A growing number of elderly Americans are receiving help from those just next door.

Sarah Ellison had always been friendly with the elderly couple who lived next door, but she really bonded with Charlie when his wife died of Alzheimer’s five years ago. “He called me right after he called his son,” says Ellison (who requested a pseudonym to protect her neighbor’s privacy). Charlie planned the memorial service but agreed to let Ellison arrange a reception afterwards. Neighbors in their Boston suburb chipped in for finger sandwiches, tea, and flowers. “ ‘Sylvia would have liked that,’ ” Ellison recalls Charlie saying.

Soon she began popping over with muffins or soup. “When Sylvia was gone, I felt a greater responsibility to check in on him,” says Ellison. “I was very fond of him.” Charlie would come by to chat at Ellison’s kitchen island, bringing magazines for her husband and daughter. He remained proud and independent, doing his own yard work and minor home repairs. “If he needed something, he’d call me,” says Ellison. He didn’t have much family; he was an only child, and his daughter had been killed in a car accident when she was a teenager. So on holidays, Ellison always made sure he had plans to see his son, who lived within driving distance but didn’t visit often.

Then late last year, at age 82, Charlie became ill. His appetite flagged and he lost weight. Ellison accompanied him to the doctor, and she was by his side when Charlie heard the diagnosis: pancreatic cancer. She helped him digest the news and weigh the treatment options, and offered to drive him to follow-up appointments. “He said, ‘Absolutely not,’ ” Ellison recalls. “ ‘There may come a time when I’m really going to need help, but not yet.’ Then he kissed me on the head.” Lately, Charlie’s son has become more involved in his care, taking him to the doctor and spending more time at his house. “It makes me happy, but I also want to say, ‘Where have you been the past twelve years when I’ve been here?’” Ellison says.

All around the country, people like Ellison are quietly stepping in to help care for the elderly in their midst. Whether through informal arrangements or organized neighborhood watch groups, community members are joining forces to provide food, transportation, household maintenance, and companionship for the aging and infirm. In Sacramento, the local parks department has launched the Caring Neighborhood Programs to help neighborhoods develop their own strategies for tending to their elderly populations. Suggestions include planting flowers, sharing picnic lunches, or helping with “light spring cleaning tasks.” Non-profit organizations like The Andovers Village at Home program in Massachusetts charge a small annual fee to provide seniors with volunteer services ranging from help with home electronics to dog-walking to picking up prescriptions.

With people living longer in their homes, often far removed from loved ones, communities are essentially taking over the role families used to play. But how much do we owe someone simply because they happen to live next door? “I do think we have an obligation to help our neighbors,” says Robert Bornstein, a psychology professor at Adelphi University and the co-author of When Someone You Love Needs Nursing Home, Assisted Living, or In-Home Care. “The question is, how far should we go? Not many people would offer to take over a struggling neighbor’s mortgage, for example.” Sometimes good-hearted people who reach out to help end up feeling obligated to continue, and may become resentful if their assistance is taken for granted. Bornstein recalls how some of his Long Island neighbors teamed up to shovel an older resident’s driveway after last winter’s first major snowstorm. Little did they know that three more storms would strike in short order. “They kept saying, ‘Now I feel like I have to go shovel.’”

The challenge is establishing boundaries and being up front about what you can and can’t do, says Bornstein. Joanne Derwallis, 47, recalls how she used to set parameters on visits to Judy, an elderly widow in her Fairfield, Connecticut, neighborhood who died four years ago. “I’d say, ‘I can only stay 10 minutes,’ or she’d keep me all night,” says Derwallis, who started out bringing Judy food a few times a week but eventually developed a deep friendship with her built around going out to lunch and discussing books and parenting. “Toward the end, she started relying on me more, asking me to drive her to doctors’ appointments or lift something heavy.”

It helps to spread the responsibility by enlisting other neighbors or family members, says Bornstein. Derwallis recalls how she and one of her neighbors tag-teamed caring for Judy, trading notes on her medical care and mood as her health deteriorated. They also communicated by email with Judy’s son, who lived in Wisconsin. “He felt better because he knew that we were looking after his mom,” says Derwallis. When Judy died at age 87, Derwallis spoke at her funeral.

Not all children are so appreciative. “Kids sometimes resent the neighbor taking over, even if they don’t want to do it themselves,” says Bornstein. “It’s very rare when the neighbor who’s taken a family role has an ongoing relationship with the kids. There’s a replacement dynamic, where the kids get shifted out of that role.”

For the elderly, regular contact with neighbors can help maintain health and happiness. Roz Gordon, 88, who lives alone in a condo in Bridgeport, Connecticut, considers herself “very, very lucky” to have downstairs neighbors in their 60s who check in on her, get her mail, and clear her parking spot when it snows. An avid Jane Austen fan who has attended numerous conferences (in period garb), she steers clear of events aimed at senior citizens. “Their outlook on life is very negative,” she says. “I just can’t stand downers. I like the idea of being with a young person.”

Future generations may be less determined to preserve their independence. According to clinical social worker Barbara Kane, who co-founded Aging Network Services, a Bethesda-based company that specializes in coordinating all aspects of elder care, the current elderly population has an “up from the bootstraps” mentality and likes to prove they can do everything on their own. By contrast, baby boomers, who are just hitting retirement age, “like being catered to,” she says. “They like massages, spas, food brought in.” In fact, Bornstein says that Baby Boomers have begun taking the 60s notion of communal living and adapting it to create a formal and informal network of Aging in Place collectives. “They make explicit agreements—‘I’ll look out for you, you for me, one of us can drive, one of us can take care of the lawn.’ Or they might negotiate as a group for lawn care.”

But for those aging in place today, often it’s the neighbors who take charge. “If you’re a caring person, you do feel a sense of obligation to help those around you who need help,” says Ellison, recently back from a four-hour chemo session with Charlie. She acknowledges that her desire to help him stems from genuine affection. But what about the unfriendly old woman across the street, who “turns off her lights on Halloween?” If she really needed help, “Would I reach out to her?” wonders Ellison. She pauses for a moment. “Probably.”

Susan H. Greenberg is a writer, editor, teacher and author of the blog Unvarnished Mom.