Sometimes, it comes down to hard choices:
Eat and shiver in the night, or pay for the heat and go hungry.
Pay the rent and do without health insurance, or don't give the landlord his due and worry whether you'll have a home.
Buy the medicine the doctor says you need to stay alive and worry about the end of the month when it comes, or hope and pray the doctor's wrong.
Give up most of your life's possessions and savings so the government will foot the bill for a nursing home, because you can't afford to pay anyone to help you with simple tasks at home.
Or live in a house that becomes a prison, with steps you can no longer climb, a bathtub you can no longer get into, a kitchen where you can no longer cook.
Nobody plans it this way.
Nobody plans to end up isolated, alone, wondering how to stretch the money until the end of the month, wondering if anyone anywhere cares, wondering, at times, whether it's worth going on.
You work a lifetime, you expect better.
These, after all, are the golden years.
Or are they?
Not by any measure for more and more of the elderly people of Anne Arundel County, where state forecasts show the senior population growing faster than anywhere else in Maryland.
Indeed, interviews with dozens of seniors, their advocates, officials at public and private social service agencies, health-care experts and housing officials reveal a disturbing consensus: Like never before, explosive growth in the number of seniors is overwhelming the limited resources available, and the gaps likely will widen considerably in the coming years.
Already, Arundel's mushrooming elderly population has led to acute shortages across a broad spectrum of basic needs: housing in every price range; in-home care ranging from help with daily tasks like bathing and cooking to skilled nursing; beds in county nursing homes; health aides and nurses to care for the aged; transportation; adult day care.
Moreover, staggering growth in the elderly population in the next few decades will dramatically expand the need for senior housing, care and public transportation -- and could alter the face of public policy, government programs and services.
To understand why, consider:
* In the next two decades, the number of Arundel residents ages 60 and over will rise almost 62 percent, five times the rate of the county's overall population, from 56,266 today to 90,951.
* The elderly will comprise a much greater proportion of the population as well. Just 20 years ago, seniors made up only 8.3 percent of the county's population. Within two decades, nearly one in five Anne Arundel residents will be 60 or older.
Naturally, the elderly, who traditionally vote in greater numbers than any other segment of the population, will demand a bigger share of government money. Hence, experts predict a shift away from traditionally youth-oriented, big-ticket expenditures -- items like schools, ball fields and recreation centers -- to more programs for seniors, in-home care and senior centers.
* As the population ages, the fastest growth among seniors will occur in the "old-old," those 85 and over, whose numbers will soar from 3,010 today to almost 8,000 within two decades.
Such rapid growth among those most likely to suffer the debilitating effects of chronic illness will further strain an already overwhelmed care system, necessitate more home health-care, more nursing-home beds and more retirement housing that offers everything from help with daily tasks such as cooking, bathing and housekeeping to full-scale nursing care.
None of this is to suggest, however, that most of the elderly are sickly, isolated or impoverished. To the contrary, in Anne Arundel County, as elsewhere, most seniors today generally are healthier and wealthier, living longer, more active lives than a generation ago.
Yet at the same time, many of those most in need -- the frail, the sick, the poor -- remain a largely forgotten population.
Their numbers are growing by the day.
At public and private social service agencies, staffers hear the desperate voices of the forgotten regularly.
Isolated, often depressed, sometimes even suicidal, caller after caller pleads for senior housing they can afford, assistance to pay for prescriptions or rent, someone to help with basics like cooking or bathing and in-home nursing care.
And caller after caller hears the same response.
In a word, wait.
Today, in Anne Arundel County, thousands of seniors wait -- for help that may never come in their lifetimes.
Many of them worked and scrimped and saved and always figured their autumn years would be a time to relax, travel, read and savor the small pleasures they never seemed to have time for.
They are the elderly people you rarely see or hear.
A 72-year-old Millersville woman weeps as she tells how she got pneumonia when forced to forgo the heat in her mobile home last winter because the money ran out. She would like to move into public housing for seniors, but figures she'll be dead before by the time her name comes up on a waiting list.