As Rural America Ages, Volunteers Give a Hand

 By Jenni Bergal

© The Pew Charitable Trusts

Dave Brown, 75, a volunteer for the Harpswell Aging at Home team, insulates the floor under a house in coastal Maine. Volunteers in the graying state are helping seniors remain in their homes.

HARPSWELL, Maine, October 26, 2016 — Dianna Haller loved her small, one-story home in this coastal fishing town, but it didn’t love her back. The living room floor was sagging. Snakes and mice were wriggling in through a gap under the front door. And mold was seeping in through a crawl space full of standing water.

Haller, a 65-year-old widow with chronic obstructive pulmonary disease who uses an oxygen generator, was rushed to the emergency room several times this year because of breathing problems her doctors said were exacerbated by the mold. She badly needed help, but couldn’t afford the repairs.

Last month, the Harpswell Aging at Home team came to Haller’s rescue. The group of volunteers in their 60s and 70s, dubbed the Dream Team, went to work insulating and shoring up the floor, sealing the foundation, rebuilding the front door, installing rain gutters and storm windows, replacing ceiling lights that were fire hazards, and doing other work — all for free.

Across Maine, volunteers are stepping up to help rural seniors like Haller who want to remain in their homes as they age. Some work with local governments or nonprofits. Others have simply gotten together to offer a hand. Many of them are seniors themselves.

And what they are doing can be emulated by the rest of the nation, as the number of people 65 and over is projected to explode from 48 million to 77 million between now and 2035.

Maine’s rural population is older than that of most other states. Demographers project that a third of the state’s population will be 65 and over by 2032.

And the challenges confronting Maine as it deals with an aging population are turning up elsewhere. Rural America is aging faster than its urban counterparts, as fewer children are born and younger, working-age adults are moving away.

John Cromartie, a U.S. Department of Agriculture geographer, said the problems would be particularly severe in New England, the Great Plains and Midwest farming states.

“The rural areas are the canary in the coal mine,” he said. “In lots of cases, older people don’t have the means to leave, even if they wanted to. And many want to stay because it’s where they were born or settled down and raised a family.”

Local governments cannot afford to pay for all the services needed to help seniors stay in their homes.

State governments face the same dilemma. And retrofitting a house for aging people can be expensive. It can cost $800 to $1,200 to widen a doorway to accommodate a wheelchair, $1,600 to $3,200 for a ramp, and up to $12,000 for a stair lift.

That’s what makes Maine’s growing volunteer network so valuable.

“There isn’t enough money in Maine to deal with this problem,” said Jess Maurer, executive director of the Maine Association of Area Agencies on Aging. “It’s going to have to be community by community, using volunteers and public and private resources.”

Already, more than 60 communities throughout the state have started or are in the process of starting programs to help seniors age in their homes, Maurer said.

Some volunteers offer rides. Others grow and donate fresh fruit and vegetables. Some offer respite to caregivers. And many, like the Harpswell Aging at Home team, perform home maintenance or do chores that residents can’t do themselves.

Sandy Markwood, CEO of the National Association of Area Agencies on Aging, called what’s going on in Maine a model for other states.

“These are really small communities doing incremental changes that make a huge difference to the people who live there. They’re doing it with existing resources and the human capital they have there.”

As in other rural areas, many of Maine’s seniors live in multilevel homes without a bathroom or bedroom on the first floor.

When they can no longer drive, there’s little, if any, public transportation available, and grocery stores, pharmacies and doctors can be far away. Experts say older adults who stay in their homes often do less maintenance as the years go by, so their houses often deteriorate.

“The challenges in rural areas are probably the most severe,” said Susan Reinhard, a senior vice president at the AARP Public Policy Institute. “Isolation is a serious problem. Depression goes up. Physical health declines.”

For Haller, the Dream Team not only improved her house but improved her health. She is breathing better and hasn’t been to the hospital since they did the work. “You used to smell the mold all the time,” she told volunteers who arrived to make more repairs this month. “Now I can smell the salt air.”

At the Forefront of a Trend

In Maine, people 65 and over made up 19 percent of the state’s population last year, up from 16 percent in 2010. And many state officials and advocates foresaw the coming trend.

