Annie Kelly, 94, weighs less than 100 pounds, suffers from cancer and lives alone in one of the city's 15 public housing projects for the elderly.
She can't walk to the bathroom without help, fix her own meals or go to the table when they are prepared for her, comb her white hair or wash her clothes.
Lillian Carey, 66, a retired registered nurse and Kelly's friend, cares for her during the day. Kelly's family has hired somebody to stay with her at night.
While Kelly is an extreme case, about half the people who live in the city's senior citizens buildings are unable to care for themselves without assistance, according to Karen Spellman, head of resident services for the housing department.
Two percent are bedridden, like Kelly, while 6 percent are housebound and another 6 percent have difficulty going outside their apartments without help.
At the Garfield Terrace in Northwest, where Kelly and Carey live, one-third of the 247 residents are either confined to bed or severely handicapped to such an extent "that makes it difficult or impossible for them to live independently without support" according to a recent housing department survey.
Faced with a growing population of helpless elderly residents and long waits for nursing home space, public housing officials have decided to convert one of their buildings to a quasi-nursing home.
Two weeks ago the city asked the U.S. Department of Housing and Urban Development for $160,000 to start an experimental "congregate care" program at Garfield Terrace.
Under that proposal the housing department, for the first time, would coordinate meal service, housecleaning medical services, shopping and check-cashing for about 60 elderly men and women who are too frail to provide for themselves.
Many of these services are currently available through "a bewildering collection of fragmented services" because "there is no coordinated care program," Spellman said.
Although the city's Department of Human Resources assigns "homemakers" to the elderly to fix meals and clean apartments, "we've had a lot of cases of people watching the soap operas when they are supposed to be helping the elderly," she said.
Pat Yates of DHR said her office received similar complaints, "but there aren't many and they are resolved."
In addition, Spellman said homemakers only work Monday through Friday, and some elderly residents need seven-days-a-week care.
Yates agreed. "Some should be in nursing homes because they need round-the-clock care, but there is a serious shortage of services for these people. We try to patchwork the services" by asking family members to help out on weekends, she said.
The city's proposal is for money from a new $10 million HUD program to establish congregate care facilities in public housing and federally subsidized projects around the country.
It is a program that HUD officials resisted, contending that public housing should provide only shelter and not social services.
But as the landlord for more than 1.3 million elderly, about 10 percent of whom are "not able to care for themselves 100 percent," HUD has taken steps to spend the $10 million Congress appropriated in the past fiscal years.
HUD officials said the grants would be made before the end of November.
But D.C. public housing officials admit that 25 percent of the Garfield residents have health problems so serious that they are "beyond the care standard for the congregate program. However the city's nursing care program cannot accommodate these residents and so they remain in public housing."