How many financially struggling senior citizens live in your county? Watch video
They've had to go without heat to get medication, or without medication to get food.
The bottom line for New Jersey's senior citizens, advocates say, is this: many are just not getting by.
Elizabeth resident Mary Bedward, 66, is struggling on a limited income and $16 a month in Supplemental Nutrition Assistance Program benefits since a back injury forced her to retire in 2004.
"Really, I didn't think about being older, or old (when I was younger)," she said. "I live alone and I know what it's like for others like me (who are) disabled and elderly."
'Can you live on $16 (a month)?' Photos show N.J.'s struggling senior citizens
"They're going without, because of their inability to make ends meet," said the NJ Foundation for Aging's Deputy Director Melissa Chalker. "(There are) women who are widowed and living alone and receive somewhere in the range of $800 to $900 a month on Social Security as often their only income."
Of all N.J.'s counties, based on the foundation's most recent county-by-county analysis, Hudson County has it the worst. About 62.9 percent of Hudson County seniors, who live alone or in two-person households, have incomes that are below the cost of baseline comfortable living.
The other counties' percentages are listed in the gallery above.
According to NJ Foundation for Aging Director Grace Egan, the foundation has issued three senior reports, in 2009, 2012, 2014.
The "elder index," which the reports analyze (see box below), is a cost of living analysis of food, healthcare, transportation and miscellaneous needs.
Based on the most recent U.S. Census Bureau's population estimates, nearly 15 percent of New Jersey residents (1.292 million people) are 65 years or older.
Of those seniors, about 586,975 either live alone or in a two-person household, according to the foundation. Though many are technically living above the federal poverty line, the foundation says many are not taking in enough money through Social Security to support their basic needs.
The number of these struggling seniors in New Jersey "has increased slightly," in the past few years, Egan said.
"I think that we will see it increase a little sharper," she said.
It's also important to take into account that the reports don't look at multigenerational households: "people living with their children, their nieces and nephews, because they can't afford to live alone," Egan said.
In Hudson County, for example, the foundation estimates living costs at at least $28,836 for a senior renting a one-bedroom apartment. The federal poverty level, in contrast, comes to $11,670 for a single elder person, the report notes.
Nearly 1M people live in poverty in N.J., new Census data shows
Some struggling independent-living seniors are helped by food and nutritional support through community partners, or they receive support from adult children, Chalker said.
Yet, with the economic crisis, there are also stories of "adult children moving home," she said.
The NJ Foundation for Aging has used its reports to advocate for policy changes for seniors, but it won't be in charge of the elder index report from now on.
This past spring, the state decided to take over the elder index report, because "legislators thought it was significant," Egan said.
"The state and counties and other providers have been using the data but were not required to use it (before)," Egan said. "This transfer enables the state to develop and use the data going forward. This is a very positive outcome."
A law was passed in spring 2015 that requires the Department of Human Services to update and use the NJ Elder Index in making funding recommendations to the governor and legislature, establishing public benefit income eligibility, and designing public outreach programs.
The next senior report likely will be completed in late fall 2016, said Nicole Brossoie, the department's assistant commissioner of public affairs.
"Data collected helps the counties to plan budgets associated with transportation, senior luncheon programs, Meals on Wheels and other senior services," Brossoie said.
While there are many ways to increase senior security through policy, more affordable housing is particularly crucial, but is also "the toughest public benefit to get in New Jersey," Egan added.
There are several reasons for Hudson County's high percentage of elders below the index, Chalker said.
"It's an expensive, mostly urban area and they have a high minority population," she said. "The data shows that minorities are more likely to be below the index. We can attribute this the income/job inequality, meaning lower wage jobs, less payment into social security, etc."
A Hudson County spokesman has not yet responded to inquiries about senior care.
Hudson County has nearly 17 percent of people living below the poverty level, according to the U.S. Census, and the median income is $58,442.
Laura Herzog may be reached at lherzog@njadvancemedia.com. Follow her on Twitter @LauraHerzogL. Find NJ.com on Facebook.