In 2013, the Maine Council on Aging and House Speaker Mark Eves held a series of roundtable discussions about the issue with leaders of business, finance, housing, philanthropy and state and local government.

That provided a framework for a summit on aging that drew 400 people in 2014, and resulted in the Maine Aging Initiative, in which groups across the state try to come up with ways to tackle the challenges posed by an older population.

Among the Initiative’s recommendations: Urging communities to help the elderly remain in their homes.

Advocates for seniors in Maine, New Hampshire and Vermont also share information about ways to help keep seniors in their homes and beef up efforts to make communities more age-friendly. The partnership is now working with more than a hundred communities in the three states.

And in 2015, Eves, a Democrat, and state Sen. David Burns, a Republican, created a legislative caucus on aging. Since then, the Legislature has passed or funded 16 measures to help older adults, including more funding for home-delivered meals and in-home care workers and expanded property tax relief for seniors.

“One of our goals wasn’t just to pass legislation, but to elevate the profile of these issues affecting our aging population so people can take the initiative,” Eves said. “If you fast-forward 10 years, I think Maine will have some lessons for other states, particularly rural ones, about how to do it well.”

Lending a Hand

Many of the lessons in Maine are to be found in the volunteer and civic groups that have sprung up or stepped in to help seniors continue to live at home.

The Dream Team in Harpswell was modeled after another home modification team, The Regulars, a group of retiree Habitat for Humanity volunteers who have been helping seniors in mid-coast Maine since 2014.

Last year, the John T. Gorman Foundation gave Bath Housing, a regional housing authority, a $156,000 grant to help seniors make home modifications. The agency used $69,000 from the grant to contract with Habitat to expand The Regulars’ work.

Like the Dream Team, The Regulars are an eclectic group of retirees, including a lawyer, an engineer, an FBI agent and an English professor, who volunteer for Habitat.

They work twice a week, rain or shine or snow — which is why they’re called The Regulars. They have taken on 60 jobs throughout the area.

They’ve done everything from widening doors and fixing gutters to replacing floors to installing ramps. Habitat pays for materials, trains the volunteers, and provides liability insurance, staff support and a van with tools.

Many seniors who’ve gotten help from The Regulars live in substandard housing or mobile homes, which often are not insulated and can be freezing during long, cold Maine winters.

“One guy who had five bypass operations had no heat. We got the furnace working,” said George Shaw, 76, a volunteer. “We’re these people’s peers. We make them feel like they’re being helped by their own community.”

Kathy Smith, development director for Habitat for Humanity-7 Rivers Maine, said it’s not just rural seniors living in modest homes or trailers who need help. The group has assisted people who live in larger houses that are worth more, but don’t have the income to maintain them.

The Village Lodge Handy Brigade, run by a team of Masonic lodge brothers whose ages range from 19 to the mid-70s, assists seniors in the small farming town of Bowdoinham and in two other towns with everything from changing lightbulbs and installing smoke detectors to replacing storm windows and making minor carpentry fixes.

“This program helps people maintain their independence and keeps their property from deteriorating,” said Peter Warner, 60, the Masons’ lodge master.

Warner said that since his team, whose motto is “One light bulb at a time,” organized in February, it has helped about 30 seniors. On a recent fall day, two team volunteers visited the home of a grateful 76-year-old woman and her disabled sons to replace ceiling tiles in a bathroom ruined by a plumbing leak.

“Older folks don’t want to be seen as needing help, but with the Handy Brigade, they know of them and may even have someone in their family who was a Mason,” said Patricia Oh, who coordinates senior services for Bowdoinham and works with the team.

‘Life Experience to Share’

Cumberland is another Maine town committed to helping seniors remain in their homes. It budgets about $50,000 a year for an aging in place initiative that includes a program that sends trained volunteers to spend time with seniors who feel lonely or who live with a caregiver who needs a break.

Susan Gold, the town’s Aging in Place coordinator, said the program offers social and psychological support, and isn’t income-based. “Providing a friend isn’t something you can buy, even if you have a million bucks,” she said.

