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One early February day, as mid-morning light fell into the bedroom through a slatted window shade, Ron Recchioni's dementia-plagued roommate was, as is so often the case, asleep.

The stray sounds of TV shows and voices in the hall were behind him, and Recchioni, 75, blind, and in a wheelchair, said he feels very alone.

"He's a really nice guy; ex-teacher," he said of his roommate in the east Santa Rosa assisted-living home, "But he can't remember anything except 40, 50years ago."

Managers have told him that most of the facility's residents have dementia of some sort, said Recchioni, a former real estate agent who moved to Sonoma County from Millbrae in 2001.

"It's like 'One Flew Over the Cuckoo's Nest,'" he said, referring to the landmark 1975 film about a mental hospital. "I can't have a conversation. I feel isolated here mentally."

His daughter, he said, busy with work and family, last visited in the fall.

"I miss her terribly," he said. "She's one of my favorites. She tries her best."

Recchioni, who has a strong voice, a face of prominent features and a furrowed brow, relies for social interaction mostly on a friend's weekly visit and dinner with another several times a month.

"I think that keeps my mind," he said.

But those occasions aside, he has found himself in many ways alone.

That debilitating situation is familiar to many elderly Sonoma County residents, say people who work with senior citizens.

"Isolation is a huge issue. In the program I run, it is the most common problem," said Melissa Fike, senior programs manager at the Community and Family Services Agency. The Santa Rosa nonprofit group offers services including individual and group counseling for elderly county residents.

There is no way to know how many of Sonoma County's roughly 81,000 residents age 60 and over are in isolated situations, which over time, experts say, lead to physical and mental health issues and even can shorten lives.

But such difficulties may well bedevil more and more people in their later years. The county's fastest-growing population group is residents age 65 and older. By 2020, it is projected to number 99,448, or 20 percent of the population, according to the state Department of Finance.

And informal measures suggest that cases of isolated elderly people are far from rare, the situations often made more acute by poverty, lack of transportation, disability and emotional or physical distance from family members.

The Community and Family Services Agency serves about 130 people a year, Fike said. She estimated that 75 percent of those clients are in some way isolated, their social interactions few and their ability to get out of their homes extremely limited.

Another gauge is at the Council on Aging, whose Meals on Wheels program delivers food to about 1,800 people five days a week. The program's clients are largely homebound with very few social interactions — often the very reason they are enrolled in the meal program, said Laura Colgate, director of the agency's senior nutrition program.

"It's very common, a very high percentage," Colgate said. "Quite often, our drivers are their only physical contact."

There is on David Harnage's wall, in a little room squeezed between his kitchen and living room, a collage of photographs of people he rarely sees or who have left the world. A son who comes once a month. Another who lives in Tahoe and whom he sees far less. His grandchildren. His wife, Alvarine, who died in 2001.

In a week, other than the Meals and Wheels delivery person, Harnage, 92, had only seen his caregiver, with whom he has an efficient but not particularly close relationship, and his four small dogs.

"What breaks the isolation is when Meals on Wheels comes. Over the years, they have pulled me out of some isolated spots," said Harnage, a onetime divinity student, seated in his wheelchair and surrounded by piles of books about Christianity.

Those spots keep coming, though, their shadows falling during a long conversation on a sunny but chilled March afternoon.

"Look," he said to a visitor, pointing across the living room at an electric fireplace that warmed the small house crowded with a lifetime's belongings.

"I'm just burning time, just like that is," Harnage said. "And my time is getting short."

He watched his wife live out her last five years in a nursing home. He spent six months in one himself after breaking a hip. He won't consider that option.

"I'm going to die here in this house," he said, making a promise, flashing some defiance he still has in reserve. It appears occasionally, then dissolves.

One minute, Harnage, a former nurse, sounded like Muhammad Ali.

"I'm as good as the best and better than the rest, because the best are not bitching and the rest are," he said. "That's how to live."

But soon, he talked of how in three weeks he had not gone to church, one of his few interactions with the world not made through his TV.

His ride had been unable to come, he said. He hadn't asked for another.

"I just don't want to beg them to come get me," he said.

Also, a man who once came to take him shopping at times could no longer lift him, and so that activity had gone away, too.

"I kind of brought it on myself by not sticking up my nose and saying, 'Come get me,'" he said.

Later still: "How many times have I counted these four walls?" Harnage wondered aloud. "And how many times have I looked at these pictures?"

Such circumstances are more than difficult to bear; they threaten well-being.

"When people are isolated and alone, you get into the tapes in your head," said Fike at the Community and Family Services Agency. "It becomes a cycle that creates even more inertia and I think can create a lot of hopelessness."

That can lead to carelessness, loss of appetite, a reduced desire or ability to reach out for support.

"It can definitely be a dangerous situation," said Healdsburg therapist Drew Ross, who works mostly with the elderly.

"Because of self-neglect, they stop having the want, will or ability, or all three, to care for themselves," said Ross, whose Creative Counseling group of therapists works with elderly clients and their families around the North Bay to manage the aging process.

"I suspect it has something to do with depression," said Kim Brown, 61, speaking about the 45 pounds she said she lost last year. "I completely lost my appetite."

Brown is struggling back from a long, hard year that started in January 2013 when she moved from Concord into a rented room in a Santa Rosa family's home.

A child of the 1970s Haight-Ashbury scene, she was steeped in the ideals of collective living. In Concord, she had lived since 2002 with two daughters and two grandchildren. But they scattered when their rent was raised.

Alone in Santa Rosa — despite a warm welcome extended by her landlords — "I felt obsolete, like I had no purpose," she said.

"They have their lives and their blood. And I get that," Brown said of the family she lives with. "I spend most of my time alone in my room or, when it's sunny, out in the backyard reading."

She has a smoker's throaty voice and nervous hands. She performs a Buddhist ceremony every morning in the backyard. She tries to stay sharp.

"I watch 'Jeopardy' every night to keep the wheels turning," she said. "I read a lot. But I miss intellectual stimulation on a regular basis."

Brown's ability to go out is limited. She has no car and must ride a bicycle or take a bus, and then she goes only to places she needs to. She also has to cope with severe leg and memory problems, stemming from a bad car accident in 2000.

Slowly, though, she is regaining a foothold in the larger world.

The county's office of In-Home Support Services steered her to the Community and Family Services Agency, which set her up in a 12-week peer counseling program. And last month, she joined a women's support group the agency runs.

"I'm hoping that I can get to know some of them a little better, but it just seemed like a good first step," Brown said.

"And I found that's a lot of what they are going through, isolation. I guess it's a symptom of getting old," she said.

In late March, allergies overtook Ron Recchioni.

One day he sat in his wheelchair in his room, sipping water between coughs, trying to keep his spirits up. Growing tired.

His roommate was asleep again. The day was rainy. Gray light came between his shades onto his yellow bedspread.

But then a friend stopped by with a cup of coffee from McDonald's. And a pianist visited, sitting down to play in the activity room down the hall. The melody drifted into Recchioni's bedroom.

He loves such moments: good company, which happens too rarely, and good, live music, which the home's activity director arranges regularly.

"It completely lifts me," he said. "I'm not here, I'm in another place."

You can reach Staff Writer Jeremy Hay at 521-5212 or jeremy.hay@pressdemocrat.com.