Letter From Langdon: The Tough Business of Growing Old
Rural areas have a higher percentage of elderly residents. Their quality of life depends on what local governments can scrounge and what local volunteers can give.
Merry Oswald (1914-2007) and great-granddaughter Anna Rehberg.
One of the toughest businesses around Langdon is the business of growing old. Without employment opportunities, young adults more often than not leave behind rural areas for life and opportunity in the big city. While they may not completely leave their small town upbringing behind them, more often than not they do leave behind aging parents.
My family recently experienced the passing of our oldest living family member, my mother Merry. Mother outlived her life-mate and most lifelong friends. She was lucky that her children and grandchildren lived close enough to help her with trips to the doctor and other problems that sometimes arose. Not everyone in Mother’s generation is as fortunate as Merry was.
It’s difficult to make decisions for a parent. My sister and I were favored in that our mother was able to make most of her own. Both she and Dad saw to it that they had advance directives and a power of attorney. That helped our family to recognize what was expected of us. It also made watching life take its course a bit less unsure for our family, as Mother and Dad grew older.
Mother and our family learned a few weeks ago that the cost of a room in a nursing home, where the patient requires a high level of care, is now at about $160 per day. Patients who are considered incurable do not qualify for Medicare the same as those who are recovering from illness, which leaves them and their families to bear the full cost of care. But we also learned that Medicare will pay for hospice care, which reduces the cost of daily care by a few percentage points.
In most small communities, Social Security income for the greatest generation is only about $700 per month. Some people have nursing home insurance. Those I know who have it spend about $2,000 to $3,000 per year. Add to that the cost of a Medicare insurance supplement at $2,500 or more, and the cost of living for many stay-at-home 80 and 90-year-olds becomes critical.
Health care is an issue facing all Americans, but most especially those in rural America. Rural doctors are overworked, and small hospitals face challenges when competing with better funded urban health centers. Partnering with larger institutions helps maintain a level of rural service for some health care providers, but the cost of that service is also an issue, along with the cost of nursing home care and transportation.
Unfortunately, sometimes an equally difficult aging experience is that of an increasingly isolated life. Some seemingly simple but nearly impossible tasks, like opening a childproof prescription bottle with arthritic fingers or preparing meals, can create a burden of worry. For older adults, all these concerns meld into one single issue: quality of life.
As our rural communities suffer for jobs, sometimes too the aging populations of those communities suffer for a quality life. To one extent or another, sooner or later, most need services like transportation, nutrition, health care, and suitable housing. Rising fuel costs have impacted the elderly heavily, by making it more costly to do even the most basic of things like home heating during cold weather or traveling to doctor’s appointments.
In the '90s, rural areas had a net outmigration of young adults. The numbers of 14-30 year olds declined in rural communities.
And the cost of maintaining services for senior citizens is rising faster than the tax revenues that used to support them. Over the hill from Langdon at the Rock Port Nutrition Center, where they normally feed 30 to 50 patrons daily, regular fundraisers are held just to keep the doors open. Close to half of those they feed have their meals delivered each day. This story is repeated all across the many rural communities around Langdon. In rural America, 15 percent of the population is over the age of 65. In urban areas, it's less than 12 percent.
Little known to many, even some elected leaders, is that the much publicized Meals on Wheels program applies little to small rural communities, as states may not support that funding. It may also be simply that cities siphon off most available aid. The nutrition site in Rock Port and most other small communities nearby rely almost totally on volunteers for meal delivery.
While state and federal assistance has remained flat, local governments and citizens have been left to take up the slack. Funding simply hasn’t kept up with the cost of operation, which shifts the burden of survival of seniors to the local community. As populations decline along with voter numbers, incentive for state and federal leaders to remedy the situation declines as well.
Up to the time when Mother had open heart surgery, she had always been very self sufficient. But a decline in her health meant life style changes. Most important to her health following surgery was that she eat regularly. If not for the meal service offered by our nutrition center, she might not have been able to live alone in her own apartment. Daily deliveries of her noon meals meant more than a nutritious diet. Meal delivery meant a continued independent existence. It also meant contact with the outside world when cheery volunteers showed up at her door each day with a nutritious hot lunch. For a woman who had always been self sufficient, someone who took pride in being the great-granddaughter of pioneers, independence was everything.
Thanks to her rural community’s undying effort, Merry could be merry just a little bit longer.
For some of us here in Langdon, that meant everything.