For Brian and Judy Hathaway, both 76, a weekly visit from volunteer Heidi Kleban makes a big difference.

Judy Hathaway suffered a stroke nearly 10 years ago. She has difficulty communicating and often gets frustrated. Her caregiver husband said he desperately needs some time away, and when Kleban visits he can take off and know his wife is having a good time playing cards or taking walks. “Heidi comes in and Judy just melts. She loves her,” he said.

Kleban, 46, said she volunteers because she enjoys the company of older people. “They have a whole life experience to share,” she said. “And besides, who else would have taught me gin rummy?”

Program Will Train Mental Health Providers, Improve Health Care in Rural Missouri

August 11, 2016--According to the U.S. Census, 37 percent of Missourians live in rural communities and have limited access to health care, particularly mental health care.

A new graduate education program at the University of Missouri has received nearly $700,000 from the Health Resources and Services Administration (HRSA) in the U.S. Department of Health and Human Services to train psychology doctoral candidates in integrated, primary health care settings, in an effort to improve health care for underserved populations with mental health and physical disorders.

“Placing psychology doctoral candidates within primary health care agencies will enhance the current infrastructure in Missouri’s communities and improve comprehensive care for patients,” said Laura Schopp, professor of health psychology and co-principal investigator for the training program.

“For example, a patient with diabetes may need psychological help to address mental barriers that could be preventing them from changing their behavior. Having psychologists working side-by-side with primary care providers should result in better patient outcomes and savings to the state in Medicaid dollars.”

The funding will support several training partnerships and placements throughout Missouri including:
• Missouri Department of Mental Health and Community Mental Health Centers
• Missouri Division of Vocational Rehabilitation
• Family and Community Medicine Clinics in the MU School of Medicine
• MU Thompson Center for Autism and Neurodevelopmental Disorders
• Harry S Truman VA Medical Center
• Fort Leonard Wood Army Post

“Previous research has indicated the need for a comprehensive approach to health care,” Schopp said. “If we treat the whole person—mind and body—patients will have significantly better health outcomes. This new training program will allow people to help patients that do not have access to the psychological care that they need.”

The HRSA Graduate Psychology Education program at MU is being led by Brick Johnstone, professor of health psychology in the MU School of Health Professions. Along with Schopp, the program is being assisted by Eric Hart, associate clinical professor of health psychology and training director; Renee Stucky, professor at the Comprehensive Pain Management Center in the MU School of Medicine; Nikole Cronk, associate teaching professor of family and community medicine in the MU School of Medicine; and psychologists from the MU department of health psychology.

This project is supported by HRSA of the U.S. Department of Health and Human Services under grant number 1D40HP29827-01-00 for $699,772 over a three-year period. As required by the grant, MU provides some benefits to graduate students who contribute to this work. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. 

Rural Residents Seek Farmers Markets, UF/IFAS study shows

Newswise, April 5, 2016--People who buy their produce from farmers markets love the freshness and nutritional value of the product. Not only that, rural residents seek out such markets more than urban residents, a University of Florida Institute of Food and Agricultural Sciences researcher says.

The latter finding surprised the researchers, led by Alan Hodges, an Extension scientist in the UF/IFAS food and resource economics department.

“We interpret this effect as due to greater awareness of farming and farm-fresh foods in rural areas,” Hodges said. 

“The finding also suggests that rural households may be seeking out farmers’ markets as a travel destination rather than as part of a multi-stop shopping trip, as would often be the case with urban consumers. In addition, there is greater competition among food retailers in urban areas, simply due to the larger number of venues available.”

If you establish farmers markets within about three miles of someone’s home, it will increase the chances urban residents will go to the market, but only by about 3.7 percent, the UF/IFAS study showed.

The findings are published in the journal Renewable Agriculture and Food Systems and come from the master’s thesis of former UF/IFAS graduate student Ruoding Shi, now a doctoral student at Virginia Tech.

Hodges and Shi surveyed 7,500 randomly selected households in Florida and obtained 1,599 valid responses from the primary food shopper in the residence. They asked consumers about shopping frequency and value of foods purchased through multiple local food distribution channels – in this case, farmers markets, U-pick operations and roadside stands.

