Robirds' daily battle is being played out across the Appalachian region, which stretches through 13 states from northeastern Mississippi to southern New York. A part of the country that has long lagged the rest of the U.S. economically finds itself on the leading edge of a national trend. The number of Americans 65 and older is increasing, and many are struggling as government services are being cut in a rough economy.
Nationally, with the aging of the baby boom generation, people 65 and over are expected to account for 1 of every 5 Americans by 2030. Some places in Appalachia have already reached that benchmark.
"These counties are like the canary in the coal mine," said Suzanne Kunkel, who directs the Scripps Gerontology Center at Miami University of Ohio. "This is a pretty dramatic change coming."
More than 15 percent of Appalachia's population is already at least 65, compared with 13 percent nationally, according to the 2010 Census.
The aging population means more demand for health care, economic help, transportation and home help, which are already in short supply in much of Appalachia.
Appalachia has long been plagued by isolation, poor infrastructure, lack of education and the decline of coal mining, manufacturing and other key industries. The region has low per-capita income (less than $30,000 in 2009), low college graduation rates, an exodus of young working people, and high rates of heart disease, cancer and diabetes, along with poor access to health care.
Peggy Basham, 74, of Summersville, W.Va., is worried.
"I think most everybody in the area is," she said. "You've got baby boomers coming on. You've got so many seniors. ... Nothing stretches very far."
Those in charge of dealing with the surging numbers of elderly people say community-based help and other innovative solutions are especially important in struggling areas such as Appalachia.
"Given our state's limited resources we're not going to hit the lottery we are changing, in Ohio, our approach," said Bonnie Kantor-Burman, head of Ohio's Department of Aging. "There is a limit to what the state and federal governments are going to be able to do."
Other community efforts to keep senior citizens in their homes include The Village concept, in which residents and volunteers help provide transportation, handyman work and home health care.
"We need to be talking about it and working together to find solutions," said Thomas Campbell, a state legislator from Greenbrier, W.Va., whose widowed mother is 89. "People in Appalachia tend to want to stay in their homes and have their family as close to them as they can, and I don't think those are bad things. I think we'll find a way to do it."