If Frances Elardo had her way, she would live in a group home where she could receive nursing care and keep her cat, Scotty.
Instead, the 51-year-old Elkridge resident, who suffers from multiple sclerosis and is paralyzed from the waist down, is looking for a place in a nursing home in the Baltimore metropolitan area.
Despite a two-month search, however, she has not found a place -- and her apartment lease ends today.
"I don't know what I'm going to do," said Ms. Elardo recently, tears filling her eyes as she looked around her apartment, which contains a lifetime's collection of furniture and nicknacks. Ms. Elardo said she can remain in the apartment only until Aug. 5, when the rent is next due.
Ms. Elardo's situation illustrates a gap in services for residents younger than 65 who need some nursing care but are too healthy for nursing homes, according to those fighting for the disabled.
"We think this situation is egregious," said Jack Prial, a member of the board of directors of the Maryland Center of Independent Living, a Baltimore-based advocacy group for the disabled. "If a person doesn't need constant monitoring and doesn't have a life-threatening illness, they don't need to be in a nursing home."
Ms. Elardo was diagnosed with MS in April 1991 and began requiring a wheelchair within three months. Because she is paralyzed from the waist down, she has a home health aide who comes once a day to help her bathe, dress and get out of bed Monday through Friday. On weekends and in the evenings, she relies on her 16-year-old daughter or on a friend who lives with them, Edward Eckart.
But that arrangement is coming to an end because Mr. Eckart is moving out, and Ms. Elardo won't be able to afford the $650-a-month rent alone.
Ms. Elardo's daughter plans to live with Ms. Elardo's grown son in Baltimore, but Ms. Elardo is estranged from him.
Arranging for a home health aide for about 1 1/2 hours twice a day seven days a week is impractical because of the limited number of hours offered and the double daily visits, she said.
Ms. Elardo said she would like to stay in an assisted-living program in which residents, who are largely independent, receive help with daily chores. But such programs generally are limited to those 62 years and older and cost an average of $1,500 a month, county officials said.
She has resorted to looking for a nursing home, for which she could receive state medical assistance. "I have no choice," Ms. Elardo said. "I have to go to a nursing home."
"I can cook, I can do laundry, whatever," Ms. Elardo said. "Yet the state is willing to pay thousands of dollars a month for me to go into a nursing home. I don't understand it."
Since June, she has contacted about 20 nursing homes in Howard, Anne Arundel, Carroll, Baltimore and Prince George's counties as well as in Baltimore.
Although she is on the waiting list for some, she said, she has been turned away by others because of her youth and independence.
Bon Secours Extended Care Facility in Ellicott City, is processing her application to move there. Administrator Leslie Goldschmidt said residents are admitted based on medical frailty -- not age.
Social services officials say that they are aware of how difficult it can be for people like Ms. Elardo to find appropriate care.
People in the 18-to-64 age bracket who have severe health problems need programs "because they're the ones who are really getting lost," said Thomasine Baskerville, supervisor of adult services for the Howard County Department of Social Services.
Nancy Foster, a social worker with Bon Secours Home Health Program, said community-based services for people such as Ms. Elardo are slowly increasing. She said the state wants to establish group homes with room for four or five residents.
Meanwhile, as she waits to find out what nursing home will admit her, Ms. Elardo is preparing for the reality of living in a facility without many of her mementos or her cat, which she hopes to give to a friend.
"I have things I've collected my whole life," Ms. Elardo said. "Now I have to discard them. It's like someone going to jail."