Aging in rural America: Helping networks of older adults in Appalachia

The Healthy People 2020's new objectives for older adults, the nation's fastest growing age group, target the lack of services and support for older adults and their caregivers. Rural older residents in particular have care challenges unique from their urban counterparts. Thus, the purpose this study was to understand the formal and informal care networks of rural older adults and their helpers.

A random sample of 471 older adults living in rural southwest Virginia completed a telephone interview about their service use and helping networks. Respondents were asked about the number, type, and nature of the sources of support they use, and their perceptions of community services. A follow-up telephone survey was conducted with 193 individuals identified by the older adults as their helpers. These formal and informal caregivers were asked about their reasons for helping, the extent of support they provided, and their perceptions of community services.

Most older adults relied primarily on informal helpers (60%) or a combination of informal helpers and community services (16%). They needed the most help with transportation and mobility activities. Both older adults and their helpers attributed the provision of care to relational expectations (41.5%) and attachments (32.5%). Helpers also felt an obligation to help (80%), even if it added to the demands of their daily lives. Findings suggests that informal care networks of rural older adults are deeply rooted in norms of filial responsibility, and that public health measures are needed to support both rural older adults and their helpers.