age-related changes in sleep don't consistently produce the level of discomfort as they would in a younger person,”

Beyond this, there just may be generational differences.

“The generation of people in that age range [seniors] may me more likely to take a stoic attitude towards symptoms,” Grandner said.

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