" the old man has nowhere to turn for help or even access to a toilet."
"forced thru the cracks by purposeful systemic neglect "
Yep.
Businesses put up signs all over the city "NO public bathroom !"
Then the same businesses complain with people use the street as a toilet.
Sorry, you can't have it both ways. You have to pick one or the other. 
We created or allowed the creation of the problem we are dealing with.

Amazing there are no health codes that require restaurants and other businesses to have toilets here in Hawaii. No wonder we have such high rates of staph infections.