Rural Aging during COVID-19: A Case Study of Older Voluntarism

During large-scale crises such as the COVID-19 pandemic, the precarity of older people and older volunteers can become exacerbated, especially in under-serviced rural regions and small towns. To understand how the pandemic has affected “older voluntarism”, this article presents a case study of three volunteer-based programs in rural Ontario, Canada. Interviews with 34 volunteers and administrators reveal both challenging and growth-oriented experiences of volunteers and the programs during the first wave of COVID-19. The findings demonstrate the vulnerability and resiliency of older volunteers and the adaptability and uncertainty of programs that rely on older voluntarism, as the community and its older residents navigate pandemic-related changes. The article advances a framework for understanding the pandemic’s impacts on older voluntarism in relation to personal, program, and community dimensions of sustainable rural aging. Further, it explores ways that older volunteers, organizations that depend on them, and communities experiencing population aging can persevere post-pandemic.

The Association between Poor Diet Quality, Physical Fatigability and Physical Function in the Oldest-Old from the Geisinger Rural Aging Study

More perceived physical fatigability and poor diet quality are associated with impairments in physical function in older adults. However, the degree to which more perceived fatigability explains the association between poor diet quality and low physical function is unknown. We examined this relationship in 122 (66F, 56M) of the oldest-old participants from the Geisinger Rural Aging Study (GRAS). We used 24-h dietary recalls to assess the Healthy Eating Index (HEI), the Pittsburgh Fatigability Scale (PFS, 0–50) to assess perceived physical fatigability, and the PROMIS Physical Function 20a* to assess physical function. We grouped participants into three age categories: 80–84 (n = 51), 85–89 (n = 51), and 90+ (n = 20) years. Multiple linear regression revealed that a lower HEI was associated with higher PFS Physical score after adjusting for age group, sex, body mass index, and the number of medical conditions (p = 0.001). Several macro- and micro-nutrient intakes were also lower in those reporting more (≥15) compared to less (<15) perceived physical fatigability. Mediation analysis revealed that PFS Physical scores explained ~65% (p = 0.001) of the association between HEI total score and PROMIS19 Physical Function score. Poor diet quality may contribute to more perceived physical fatigability, which could exacerbate impairments in the oldest-old’s physical function.

Aging in rural Canada

This chapter provides a snapshot of Canadian rural demographic trends, an overview of the state-of-the-art thinking on rural aging, and contextual framing for in-depth research. It cites key debates on rural aging in relation to the built-environment and the extent to which it disserves the older population. It also talks about the limitations associated with lack of funding, service availability, and geographical isolation in rural environments. The chapter highlights the importance of service accessibility, particularly to the almost quarter of a million low-income, older-adult rural residents. It summarizes the existing research on aging in Canadian rural communities and further unpacks the challenges and benefits of rural aging.

How Area Agencies on Aging Contribute to Social Connection for Older Adults in Rural America

Social ecological models of health identify intrapersonal, interpersonal, institutional, community, and policy-level contexts as social factors influencing individual and population health outcomes. However how institutions such as Area Agencies on Aging (AAA) shape rural older adults’ social networks and influence health is little explored. This research examines institutional influences of social networks for rural older adults, particularly the social connections resulting from their AAA services and programs. AAAs are local social service organizations that coordinate home- and community-based supports. Our 2020 case study of a rural AAA in upstate New York involved in-depth semi-structured interviews with AAA staff, volunteers and participants included key themes related to older adults’ social networks, social wellbeing, and physical and mental health. Our findings have both theoretical implications for rural community social structure as experienced by older adults, and practical implications to build AAA’s capacity to address social isolation for rural older adults. Part of a symposium sponsored by the Rural Aging Interest Group.

Identifying the Transportation Needs of a Rural Aging Community: Findings From a Community Assessment

Community senior centers are tasked with providing aging adults services and programs, congregate meals, and transportation, set forth by the Older Americans Act. The overall function of senior centers is especially critical for rural communities, as rural communities are home to a greater proportion of older adults compared to metropolitan and low-density urban areas. To assess the current needs of the aging population in rural Northwest, OH, a total of 9 focus groups were held (N=45) as part of a larger mixed-methodological study. Through this work, older adults identified limitations of the current senior center transportation. A lack of transportation and accessibility of current transportation were noted as barriers to full senior center use. Findings from this study confirm disparities in rural transportation; a lack of transportation is a major obstacle to program completion. Recommendations address the unique challenges and needs for transportation services for in rural communities are presented.

Social Games: The Intersection of Established Reward Structures and Exercise for Older Rural Adults

A high percentage of older adults engages with games; however research about impacts of gaming on older adults is focused almost exclusively on games intended to strengthen cognitive health or slow age-related cognitive decline, very little relates gaming to exercise. Rural –dwelling older adults are underrepresented in this as in other health-related research. Nonetheless, recent developments that explore effectiveness of embedding positive health behaviors (including exercise) in established games such as Bingo hold great promise for addressing the endemic social isolation and chronically debilitating conditions often associated with rural aging. Using recent research with a challenging population group (rural Appalachian older adults) as an anchor for discussion, this paper describes the state of the art of such interventions and, through a multinational lens, finds that these suggest a new direction for gaming design that could enhance effectiveness of the use of gaming to improve health and happiness of rural adults. Part of a symposium sponsored by the Rural Aging Interest Group.

Rural Aging: Multidisciplinary, Multinational Innovations That Support New Approaches to Address Unmet Needs

The meaning of aging in rural areas is not well explored in the literature. To address this gap each presenter in this multidisciplinary and international group of researchers will address different components of rural ageing. An exact definition of “rural” is essential to forming, implementing or evaluating policies and programs impacting rural populations; however there is no universal definition. Cohen introduces definitional issues, and underscores the heterogeneity and regional variability of “rurality” and how such factors drive rural-urban disparities. Pendergrast, an early career researcher, reports results of in-depth semi-structured interviews that examined institutional influences of social networks on health of rural older adults, with specific focus on support services. Leavey describes lessons learned from the activities of PLACE-EE, a transnational partnership of public health agencies, local authorities, academics and ICT experts dedicated to improving the quality of life for older people. He describes the impacts on relationships of a program of community engagement and intergenerational exchange between younger and older citizens that used an assets-based approach. Żurek explores the potential for reward structures that can be embedded in ‘social games’ to motivate older adults to exercise in the context of research conducted in the rural US (Appalachia) and urban Poland (Krakow), and suggests a new direction that can inform services intended to improve health and happiness of rural adults. Our discussant will reflect on the major themes that emerge from these multidisciplinary perspectives, especially the potential for intersection of rural community-based innovations and learning from different regions of the world. Rural Aging Interest Group Sponsored Symposium.

Defining Rurality: Structural Relationships, Regional Differences, and Applications for Research With Older Adults

There is no universal definition of rurality due to the heterogeneity in what makes a place “rural” or “urban”. This study explored how elements of rurality are related to each other, and how the elements that define rurality vary by region. Data were abstracted for all 1948 non-metropolitan counties in the contiguous 48 states on rurality. K-means cluster analyses (k=4-8) were conducted to examine classification structures among component variables examining regional differences. In the South region, the majority (51.2%) were “Type 2” counties: low population size and density but higher urbanized population. The Midwest had a majority of “Type 3” counties (56.4%): intermediate for population size and density, but higher distances to metro areas. These exploratory findings underscore the heterogeneity and regional variability in rurality and how those measures are structurally related to each other, and essential to understanding those factors that truly drive rural-urban health disparities for older adults. Part of a symposium sponsored by the Rural Aging Interest Group.