Several questions asked consumers their perceptions of local food attributes, such as freshness, nutrition, food safety, food security, organic certification and more. Questions also asked about limiting factors such as unavailability, seasonality, not knowing if the produce was truly local, high price and more.

Of those surveyed, 62 percent said they had bought locally grown foods at a farmers’ market, roadside stand or U-pick operation. Of those respondents, 90 percent rated freshness as very important; 78 percent mentioned food safety and 67 percent noted the produce’s nutrition as very important.

“The main takeaway from this study for local economic development is that consumer perceptions about local food attributes affect the likelihood of shopping at farmers’ markets,” Hodges said.

 “These favorable attributes, such as freshness and nutrition, can be emphasized by market managers to increase business volume. In addition, accessibility of farmers’ markets to consumers in terms of distance from home is just one factor among others that should be considered for locating markets.”

Many Aging Farmers don’t plan to retire and lack strategies to keep Family Farms going in the future…Rural Culture at stake

(Reposted January 31, 2016)  Newswise — Farming is less a job than it is a way of life for the Kansas farmers who watch their peers retire from office and factory jobs without intentions of quitting themselves.

They also often don't have plans for the farms after they're gone.

That's what a Kansas State University sociologist has found in a study of farmers in Rush County. 

Although such a work ethic and commitment may be admirable, it leaves the future of family farming and the culture surrounding it up in the air, said Laszlo Kulcsar, a K-State associate professor of sociology and director of the university's Kansas Population Center.

"Farming is really an essential component of the local culture, and many farmers think that local culture simply cannot exist without farming," he said. "At the same time, farming is a core element only as long as it's a family farm or a medium-sized operation. Once the big companies take over, the economic activity remains the same but the culture is going to change."

Kulcsar's study of aging Kansas farmers began by examining 2007 U.S. Census Bureau statistics showing that more than one-third of U.S farmers -- about 550,000 of them -- are 65 years old or older. Kulcsar and two graduate students wanted to see how Kansas farmers fit in. 

They made Rush County their model because of the greater significance of farming on the local economy compared with other Kansas counties, and Rush County's large number of older farmers. Kulcsar said that 30 percent of the county's farmers are 70 or older.

Beyond extended life expectancies, Kulcsar said that several cultural and technological shifts explain why there are so many older farmers in Rush County, as well as elsewhere in Kansas and the country. Thanks to more sophisticated equipment, farm labor is less demanding than it once was. In addition, some farmers are not farmers in the traditional sense but rather retirees who took up farming activities as a pastime.

Another significant cultural change, Kulcsar said, has been in family structure. Many farmers inherited their farms from their parents but now find that their own children are not interested in farming.

The second part of Kulcsar's research involved asking these farmers about their strategies for transitioning their farms if they ever do retire or after death.

"They don't even think about retirement whatsoever," he said. "Their take on farming is one that you'd expect. It's a way of life. It's not just making money, it's a culturally important thing

."

Kulcsar said that from a demographic standpoint, the problem that arises from increased corporate farming is long-term sustainability, for which family farming is better suited.

"It is expensive and difficult to enter the profession as a farmer who didn't inherit a family farm," Kulcsar said. "The land is expensive, the equipment is expensive, and for that reason there really is no other way to enter the family farming business."

He said this poses another problem in that farmers just entering the profession are more likely to adopt technology and innovations that could improve profit margins and help them compete with the economies of scale that corporations have.

"Family farming creates certain values and a work ethic that corporate farming just can't have," Kulcsar said. "The farmers we talked to said that their advantage over corporate farming is that they're going to do the right thing and care about people."

Kulcsar presented the research in August at the annual meeting of the Rural Sociological Society in Madison, Wis. The students participating in the research are Benjamin Bolender and Albert Iaroi, both K-State doctoral students in sociology. 

The project is funded by K-State's Center on Aging.

Kulcsar said that the future of the research could involve extending the study to other farming-dependent counties in Kansas, as well as working with the Center on Aging and with K-State Research and Extension on ways of getting farmers involved in transition plans for their farms.