Social isolation is one problem facing older adults in rural areas, said Trudy Yoder, a resident at Green Hills Retirement Community in Ames. Yoder and her husband, Ralph, moved to Green Hills to have easier access to care and transportation. Photo by Blake Lanser.
Social isolation is one problem facing older adults in rural areas, said Trudy Yoder, a resident at Green Hills Retirement Community in Ames. Yoder and her husband, Ralph, moved to Green Hills to have easier access to care and transportation. Photo by Blake Lanser.

Iowa State researchers urge rural states to prepare for aging

Older adults living in rural states are at risk of lacking access to the resources they need, according to a new study led by Iowa State University.

“Care deserts” — or areas where it’s difficult to access resources such as transportation or medical care — leave older adults without the means to stay healthy, active, and independent, the study found.

“We’re looking at decreased quality of life, increased cost, and more people living in long-term care who won’t have their needs met,” said Jennifer Margrett, director of Iowa State’s interdepartmental gerontology program and associate professor in human development and family studies.

Margrett led researchers from Iowa State University, the University of Northern Iowa, the University of Iowa, and the Iowa Department on Aging in analyzing common characteristics of states with the highest proportion of people over 50. They found that 14 of the 20 oldest states are also rural.

In rural communities without resources such as public transit, assisted living communities, or home-based care providers, older adults enter long-term care facilities prematurely, Margrett said.

“Transportation alone is a huge issue,” she said. “We tend to rely on our own cars so if you can’t drive, you can’t get there.”

Older adults in rural areas also have fewer options for assisted living. For example, 76 percent of assisted living centers in the United States are in metropolitan areas. Assisted living centers in rural areas are also 40 percent smaller than those in urban areas.

Iowa underperforms nationally

When it comes to meeting the needs of older adults, Iowa underperforms even among rural states.

“Ninety-three percent of Iowans over 50 want to stay at home as they age, but Iowa ranks second in the nation in the number of older adults entering long-term facilities,” Margrett said. “These are people who would be prime candidates for home and community-based services.”

Of the five states with the highest percentage of older adults in long-term care, the top three could be considered rural, the study found. North Dakota leads the nation in the use of long-term care facilities, followed by Iowa, with South Dakota ranking third.

When older adults enter long-term care facilities prematurely, they’re forced to give up their freedom, assets, and communities, said Di Findley, director of Iowa CareGivers, an organization that advocates for direct care workers and the Iowans they serve.

Margrett said caring for older adults in long-term care facilities is far more costly than providing home and community-based services such as food or medication delivery. The amount of money needed to support one person in a long-term care facility could pay for home or community-based care for three people.

“It could be something as simple as Meals on Wheels or respite care for the caregiver or finding adaptive technology to use in the home,” she said.

Rural living poses many challenges

Living in a rural state poses many challenges to older adults who want to stay in their homes as they age, said Megan Gilligan, an assistant professor in human development and family studies.

For example, lack of access to technology leaves rural residents unable to use online services.

“There are a lot of promising services that are web-based but in many of these rural areas, there’s a lack of broadband,” Gilligan said.

Social isolation can also be a problem, said Trudy Yoder, a resident at Green Hills Retirement Community in Ames. Yoder and her husband, Ralph, moved to Green Hills to have easier access to care and transportation. But she said being surrounded by a community is just as important.

“People don’t realize how important interaction is,” she said. “Being around other people is stimulating.”

Helping communities prepare for aging

Studying gerontology, the science of healthy aging, can help people understand the benefits of creating aging-friendly communities, said Donna Wagner, president of the Association for Gerontology in Higher Education.

“Ageism is a barrier to good policy at a local, state, and national level and is responsible for marginalizing older adults and their potential contributions and real needs,” she said. “Gerontology students know that active aging is important to our communities.”

Iowa State offers on-campus and online interdisciplinary graduate degrees in gerontology.

In addition to the college’s gerontology degree programs, College of Human Sciences Extension and Outreach offers three programs to help prepare individuals and their families for aging: the Mid Life and Beyond initiative, Conversations On Aging, and Powerful Tools for Caregivers.

It’s important to recognize the contributions older adults make to communities, Margrett said.

Older adults tend to be more financially stable and are able to consume consistently. They are more likely to own their homes, providing tax revenue to support schools. They have more time to perform community service and volunteer work. And they are important sources of financial and emotional support for their families.

Preparing an aging-responsive workforce

Preparing an aging-responsive workforce is another key solution, according to the study.

Nationwide, the growing population of older adults brings opportunities as well as challenges, Findley said. She expects tremendous growth in demand for care professionals, particularly in rural states, above the estimated 75,000 direct care workers currently in the field in Iowa.

“By 2020, we will need an additional 20,000 direct care workers in Iowa and 1.6 million nationally to meet the growing demand for services,” said Findley, citing data from the  Iowa Department of Public Health’s Iowa Direct Care Workforce Initiative.

Margrett said a background in gerontology prepares graduates to join this aging-friendly workforce. Studying gerontology also adds value to a wide variety of careers because nearly every industry can increasingly expect to serve older adults.

“We’ll be preparing students for careers in direct care, research, policy, and advocacy,” she said. “There are opportunities for entrepreneurial careers, things that we can’t even imagine. Everything will have to be designed with older adults in mind, from housing to clothing to entertainment.”

KEY CONTACTS:

Jennifer Margrett, director, ISU gerontology program; associate professor, Department of Human Development and Family Studies, Iowa State University, 515-294-3028, margrett@iastate.edu

Megan Gilligan, assistant professor, Department of Human Development and Family Studies, Iowa State University, 515-294-5074, mgilliga@iastate.edu

Di Findley, director, Iowa Caregivers, 515-223-2805, di.findley@Iowacaregivers.org

Donna Wagner, president, Association for Gerontology in Higher Education; interim dean, College of Health and Social Services, New Mexico State University; dlwagner@nmsu.edu

Trudy Yoder, 1952 B.S. and 1955 M.S. in home economics, Iowa State University; resident, Green Hills Retirement Community; 515-296-5056, rdy2436@ghrc.co

Meghan Brown, graduate assistant, College of Human Sciences, Iowa State University, 515-294-9424, hsnews1@iastate.edu

  • Quick Look

    Older adults living in rural states are at risk of lacking access to the resources they need, according to a new study led by Iowa State University. “Care deserts” — or areas where it’s difficult to access resources such as transportation or medical care — leave older adults without the means to stay healthy, active, and independent, the study found.


  • “Ninety-three percent of Iowans over 50 want to stay at home as they age, but Iowa ranks second in the nation in the number of older adults entering long-term facilities. These are people who would be prime candidates for home and community-based services.”

    Jennifer Margrett