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Cost of rural care eyed

Providers seek aging research in outlying areas

Rural and urban communities have different needs, and the local Area Agency on Aging thinks it is time to remind the state of that.

According to the 2010 census, 29 percent of Wheeler County residents are over age 65 and only 10 percent of Portlanders are, but you wouldn’t know it from the research.

“What we see is a lot of need in rural communities for services and support, but the research done on aging has focused on the urban communities,” said Julie Reynolds of the Senior Advisory Council.

Reynolds and Marvin Pohl, the Area Agency on Aging’s director, brought members of the Portland State University Institute on Aging to The Dalles Monday to speak with local healthcare, social services and government leaders about using the five-county area of Wasco, Hood River, Sherman, Gilliam and Wheeler counties as a base for studying the needs and attitudes of senior citizens in rural areas.

The institute, established in 1969, is one of the oldest aging-related centers in the United States. Its research has mostly been focused on the Portland area, but when Pohl became the Area Agency on Aging director in January he said one of his goals was to help his five-county jurisdiction become a center of rural research. He said urbanites tend to have a “very skewed view of rural life” and, as a result, rural communities are often forced to cope with state policies that don’t work well for them.

At Monday’s meeting Pohl told participants having the data to back up their claims could help state officials see the need for treating rural and urban seniors differently. For example, rural Area Agency on Aging offices don’t get any more money than their urban counterparts to make up for the fact that a case management visit to the edge of their territory might involve six hours of driving time.

“Multnomah County can see 100 people in that time,” he said.

Reynolds said the Institute on Aging could provide the expertise to study the needs of senior citizens in the area and determine how they are different from the needs of senior citizens in Portland, which could result in more money for local social services. She said the data is also needed to decide how best to address the needs of an aging minority population, build an aging-friendly community and meet the needs of a new generation of retirees.

“People who are considered seniors now might have completely different tastes and expectations than the people who will be becoming seniors,” she said.

As for the question of building aging-friendly communities, Margaret Neal from the Institute on Aging told participants at Monday’s meeting that the institute could help provide expertise on that level. She has been working on applying the World Health Organization’s “Age-friendly Cities” project to Portland and would like to see the concepts applied in rural Oregon as well. An age-friendly city includes features like reliable transportation for seniors who have given up their keys, affordable and accessible housing for the elderly, accessible green space and social inclusion. Neal said features like door handles in public buildings that are arthritis-friendly also benefit people who have their hands full with groceries or a child.

“There are a lot of features of design that make good sense for all ages,” she said.

Neal said if the Institute on Aging helps study the needs of seniors in the five-county area they would like to start with focus groups to help them design the best survey possible.

No definitive decisions were made during Monday’s meeting, but participants discussed the best way to go about collecting data, and several people suggested that the group might be able to work with the Coordinated Care Organizations that are currently collecting data about medical needs.

Mid-Columbia Medical Center CEO Duane Francis said he worried people in the area are already getting “survey fatigue” but said he loved the idea of trying to become a more age-friendly community.

Janet Hamada of Next Door, Inc. said even if it takes a while for the results of the research to help guide new policies, the focus groups and surveys can be useful right away in an educational capacity — as seniors are asked about their knowledge of different resources available to them they can find out about ones they didn’t know existed.

Coco Yackley, a Coordinated Care Organization facilitator, said it would be “fabulous” to collaborate with the health care entities but pointed out that seniors have a high interest in issues such as transportation and housing as well, so the research needed to not just be healthcare-specific.

After the meeting Reynolds said the rural research project would be a long-term one but she hoped it eventually resulted in more money for services for seniors in the gorge.

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