Rural communities are aging more rapidly than are other areas, in Wisconsin and across the country.
Nearly everyone wants to stay in their community as they age. Increasingly, rural leaders are asking how they can help older residents to thrive. Some are pioneering age-friendly approaches that other communities can learn from.
In Wisconsin, three coalitions—in Iowa County, Langlade County, and the city of Waupun—are working with the Center for Aging Research and Education (CARE) at the University of Wisconsin–Madison School of Nursing to support rural aging-in-place.
Vickie Stangel is part of the Iowa County coalition for the Healthy Aging in Rural Towns, or HeART, project. She knows the importance of increasing supports for older adults from her work at the Dodgeville Public Library.
“We have patrons who have been using our library probably 70 or 80 years,” says Stangel. “We’re seeing their changing needs. We’re seeing them going from regular print to large print and audiobooks. We take books out to the senior living facilities. Families come in with questions about dementia care and senior resources.”
In 2018, the HeART project focused on understanding challenges and resources for older residents. Each community coalition did in-depth assessments, surveying adults and family caregivers, and interviewing local healthcare providers, first responders, church leaders, librarians, and others.
“Thinking through who we’re going to ask, what we’re going to ask, why we’re going to ask it, and what we’re going to do with that information took time,” says Ruth Schriefer, a member of the Iowa County HeART Coalition who works with UW Extension.
“Taking that time is part of coalition development,” adds Schriefer. “In addition to coming up with what I think are some really good strategies to work with our older and aging population, we’re learning how to work together as a group. That’s something that we can carry to the next initiative, then the one after that, and the one after that.”
The assessments show that close-knit rural communities, local media, libraries, and Aging and Disability Resource Centers (ADRCs) are important in all three areas. Common challenges include too few paid caregivers, little coordination between existing services, resources being limited to town centers, and a lack of transportation options.
“Transportation affects everything we do in rural areas,” says Schriefer.
After reviewing their assessment results, the Building a Healthier Langlade County coalition decided to broaden their scope.
“We expanded our definition of a caregiver,” says Stephanie Thiede, RN, BSN, who works at the Langlade County Health Department. “With our methamphetamine issue here, we’re finding that quite a few grandparents are taking care of their grandchildren. So for us, caregivers need to include grandparents taking care of their grandkids, as well as the typical spouse taking care of a spouse, and son or daughter taking care of their parent.”
Some assessment results surprised Sue Matye, RN, BSN, with the Iowa County Health Department.
“People tended to know about the ADRC, yet we found that caregivers and others still weren’t sure where to look for resources,” says Matye. “People didn’t think about using the ADRC themselves.”
Matye found the feedback from older adults “refreshing,” because “people are alive out there. They want to serve a purpose. They want to be involved, to go to events.”
Each coalition is using their assessment data to decide how to increase awareness of local resources, develop programs for unmet needs, make social and community activities more accessible, and support family caregivers. Over the next three years, each coalition will carry out the action plan they developed with support from CARE and the Wisconsin Office of Rural Health.
“We have small ideas and really big ideas,” says Matye of the Iowa County HeART Coalition. “We’re going to provide a bench for eleven little villages and townships. It’s practical and tangible and will give us a small win right away.”
“Each bench will have our logo, to get our name out there,” adds Matye. “The benches can be a place to drop someone off, if you’re bringing them to an event at a school. The benches can promote walking or socializing. We’re thinking of putting Little Free Libraries next to the benches, stocked with information.”
How to communicate these initiatives is important, says Jen Beran with the Langlade County Health Department.
“Especially in real rural areas, people feel like, ‘We can take care of ourselves, we don’t need any help,’” explains Beran. “But quite a few of these same people receive Meals on Wheels, because someone inside of their circle suggested it. So, we’re thinking of sharing information through Meals on Wheels delivery people. We’re also trying to find more common ground to hold events, like the library.”
Beran’s excited to increase outreach for existing older adult and caregiver programs.
“We’re the most rural” of the three HeART community partners, but “we have a lot that we offer,” says Beran. “People don’t know where to look or they’re just so overwhelmed. We’re pretty hopeful that by getting the word out, we’ll make these best-kept secrets not secrets anymore. People really want more information.”
The HeART project “is allowing us to strengthen what we’re already providing and also add to it,” agrees Thiede. “We’ll be able to act on what the community has told us. We do a lot of surveys like the community health needs assessment, but the outcomes aren’t always obvious. I think the community will appreciate that we’re delivering something visible. That goes a long way.”