For some, home means the smell of the desert after a winter rain. For others, it might be the sound of spring peepers; the taste of the summer’s first tomato, fresh from the garden and still warm from the sun; or the sight of gold-hued tamaracks through a frost-touched window. More than one-quarter of the 50 million older adults in the United States live in rural areas or small towns, and for many of them, aging well means aging where the sights, sounds, and tastes of home are renewed with each new season – not locked in memories or frozen in photos that hang on walls far from the places they once called home.
I can’t tell you how many people will say they will take whatever risks necessary – even dying, even spending hours on the floor without help—just to stay in their home,” says Louise Aronson ’92, a professor of geriatrics at the University of California, San Francisco.
Unfortunately, that home may be hours away from a cardiac center, completely isolated from high-quality long-term care facilities, and bereft of local caregivers trained to aid the elderly.
As a demographic group, Aronson notes, older adults are the highest consumers of health care, the most likely to become hospitalized, the most likely to take medications and to have adverse drug reactions, and the most likely to be harmed by medical care.
Providing comprehensive, affordable care for this medically complex population, particularly in economically strapped rural areas, presents a tough challenge that clinical and policy experts say will require creative solutions. That challenge is compounded by the fact that as people age, they often face multiple chronic health problems without access to appropriate medical expertise and needed social supports. Older adults need access to acute and long-term health care, and some may also require help with transportation, nutrition, and managing the physical and cognitive demands of daily life. And they need these supports in ways that don’t diminish their sense of self.