Aging in place can be difficult for many seniors, no matter where they live, but it’s especially daunting for those who live in rural areas.
“The housing stock tends to be older and of lower quality, there is less access to health care, and people in rural areas tend to have lower incomes,” says associate professor Carrie Henning-Smith. at the University of Minnesota School of Public Health and adjunct. director of the school’s rural health research center.
University of Minnesota Rural Health Research Center recently performed an environmental scan on statewide age-friendly initiatives for aging in place (i.e. the ability to stay in place as one ages). It focused on transportation, provider training and education, workforce development, and dementia-friendly and underserved communities.
The analysis identified 33 statewide aging-in-place or age-friendly initiatives in 22 states that support independence as people age. Of these 33, only six focused explicitly on rural communities or included rural communities in one of the priority areas. They include:
“We were a bit surprised by the results. States have a responsibility to support everyone,” says Henning-Smith. “Many regions are probably good for rural adults, but we only found six with an explicit rural orientation.”
Aging in place is especially important for rural communities
Erica Husser, project director for Age Friendly Care PA at Penn State College of Nursing in State College, Penn., says aging in place is generally less expensive than assisted living, and the familiarity of seniors’ homes generally makes it a safer option. “Most older people just want to stay home,” Husser says.
“When you compare the rural way of life with others, being part of a rural community for many seniors is what they are,” says Husser. “Taking these people away from the landscape to urban areas, where there are few green spaces and trees, is a very different way of life.”
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Moving older people from their rural or small-town homes, where they have likely lived for decades, raised their families, and are likely still part of their city, can not only tear apart the fabric of the community, but also lead to depression. , health problems and a higher death rate.
Linda Clark, director of community and development for the Verde Valley Caregivers Coalition, which serves rural areas and small towns in Arizona’s Verde Valley region, said she noted anecdotally that when people are moved to living centers for the elderly, they tend to die. within one to two years. “If they can stay at home, they [live] three to five more years,” says Clark.
Age Friendly Care PA works in partnership with geriatric centers, healthcare organizations, primary care providers, students studying healthcare careers, and community organizations to improve care for the elderly and people with dementia in rural and underserved communities in Pennsylvania.
“We are here to train all those who [works with] older adults, from nursing students to doctors,” says Husser. To that end, they work with partners to identify older people through screenings and connect them to the right services.
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The programs, which aim to ensure that clients receive adequate and targeted health care, are on a mission to reduce what matters, including medication, mentation (emotional and mental health) and mobility. The 4 Ms as they are called, were designed by the John A. Hartford Foundation and serve as a framework for age-friendly care.
“It’s the idea of practicing as a set with those four Ms,” says Husser. “It improves health care and provides a better quality of life.”
Connecting older people in rural areas to the right services is not always easy. “There’s a lot of distrust in health care and government,” Husser says. Yet his program reached 70,000 adults in 2020.
Verde Valley caregivers have a wide scope of action
Arizona’s Verde Valley claims a population of 58,835, but the vast region includes small towns with typically fewer than 1,000 residents and people who live on the outskirts of those towns, Clark says. Flagstaff is the closest town, about 40 minutes from the area and about two hours north of Phoenix.
“We have people who have been retiring here for years and because they’re from other areas, their kids and families are usually out of state,” Clark says.
The pandemic has made this population particularly vulnerable to isolation and loneliness, with some of them not even having access to healthcare. “If they can’t drive, they’re just stuck, regardless of income,” Clark said of the rural area.
Clark says transportation is his organization’s biggest service, providing rides to doctors, physical therapy and other medical appointments or picking up prescriptions or taking people to groceries.
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Clark says a recent survey showed that 88% of their clients said they missed one or more healthcare appointments before signing up for services; 98% of clients said they were able to keep their appointments after signing up.
Programs through Verde Valley Caregivers provide several services, including the Guardian Angel emergency alert program, which lends emergency alert devices to low-income adults at risk of falling.
His pets matter too! The program helps customers’ pets, including veterinary care, vaccinations, medications, food, and even boarding a pet if the customer is temporarily hospitalized or sent to rehab. The Tech Coaching program helps adults stay in touch with family and friends by teaching them how to use their cell phones, tablets and computers.
“Because so many of our clients have family living out of state, pets help with loneliness and depression,” Clark says. “And because so many people live out of state, [families] were sending devices to our customers, which is great, but many of our customers didn’t know how to set them up or use them.
One of its most successful programs over the past year has been the vaccination program, which allowed 400 clients to receive COVID-19 vaccines in their homes and brought an additional 600 people to appointments for vaccines. Clark says the program is underway, now focusing on callbacks.
She notes that the total number of people served is an ever-changing moving target. “We lose 300 to 400 a year, but there are always new customers to take their place,” Clark explains. “We have signed up 600 new customers since January 2021.”
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Kent Ellsworth, its Executive Director, says, “Our seniors want to do what they can to continue to live in the community of their choice. We can expect to serve more people than ever before who need our help. »
Kerri Fivecoat-Campbell is a full-time freelance writer and writer living in the Ozark Mountains. She is the founder and administrator of the public Facebook page, Years of Light: Living Large in Widowhood and a private Facebook group, Finding Myself After Losing My Spouse, dedicated to helping widows/widowers move forward.
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