One of the biggest problems a home care agency faces is a logistical one: how to consistently get caregivers to and from their rural and remote suburban assignments.
I ran an agency in Westchester County, New York for 4 years so I know how tough the logistics can be. One of our biggest problem areas was Pound Ridge, NY, situated between the cities of White Plains, New York and Danbury, Connecticut.
Caregivers tend to live in or near city centers and we called Pound Ridge the “doughnut hole” because of our inability to get caregivers there. Though it was only 35 minutes or so away, the mostly back roads are off the beaten path, winding and sometimes confusing. The area in and around Pound Ridge is also densely forested, which only added to the confusion and anxiety of commuting caregivers.
My partner and I considered a multitude of possible solutions, all of which were untenable. Shuttling caregivers by van seemed the most logical choice but that was cost prohibitive because of the low density of clients and the distance between cases. Case turnover also posed problems to the math. This was back in 2004.
An interesting fact is that aging populations are continuing to grow at a faster rate in rural and remote suburban areas. According to a recent Harvard report as cited in homehealthcarenews.com, between 2000 and 2016 the number of adults aged 65 and older grew in less densely populated areas and declined in urban ones. The problem of access to home care services in remote areas is only increasing and some how agencies need to figure out how to expand their reach.
With an increasing number of older adults calling rural and suburban communities home, home care in low-density areas must grow in order to catch up, according to a new Harvard report.
Older adults who live in less populated areas are less likely to have access to the services they need to age in place, the report says. Yet aging populations are growing there faster than in urban areas.
From 2000 to 2016, the number of adults 65 or older living in low-density metro areas increased by more than 6 million people, totaling about 15 million. Additionally, another 8 million seniors live in non-metro areas, according to the report. Meanwhile, the percentage of seniors living in dense urban neighborhoods fell.
Homeowners’ desire to age in place was a driving force for growth in rural and suburban areas, according to the report. In 2017, less than 4% of those over 65 had moved in the past year.
But still, offering home care in low-density communities comes with its own unique set of challenges. For example, in rural areas, caregivers often must travel farther, sometimes for hours, to get to patients.
“The geographic dispersion of older households is significant because lower-density areas are more difficult to service and typically provide few housing options other than single-family homes,” the report says.
In the past, Medicare’s rural add-on payments have helped home health providers overcome obstacles that come with operating in rural areas.
In 2018, rural home health agencies across the country received a 3% rural add-on payment increase. But in 2019, rural add-on payments will start to change — and decrease — until they go away entirely in 2022.
With 10,000 baby boomers turning 65 every day, a growing number of seniors will need access to supportive services.
And as baby boomers begin to turn 80 in the decade ahead, growing numbers of seniors will need affordable, accessible housing as well as supportive services. It’s up to state and local governments, as well as private and nonprofit sectors, to help make it possible, according to the report.
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