“How can we address healthy aging within these communities in ways that are feasible, achievable, and relatively inexpensive, but also have a great impact?” asks Geana Shemak, MS, ATC, the community coordinator and educator for the Healthy Aging in Rural Towns (HeART) coalition in Iowa County, Wisconsin.
For three years, HeART coalitions in Iowa County, Langlade County, and Waupun have worked with the University of Wisconsin–Madison School of Nursing to assess community needs and resources, and identify and implement strategies to support rural aging-in-place.
During that time, the HeART coalitions have carried out projects to support older community members. These include adding accessible parking, placing benches in popular public areas, increasing the safety of pedestrian crossings, and developing and promoting lists of resources for older adults and their family caregivers.
Now—despite the challenges of the ongoing COVID-19 pandemic—HeART coalitions are helping older residents increase the safety and usability of their homes.
“People want to stay in their homes,” says Shemak. “But our homes aren’t necessarily built for us as we get older. Disabilities or unexpected health outcomes might mean that suddenly our homes don’t fit us anymore.”
Just 3.5 percent of U.S. homes have basic accessibility features like handrails, grab bars, or extra-wide doorways, according to the 2011 American Home Survey.
“Most people don’t realize how important even simple home modifications are for preventing accidents that can cause serious, permanent loss of mobility,” says Barb Bowers, PhD, RN, FAAN, UW–Madison School of Nursing professor and faculty lead on the HeART project. “This project fits nicely within the School of Nursing commitment to improving the health of Wisconsin’s rural communities.”
Rural communities tend to have older residents and older housing stock than urban or suburban areas. While much could be done to renovate older housing, the HeART coalitions are focused on safety.
“It’s all looking at the safety of the individual, whether they have a hard time getting into or out of the shower, or up and down the steps, or around the kitchen area,” says Kevin Bouche, a contractor in Langlade County. He’s working with the local HeART coalition and partners to offer free home assessments and safety modifications to 30 older homeowners across the county.
“A lot of it is pretty minor things,” says Bouche. “It’s handrails for steps, grab bars for bathrooms, handrails for toilets, raised toilets. That’s what’s really lacking in an older community like ours.”
“We’re making sure people are safe and have the ability to move around their house the best they can,” says Bouche. “It’s a great thing for anybody who has a contractor’s license to help out with. And boy I tell you, you get some pretty good stories, talking about the past.”
More and more people are becoming aware of older adults’ home safety needs.
“One thing to note about rural communities is that everything is word of mouth,” says Terri Johnson, the community health aging coordinator with HeART in Langlade County. When she reached out to the president of the local Habitat for Humanity, both had heard about home safety struggles.
“We just both kept hearing over and over again, ‘I don’t know who to get to come over to my house to put a ramp up.’ ‘I don’t know who to get to come over and put grab bars up.’ ‘I don’t even know if I need grab bars.’ ‘I’m getting older and I think I might need help, but I don’t know what kind of help I need,’” says Johnson.
With Habitat for Humanity, Johnson has a partner with licensed, insured contractors, which can be hard to find in rural areas. A CoVantage Credit Union grant covers contractor costs. Midstate Independent Living Choices, a nonprofit working for and with people with disabilities, carries out the home assessments. HeART covers the cost of supplies and coordinates efforts.
“This is the first time any of us have done anything like this,” says Johnson. “We had a little bit of stumbling there, but we are all really great at communicating, recognizing it, and then pushing forward. We all wanted this to work. We stayed focused on keeping people safe in their homes.”
In Iowa County, one of the struggles is building trust with older homeowners during a pandemic. It helps that one of the people leading the project is known to potential participants.
“I deliver meals to people, so I see different situations,” says Bruce Paull, a retired farmer and volunteer with HeART and Seniors United for Nutrition (SUN), a local Meals on Wheels program.
“I have tried to do home assessments for the Seniors United for Nutrition,” he says. “That gets people comfortable to answer some questions. I spend a couple hours with somebody, talking and explaining, showing them pictures of bathroom redesigns.”
Paull is so committed to the program that he took a three-day online aging-in-place course.
“I keep learning all the time,” says Paull. “I hadn’t really considered how important it is to have stove controls that can be reached from a wheelchair or walker. We talked about faucets that aren’t just a mixing valve, but actually sense the temperature of the water. So if you lose cold water, it shuts the hot water off at the same time. That’s important to seniors with diabetes, so they don’t get scalded.”
In addition to SUN, the Iowa County HeART coalition is working with Habitat for Humanity of Wisconsin River Area and the Aging and Disability Resource Center of Southwest Wisconsin for their home safety program.
“Each of the HeART coalitions developed new partnerships and approaches to home modifications that fit their communities, and also raised awareness about the problem,” says School of Nursing professor Bowers. “The amazing achievements of these coalitions in the midst of a pandemic demonstrate the resourcefulness, resilience, and creativity of each community.”
“Life is not about the money,” says Paull. “If you can help other people, that’s what it’s about. I’ve always believed in the statement if you want to go fast you go alone, but if you want to go far you go together.”