Providing Options to Rural Older Adults

For older adults living in rural communities, the challenge of aging in place is often magnified. What specific programs and policies have proven successful and could be replicated? View the full forum.

By Suzanne Anarde

Housing for older adults in rural areas is, indeed, an issue that we must continue to address. Aging in place is a priority for a majority of rural elderly residents as they strive to remain close to children and grandchildren, old friends, and their communities.

They face many challenges in achieving this goal, including limited appropriate and affordable housing options, adequate transportation and service availability. Aged housing stock further adds to the challenge. In addition, Rural America is older than the nation as a whole with higher rates of elderly poverty than urban communities.

Most Rural LISC local partners across the nation are responding with diverse programmatic approaches. Senior and multigenerational housing includes new construction and rehabilitation of rental units; owner-occupied rehabilitation and retrofits; and conversion of existing buildings into, or building new, assisted living environments. Community spaces, activity and exercise areas, communal dining areas, libraries with internet service, and supportive service coordination are all important considerations.

Transportation presents a big hurdle. Average travel for medical services in rural areas is 17 miles. However, four times more rural residents than urban residents drive more than 30 miles for medical services. Public transportation is rarely an option for the rural elderly, and private transportation can be complicated as rural residents age and their driving abilities wane. Dependency on others for transportation can be unreliable, adding stress.

Supportive service coordination is another critical component on a continuum of care for the rural elderly. This includes medical services, in-home health care, maturing adult caregivers and a variety of other needs. Programs with promise include telemedicine grants (USDA/RD) and the interagency Rides to Wellness. HUD’s Supportive Services Demonstration is also an exciting opportunity and will include an attractive educational component.

From a funding standpoint, there are several programs that provide particular value in the continuum of care. New Markets Tax Credits and USDA/RD Community Facilities programs both provide viable funding options for the built environment. CDBG and HOME subsidies are also integral funding components, as are CSBG, USDA/RD 504 and LEAP for owner-occupied solutions. In terms of services, LISC’s Healthy Futures Funds can be utilized in communities.

How do we, as rural practitioners, approach this combination of issues? On a national level, evaluation of rural community and regional housing and population data by community-based organizations is ongoing. Creative solutions are emerging. One concept is conversion or construction of rural assisted living facilities, drawing on the lessons learned through HUD’s Assisted Living Conversion Program, past USDA/RD Community Facility uses, and LISC’s Healthy Futures Funds.

It is incumbent upon us to give our best to provide viable options for aging rural residents. Providing them with attractive housing, transportation and services options, rural older adults and their families may retain control of their lives while retaining dignity and identity.

Suzanne Anarde is program vice president for Rural LISC.

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Welcome to the BPC Health and Housing Expert Forum. Each month contributors from different parts of the health and housing sectors will be invited to respond to a discussion topic. Have a question you’d like us to consider? Please leave it in the comments.

Any views expressed on this forum do not necessarily represent the views of the Senior Health and Housing Task Force, its co-chairs, or the Bipartisan Policy Center.