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Rural Aging – Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

Evidence-Based Examples

Fit & Strong!®
Updated/reviewed August 2020
  • Need: Osteoarthritis is a chronic condition which often causes multiple related disabilities in older adults.
  • Intervention: An 8-week physical activity, behavior change, and falls prevention program geared to older adults with osteoarthritis.
  • Results: Participants gained confidence with increased exercise, lessened stiffness, improved joint pain and improved lower extremity strength and mobility.
Telepsychology-Service Delivery for Depressed Elderly Veterans
Updated/reviewed December 2019
  • Need: To provide evidence-based psychotherapy for depression in elderly veterans who are unable to seek mental health treatment due to distance or stigma.
  • Intervention: Telepsychology-Service Delivery for Depressed Elderly Veterans compared providing behavioral activation therapy via home-based telehealth and the same treatment delivered in a traditional office-based format.
  • Results: A 2015 study and two 2016 studies show that providing treatment via home-based telehealth to elderly veterans in South Carolina resulted in the same improved health outcomes, quality of life, satisfaction with care, and cost of healthcare compared to those receiving face-to-face treatment.

Effective Examples

funded by the Federal Office of Rural Health Policy Livingston County Help For Seniors
Updated/reviewed May 2020
  • Need: Meeting the health needs of geriatric patients in rural Livingston County, New York.
  • Intervention: The Help for Seniors program was developed and using its 'vodcasts,' local EMTs were trained in geriatric screening methods and health needs treatment.
  • Results: In addition to developing a successful model for educating EMS personnel, the program screened over 1200 individuals and identified various risks among the geriatric population.
LIFE - Living well through Intergenerational Fitness and Exercise
Updated/reviewed December 2019
  • Need: Older adults in rural Iowa have inadequate access to physical activity specialists and/or exercise facilities, which limits their ability to remain sufficiently active.
  • Intervention: Iowa State University implemented an intergenerational "exergaming" program to encourage fun and safe physical fitness among rural older adults.
  • Results: Pilot studies showed that older adults demonstrated increases in strength, flexibility, activity levels, and confidence in their ability to be physically active. Younger adults experienced reduced ageism and increased knowledge and expectations of aging.

Promising Examples

funded by the Federal Office of Rural Health Policy ARcare Aging Well Outreach Network
Updated/reviewed March 2020
  • Need: To reduce falls and improve chronic care management for adults 50 or older in rural Cross County, Arkansas.
  • Intervention: The ARcare Aging Well Outreach Network, run by an FQHC, provided services like falls prevention assessments, transportation to appointments, medication management, and senior-specific exercise opportunities.
  • Results: From May 2015 to April 2018, the network served 639 patients through 1,580 medical encounters.
SASH® (Support and Services at Home)
Updated/reviewed January 2020
  • Need: In Vermont, the growing population of older adults, coupled with a lack of a decentralized, home-based system of care management, poses significant challenges for those who want to remain living independently at home.
  • Intervention: SASH® (Support and Services at Home), based in affordable housing communities throughout the state, works with community partners to help older adults and people with disabilities receive the care they need so they can continue living safely at home.
  • Results: Compared to their non-SASH peers, SASH participants have been documented to have better health outcomes, including fewer falls, lower rates of hospitalizations, and fewer emergency room visits.
funded by the Federal Office of Rural Health Policy Health Coaches for Care Transition
Updated/reviewed December 2019
  • Need: To help older patients with chronic conditions learn to manage their illnesses and thereby reduce hospital readmissions in Oconee County, South Carolina.
  • Intervention: Community volunteers trained as health coaches mentor discharged patients with certain chronic conditions, to help them transition from home health care to self-care.
  • Results: Participants had improved health behaviors and reduced readmissions.
Health Motivator Program
Updated/reviewed July 2018
  • Need: To increase physical activity and other healthy habits for older adults in West Virginia.
  • Intervention: Community members called Health Motivators lead senior centers and community groups in a monthly educational activity.
  • Results: In a 2016 survey, 97% of Health Motivators and 92% of group members said that their health improved because of the program.

