Caregiving in rural communities

The challenge

Most older people want to age in place in their own homes, but 70% will need long-term care – help with activities of daily living like eating, bathing and dressing. Long-term care can keep you living independently for longer, but it can be expensive and most people don’t have a way to pay for it.

Older adults make up a higher share of the population in rural areas and face additional challenges when it comes to aging at home. Lynn Kimball, the executive director for Aging & Long Term Care of Eastern Washington (ALTCEW) says many factors can impact older adults’ access to long-term care in rural areas.

Physical access (including the impacts of winter snow and summer wildfires) and lack of transportation can create significant barriers. The nationwide shortage of professional caregivers is often worse in rural communities and there are fewer working age people in rural communities who can provide care. Older adults in rural areas also face the impacts of limited access to healthy, affordable food; affordable housing; and broadband.

“You see a lot of reliance on family members and neighbors to get your needs met,” Kimball says. She points out that local communities often have to get creative in finding ways to take care of each other and address these challenges.

Dani Rice, a caregiver living in Asotin, says it can be hard to get caregivers from larger areas to come to small towns to provide services due to transportation costs and limited community transportation options. When she needed long-term care after a spinal cord injury a few years ago, she was also the only caregiver in the town where she lived at the time and her mother had to step in to provide unpaid care.

“Families struggle to make it work because we don’t have a choice,” Rice says. The family members, friends or neighbors who provide unpaid care often have to take time off from their jobs to do so and sacrifice their own financial security.

Finding solutions

In Washington, there are several groups working to address the shortage of professional caregivers, including in rural areas. The Department of Social and Health Services (DSHS) has a workforce development team focused on improving provider recruitment, retention and career advancement.

Julie Gardner is a workforce development long-term navigator at DSHS responsible for recruiting and supporting caregivers in eastern Washington. In her work, Gardner faces challenges with access to technology, language access and finding new ways to reach people in rural areas who may be interested in a career in caregiving.

“It's been a challenge to figure out how to get into some of these communities and get them through the process,” Gardner says. Her efforts have included outreach through WorkSource and DSHS offices, job fairs, and getting flyers into libraries and other community locations. In addition to DSHS’ work in this area, the Workforce Training & Education Consulting Board is also leading an effort to address long-term care provider recruitment and retention statewide.

What WA Cares is doing

As we work to implement the program, the WA Cares Fund team is already planning how to best serve beneficiaries in rural areas. To ensure we have enough providers to offer services to all WA Cares beneficiaries, we have a team dedicated to recruiting and supporting providers. In addition to participating in state-level efforts, this team is planning for other ways to increase providers in areas where they are most needed.

Some of these plans are as simple as making it easy for providers to register so more of them are willing to go through the process. We are also looking at policy solutions to help address this problem. For example, as part of our work with the LTSS Trust Commission to set maximum rates for providers, we’re studying ways to incentivize providers to offer services in rural areas.

WA Cares also offers a variety of ways to use your benefit, many of which do not depend on the availability of professional caregivers. The ability to make a family member a paid caregiver helps us tap into an additional source of care and offers more options for beneficiaries who want to receive care from a loved one. You can make a family member – even a spouse – your paid caregiver and get them training and other resources. Or you can use your benefit for things like home safety modifications or assistive technology that can help with some care needs, like medication reminders and fall detection.

Learn more

Interested in hearing more about long-term care challenges in rural areas? Check out the recording of our February webinar, WA Cares Conversations: Caregiving in Rural Communities.