Randy Howdyshell, 64, quit his job and temporarily left behind his family in Wyoming to move in with and care for his 88-year-old mother in her Bethel Park home. He hopes that by making this move, he can keep his ailing mother in familiar surroundings as she lives out her remaining days.

Tight economic times are making what has always been a challenge--making ends meet on a senior's fixed income--even tougher for Mr. Howdyshell. He struggles to stretch his mother's income to cover medical care and necessities, while still keeping up his mother's quality of life.

"Her income has been lower than her expenses for a while, Mr. Howdyshell said. "We're in a race with time to see if her money can outlast her."

Her medication costs about $80 a month, he said, and medical supplies like disposable undergarments alone can cost $60 a month. A monthly gas bill can run about $220. All of this, plus a mortgage payment, is a large draw on a monthly income of about $1,038.

The housing market adds to Mr. Howdyshell's financial concerns. His mother's largest asset is her house, he said, and when it comes time to sell her home, he worries that it will take a long time to sell and will not sell for as high a price as it might in a stronger market.

Mr. Howdyshell is not alone. People whose job it is to care for the elderly report that many seniors in the area are making difficult choices as their incomes remain stagnant while costs, like gasoline and groceries, escalate.

The hardest hit are retired seniors on a fixed income, said Virginia Jurofcik, the executive director of Lifespan, a private non-profit agency that provides services like senior centers, home meal delivery, and care management to seniors in Allegheny County. Lifespan has 78 employees and about 300 volunteers that provide services to over 3,000 seniors annually, Ms. Jurofcik said.

"Many of our seniors are facing really tough choices, like do I eat, and which bill do I pay," she said.

Ms. Jurofcik said that she expects the problem to worsen in winter months when some seniors will have to choose between staying warm and eating.

Lucy Seger, who owns and operates Home Instead senior care facilities in Scott and in Washington County, said that as seniors' wallets are stretched thin, some are cutting back on use of her business' services.

The company provides non-medical in-home services, such as personal care, light housecleaning, meal preparation, laundry, medication reminders and transportation.

The client care staff that report to Ms. Seger visit about 210 clients each month.

"Many of our clients lived through the Great Depression and when they hear that the economy is in tight times, they start to conserve," Ms. Seger said.

But, while conserving is a good idea, she said, often seniors will cut back too deeply and will do things such as skip their medication, stop using air conditioning, or eat unhealthy, fast foods.

Cathy Weaver, 55, of Pleasant Hills, said that her mother, who is 85 and is suffering from Alzheimer's, lived through the Great Depression and, now that she hears news of a down economy, is in a "Depression-era" mindset.

Her mother, who grew up in Carrick and now lives with a grandson in Jefferson Hills, does not want to spend money on non-essentials, such as new clothing and visits to beauty parlor.

Like Mr. Howdyshell, Mrs. Weaver struggles to keep up with rising expenses on her mother's fixed income of about $1,200 a month. Utilities, food, healthcare, and medications overwhelm her budget, she said.

"My husband, Stanley, and I spend more of our own money on her, now," Mrs. Weaver said.

Family members, however, may also be financially pinched, making any extra help for aging relatives a challenge.

David Baron, the owner of two Home Instead offices, one in Brentwood and one in Greensburg, said that his staff members visit a 100-year-old woman in Brentwood. Recently her grandson had to stop paying for her to receive personal care services, citing financial difficulties. Fortunately, another family member was able to pick up the expense, Mr. Baron said.

Christina Gilfoyle, the coordinator for Lifeline and community services at St. Clair Hospital in Mt. Lebanon, said that many seniors that she comes in contact with are financially stressed, and she worries that their the quality of life may suffer as they eliminate extras like eating out.

Lifeline is a personal emergency response service that allows seniors to summon emergency help with the use of a medical alert system. The program services about 970 clients a month.

Pat Diamond, 74, of Peters has cut back on her socialization as she cares for her husband, Gilbert, 82, who suffers from Alzheimer's.

The couple also used to eat out regularly, she said, but they do that less often, to be able to afford medical care and some help at home.

While her husband has some stock and retirement savings, she said, the value of those investments is down with the recent decline in the market, and she is trying to save that money for use when her husband needs more advanced care.

Today many seniors are also helping to care for grandchildren, and given a choice between caring for the child and themselves, they will often short-change themselves, said David Fetterman, the director of education and community outreach coordinator for the Center for Healthy Aging at the Graduate School of Public Health at the University of Pittsburgh.

"If the economy gets worse, these seniors may neglect themselves in favor of their spouse or grandchild," he said.

Mr. Howdyshell said that finding financial assistance for his mother has required relentless phone calling and investigation.

One part of the solution for stressed seniors is neighborhood support, Mr. Fetterman said.

"Get to know your neighbors," Mr. Fetterman advises. "Check in on seniors if you see the newspapers building up, drapes always being drawn shut, or if they haven't been out in a while."

"Family members and neighbors can identify a need and problem solve as best as possible, using the facilities out there," he said.

Seniors looking for assistance can contact the Allegheny County Area Agency on Aging, or the area agency on aging in their county. For more, visit www.alleghenycounty.us/dhs/olderadults.aspx or call 412.350.5460.

For more on Lifespan, visit www.lifespanpa.org. For more on Home Instead, visit www. homeinstead.com. Erin Gibson allen is a freelance writer.