Other Project Examples

Age-Friendly and Dementia-Friendly Winnemucca and Humboldt County
Updated/reviewed September 2020
  • Need: To make a rural community more inclusive for older adults.
  • Intervention: Winnemucca, Nevada, holds monthly meetings around topics like health, housing, social events, and transportation.
  • Results: So far, these meetings have led to more accessible transportation and parking. The effort went countywide in 2017.
Rural Resources Diner's Choice Program
Updated/reviewed September 2020
  • Need: Many older adults are lacking proper nutrition, due to an inability to prepare food, lack of financial resources, depression due to social isolation, or general frailty associated with aging.
  • Intervention: The Diner's Choice meal program provides 12 coupons each month to older adults for local restaurants in two rural counties in Washington.
  • Results: Older adults in Pend Oreille and Stevens counties receive much-needed nutrition and social interaction, leading to healthier lives.
CAPABLE (Community Aging in Place—Advancing Better Living for Elders)
Updated/reviewed July 2020
  • Need: To help older adults age in place.
  • Intervention: For five months, CAPABLE participants receive home visits from a registered nurse, occupational therapist, and home repair services.
  • Results: The CAPABLE site in rural Bath, Maine, has helped 15 clients so far, one of whom went from 15 falls and one hospitalization in the 6 months prior to starting the program to one fall and no hospitalizations. The site in Hawaii has served three clients in the last year and has reconnected clients with their families and communities.
SMiles Senior Transportation
Updated/reviewed July 2020
  • Need: To provide transportation to rural seniors who are no longer able to drive.
  • Intervention: SMiles, a rural senior transportation program, was implemented in Blount County, Tennessee.
  • Results: Since 2013, SMiles has provided over 35,000 rides to its rural seniors.
Hospital2Home
Updated/reviewed May 2020
  • Need: To prevent readmissions and improve the recovery process for older adults in rural southern Ohio.
  • Intervention: Hospital2Home identifies high-risk individuals and provides vouchers for services like personal care and home-delivered meals.
  • Results: In the program's first year, Hospital2Home served twice as many patients as the region's previous program and used 27% less funding. In addition, 89% of patients did not readmit for 3 months post-hospital discharge.
funded by the Federal Office of Rural Health Policy Community Healthcare Integrated Paramedicine Program (CHIPP)
Updated/reviewed January 2020
  • Need: To reduce 911 use and improve older adults' health in rural Santa Cruz County, Arizona.
  • Intervention: Community paramedics make scheduled visits to patients and connect them to other community resources.
  • Results: CHIPP has assisted over 150 people so far, and 911 calls have decreased.
Geezers, Gulpers, and Gardeners
Updated/reviewed November 2019
  • Need: Suicide rates among white males age 65 and older have been rising in North Carolina. Challenges include losing friends, illnesses, and the loss of independence – all of which can lead to isolation and depression.
  • Intervention: The Chatham County Council on Aging of North Carolina started Geezers, Gulpers, and Gardeners (3G Group) to connect retired men in need of male friends and mutual support.
  • Results: Men in similar stages of life and varying backgrounds are forming friendships, engaging in activities, and taking care of their mental health.
Great Plains Senior Services Collaborative
Added November 2019
  • Need: To help rural, low-income older adults in rural Minnesota, Montana, and North Dakota maintain their independence and improve their health and well-being.
  • Intervention: The Great Plains Senior Services Collaborative improves service coordination, promotes social engagement, and provides programs like healthy cooking classes and caregiver support.
  • Results: Phase I served more than 1,100 vulnerable older adults in 70 communities, who reported lower stress and better quality of life.
Right Side Up Falls Prevention
Updated/reviewed January 2018
  • Need: Falling is one of the leading causes of morbidity and mortality in adults over the age of 65.
  • Intervention: The Right Side Up program was implemented in rural Otter Tail County to address the prevention and management of falls and risk for falls through in-home assessments given by interdisciplinary healthcare professionals and students.
  • Results: Short-term outcomes revealed 100% of participants found the visit and recommendations for falls prevention to be helpful, and 78% implemented these recommendations.

Last Updated: 9/11/2020