Rural older adults face big gaps in care

Older adults in rural California face mounting challenges that are expected to intensify over the next decade and a half.

Statewide, the number of residents 80 and older is projected to more than double between 2020 and 2040, with the oldest population tripling in some rural counties.

And that growth, experts say, will exacerbate a host of issues that rural Californians confront on a regular basis, such as: long drives to routine doctor's appointments, limited home-health care options, aging houses that are difficult to maintain, poor access to hospitals and barriers to finding people to help out with daily tasks.

Why rural action is urgently needed - and how state policy can help

UC Davis experts in gerontology are well aware of the looming crisis and are committed to help/offer solutions.

To better explain the challenges of older adults - and offer state-level policy solutions grounded in community insight - the Family Caregiving Institute at the Betty Irene Moore School of Nursing at UC Davis has released a set of recommendations so policymakers from across the state can better address the needs of rural older adults. The series of policy briefs, developed with The SCAN Foundation, details the structural inequities that shape rural aging and outlines steps state leaders can take to strengthen housing, long-term services and supports (LTSS), and health care access in rural regions.

"Rural communities are often left out of statewide policy conversations," said Pauline DeLange Martinez, research and community engagement manager at the institute and lead author of the recommendations. "These briefs highlight the urgent need for action and provide a roadmap for building aging equity through policies that truly work for all Californians."

The Rural Aging in California: Policy Brief Series looks at some of the most pressing issues for older adults, including:

• Housing and homelessness
• Long-term services and supports, including home care
• Access to health care in rural areas

Martinez noted that rural counties are likely to see the steepest rise in older residents who need more help with daily life activities such as bathing and dressing, preparing meals, managing medication and traveling to medical appointments or the grocery store. Yet many of these same areas lack workers to meet the demand. The policy briefs highlight significant shortages across the LTSS and health care workforce, limited transportation options and fragmentation across state systems - all issues that disproportionately impact rural regions.

Martinez will speak on a statewide panel Dec. 11 from 2:30 to 4 p.m. PST to discuss how "rural" is defined and how that affects access to care, transportation and support services. Register to join here.

Wide range of input

The policy briefs draw on listening sessions, focus groups and interviews with residents of seven rural counties across the North State, Central Valley and Inland Empire. These conversations helped researchers understand where state programs miss the mark and specific changes that could improve access. The recommendations support the goals of California's Master Plan for Aging.

Programs built for cities often do not work the same way in rural regions. Long travel distances, fewer service providers and limited transportation can make even simple tasks difficult. With current budget pressures and an aging population, researchers say the state needs to act now so rural older adults are not left behind leading to preventable crises and higher health system costs.

The briefs emphasize that rural communities bring deep strengths - tight networks, multisector collaboration and local innovation - but they need state policies designed with rural realities in mind.

"These policy briefs bring to light the unique challenges of accessing services and supports for older adults in rural California. Long-term care systems must be designed with input from those on the ground, rather than prescribed to them," said Megan Burke, director of California Health and Aging Policy at The SCAN Foundation.

"Through listening to leaders and older adults in rural California, we can better understand how to build supports that meet their needs. In doing so, we strengthen local economies, prevent costly hospitalizations and institutional care and ensure that California's Master Plan for Aging delivers on its promise for all communities - including the most rural," she said.

UC Davis expertise impacts policy and caregiving

The project builds on UC Davis's Rural Multisector Plan for Aging Initiative and reflects input from more than 60 policy experts and local leaders. The goal is to help state agencies plan so older adults - no matter where they live - can get the care and support they need.

Founded in 2018, the Family Caregiving Institute's world-class group of clinicians, educators and researchers have supported the more than 63 million individuals who provide care to aging family members or friends in the U.S. Through research for best practices, they also assist agencies in understanding what in their organization works, what does not work and what the implications are for practice and policy.