(CNN) -- West Virginians are a unique breed -- proudly rugged, independent and resilient, with ample experience braving life's ups and downs in the relative solitude of Appalachia.
That toughness has been tested in the past week, since thunderstorms fueled in part by extreme heat blew through and toppled trees and power lines.
Utilities reported about 200,000 customers in West Virginia were still without power Friday afternoon -- down from the roughly 600,000 soon after last Friday's storms, but still a significant chunk of the state's 1.85 million residents. Lt. Col. Dave Lester, a state National Guard spokesman, noted that 53 of West Virginia's 55 counties suffered significant damage due to the storms.
Extreme heat compounds the fears and frustrations, as it will for at least another day. Temperatures hit 96 degrees Friday afternoon in the capital of Charleston and are forecast by the National Weather Service to go even higher, to 101 degrees, on Saturday.
Those on the front lines of the recovery effort say that, while patience wears thinner as the days wear on, West Virginians' toughness has once again shown through. But state residents' strong sense of self-reliance can also sometimes make their jobs harder.
"We've got people who have earned their living by buckling down and working. They're not ones to take handouts," Lester said Friday. "We tell them, we're here to help you."
Some -- especially those in rural, unincorporated areas -- are wary of getting help from people they don't know and fearful someone might steal their life's possessions.
"They are afraid to leave their homes," said John David, a volunteer with the Southern Appalachian Labor School that is reaching out to people in Fayette County.
Poor communication is a major problem, given all those without working landlines or cell phones, radio stations or other means to learn what's happening or what to do or how to reach authorities.
"There's no way for us to find out what they're doing," Lester said.
And the fact West Virginia has a large amount of elderly is further complicating matters and fueling concerns. Some 16.2% of the state's residents are age 65 and over, well above the national average of 13.3%, according to U.S. Census Bureau figures from 2011.
If they're out of power for a few hours, that's one thing. But if it is for over a week, it could become life-threatening -- whether they require oxygen to breathe, are struggling to stay hydrated and cool without air conditioning, or simply can't get around or communicate as well as others.
"We're concerned about their medical situation, like prescriptions being refilled and if they have drinkable water," David said, noting the challenge of complying with orders that water is only safe to drink if it's boiled when you have an inoperable electric stove.
In Spencer, about 45 miles northeast of Charleston, Debra Harper told CNN affiliate WCHS about her fears that she couldn't maintain her husband Gary's ventilator, which he needs to stay alive.
"I'm not worried about me, I'm worried about him," a tearful Harper said of her husband of nearly 40 years, who has Lou Gehrig's disease. "If I run out of gas, we lose him."
To address such issues, state and local officials -- along with utility workers and 600 National Guard troops -- have been out for days, going door-to-door to make sure residents have sufficient food, water and other basics. While people are getting more desperate as the time passes, Lester said authorities "haven't seen a great deal of" thefts, though they have seen people coming together.
And David said outsiders, like those from his nonprofit group which promotes community development and education in the region, have a key role to serve as well, addressing gaps and getting through to people that authorities have not.
"Everything that comes in, we basically load up and give out," he said. "We are plunging into this because there's a need for it."
David said that, for all the positive community involvement and bonding, it's imperative authorities step back and take action so that tens of thousands aren't left without power for a week, with severely limited communication, the next time a big storm hits.
"At this point in time, there's no need for having this kind of situation," said David, an economics professor at West Virginia University Institute of Technology. "People come together, and it's a heartwarming experience, but people do expect that we'll learn something from this."
The logistical and other challenges notwithstanding, Lester from the National Guard said he has no doubt his fellow West Virginians will weather the weather.
That means keeping on living their lives, whatever cards Mother Nature deals them.
Lester and his family plan to demonstrate that spirit on Saturday in St. Albans, where power remains knocked out to most of its 11,000 residents. That includes the church where his daughter and future son-in-law will get married, without lights or air conditioning and in spite of predicted 101-degree heat.
"There's a certain aura around mountain people," Lester said proudly of West Virginians. "It's not always been an easy existence, but we've persevered."