When 79-year-old Delilah Gypse slipped and fell in her mobile home, she didn't call anyone.

Sprawled on the bathroom floor, she was unable to reach the phone. But even after more than an hour had passed and she managed to prop herself up on the toilet, she decided not to disturb her neighbors.

They had their own problems. Jim has also fallen a few times. Reba became blind. Dick has recently developed asthma.

“We were left in no-man's land,” Gypse said, eventually dragging his badly bruised body back to his favorite chair and turning on the television. “There's no one here, and no one's coming.”

When it comes to getting older and poorer in Arizona, there are few places less attractive than La Paz County.

“We don't have the money, so we can't give them things they can get elsewhere,” County Administrator Dan Field said..

Older adults have long flocked here for the warmer climate, and now make up more than a third of the county's roughly 20,000 annual residents. Her four counties in the United States are the only ones with a higher percentage of people aged 65 and older.

Just under 7% of La Paz's seniors (484 people, according to the U.S. Census) live below the federal poverty line, with an annual income of less than $11,770 per person.

Other Arizona counties offer services such as subsidized housing, food delivery, transportation to medical appointments and basic long-term care services not covered by Medicare.

But in La Paz, they are mostly left to fend for themselves. They live in nearly abandoned communities accessible only by dirt roads, with names such as Bowes, Utting, and Hope, and some maps classify them as ghost towns.

The reason for the neglect begins with Yuma County's history, which began in 1983 when the rural northern part of Yuma County was separated from the urban areas in the south and was named La Paz. With the desire to provide better services to the people. However, since the county did not have a large city or large tax base, it struggled to provide basic services from the beginning.

County officials say the biggest burden comes from the tens of thousands of people who spend only the winter in La Paz, sometimes more than five times the population, and who are not included in official population statistics. The county says it is causing more damage to the county than it contributes.

Officials said they could not support that claim with data and did not distinguish between part-time and full-time residents when providing services.

Most visitors live in RV parks on federal land and don't pay property taxes, the main source of revenue for Arizona counties. Field said sales tax alone won't cover their costs.

Since most of the part-time workers are elderly, the county could be stuck paying high medical bills. In 2014, a Canadian came to the country with tuberculosis and left the county after paying $120,000 for treatment. In total, the county spends about $830,000 a year, or 7% of its budget, on care for older residents and visitors.

La Paz's financial situation has been especially dire since the Great Recession began in 2007 and the state began cutting subsidies to poorer counties.

“The whole county is affected,” said Carol Brown, a Bowes resident who wrote a history of the area. “Each community has to fend for itself.”

In each of those places, a few retirees too poor to leave have formed a hardy fraternity living in the desert, holed up in trailers until the sun goes down, enduring 120-degree afternoons. Masu.

Their main support comes from the Parker Senior Center. The center started as a bingo hall, but over time its mission evolved to include meal delivery, rides to and from the hospital, housekeeping, and more.

“The state calls us rural. We call us frontier,” he said, running the organization with modest city funding, minimal county donations and philanthropy. said Dara Tilley.

Providing at least some level of care is enough.

Polly Thorpe, 81, is one of the beneficiaries. She keeps her air conditioner at 83 degrees and uses her machine to roll her own cigarettes. Usually she has someone smoldering in an overflowing ashtray, sending a wisp of smoke into the trailer.

On a typical week, Janine Acton is the only person she sees. Her caregivers are dispatched from the senior center to check dates on prescription medications, make sure she has enough frozen dinners, and take care of whatever Thorpe needs. I'll give it to you.

Thorpe was once one of Acton's most cheerful customers. He says Mr. Thorpe doesn't want his friends or neighbors now. She chose this lonely outpost as her home in one word: “Cheap.”

Has she spoken to any of her four children this year?

“no.”

Acton tried to get her to talk. It didn't work.

“If God wanted to save me, he would save me,” Thorpe said. “If not, he knows where to put me.”

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For some of Acton's customers, the world feels fast-paced.

When I visited 83-year-old Clifton Compton recently, he was confused about his bill from a local doctor's office. It was a co-pay not covered by Medicare.

When he reached out for Acton to examine him, his hands were shaking from Parkinson's disease. She read it upside down with her trained eye.

Acton called the hospital and demanded to speak to the billing department, grilling staff about the allegations.

“Go in there and offer to pay in cash,” Acton eventually told Compton. “They'll almost always lower your bill by that amount.”

Compton nodded and smiled. Acton checks the freezer to make sure there's food until her next visit, which could be seven days later, and as she leaves to meet her next customer, she slams the screen door behind her. and closed it.

nigel.duara@latimes.com

Sandra Poindexter on The Times' data team contributed to this report.

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