‘It’s Just Really Hard’- Families and Caregivers Struggle to Find Resources Inside Appalachia

Across most of central Appalachia, the population is declining as young people leave to find work. Those who stay, are rapidly aging. In West Virginia, for instance, about 16 percent of the population is 65 or older, according to a Department of Health and Human Resources report. Seniors are expected to be about a quarter of the total population by 2030. 


This trend affects a majority of the counties in Appalachia, according to a 2018 report by the Appalachian Regional Commission. The study concluded that while younger people are moving to cities, rural areas throughout our region will continue to see an increase in elderly population.

Today, many seniors in rural communities don’t have the support they need to live independently, safely. Who’s going to care for our elders in the years to come? In this episode of Inside Appalachia, we’ll explore the resources available to caregivers and their loved ones. We’ll also hear what some people are doing to help seniors feel less alone and isolated.

Appalachia Health News Coordinator Kara Lofton spent several months researching and reporting on these issues, and we're hearing her full series about aging in this week's episode.  

Shelia Brown sits on her couch below framed pictures of she and her husband over the years. The two were married for 50 years. Her husband Waitman passed away from lung cancer in 2018 after being in hospice for almost a year.
Credit Kara Lofton/ WVPB

Alzheimers

For families struggling with Alzheimer’s in Appalachia, the road can be lonely and long. Alzheimer’s is a brain disease that is the most common cause of dementia in older adults. Patients with the disease can live as long as 20 years after diagnosis. The rate of Alzheimer’s is increasing in every state in the union. Researchers, including some at West Virginia University, are working on a cure, but we still don’t have a good understanding of what causes Alzheimer’s, let alone finding a way to reverse or stop the disease. Which means for families struggling with Alzheimer's, there's no end in sight.

Staying Home

Is it better to stay in your home when you get older, or move into an assisted care facility? Most older adults Lofton spoke to for this series said they want to stay home as they age. But is that the best option? It depends on the situation.

There are a handful of programs across Appalachia to help people stay in their homes as they get older. But some have limits – you have to qualify for Medicaid, for instance. Others that help seniors just above the poverty line don’t have the capacity to handle the need. People can sit on waitlists for months, or even years.

Fighting Loneliness

Isolation and loneliness can have negative impacts on our health. The new National Report on Healthy Aging found that 1 in 3 American seniors report being lonely. Laurie Theeke, a nursing professor at West Virginia University who has conducted studies on loneliness, said isolation and loneliness can have a big impact on human health. “We know that loneliness has a negative impact on human health -- let me just say that,” she said. “And it also is linked quite clearly to inflammatory problems like hypertension, coronary artery disease, stroke and depression. And we know it leads to functional decline and overall mortality in older adults samples... from many countries.”

Health professionals say simple interactions, such as chatting with the mailman or a meal delivery person, can have some impact on loneliness. But the amount of impact varies from person to person.

There is no easy solution to any of this. Nonprofit and faith-based groups can pick up some of the slack, but it’s easy to see that without a more coordinated effort, many of our older generation will fall through the cracks and suffer because of it.

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End of Life

People can be suspicious of end-of-life care, especially hospice. There’s a perception that when hospice comes in, it’s only for the last hours before someone dies. But hospice advocates argue the service helps the dying live their last weeks or months better, and can also ease the caregiving burden on their families.

To get a better idea of what hospice is all about, Lofton sat down with Lori Carter, who’s been a hospice nurse for 20 years. Carter said for her and for many of the hospice nurses she knows, the work is a calling.

Some of what she does is straight-up nursing -- managing pain, dressing wounds, and addressing symptoms of end-stage disease. But the most subtle part of the job is helping families navigate one of the most intimate and emotional times of their lives.

There are a number of challenges facing our elderly. We want to hear from you. Are you caring for someone in your family? What are the resources you think we neglect to offer people as they grow older?

If you’re above the age of 65, we’d like to know how it’s going, and if you think we as a society do enough to care for our elders, or support your independence. Send us an email to insideappalachia@wvpublic.org. Or send a letter to 600 Capitol Street, Charleston, WV 25311.

We had help producing Inside Appalachia this week from Appalachia Health News Coordinator Kara Lofton. Appalachia Health News is a project of West Virginia Public Broadcasting, with support from CAMC and Marshall Health.

Music in today’s show was provided by  Dinosaur Burps, Michael Howard, and Ben Townsend.

Roxy Todd is our producer. Eric Douglas is our associate producer.  Our executive producer is Jesse Wright. He also edited our show this week. Our audio mixer is Patrick Stephens. You can find us online on Twitter @InAppalachia.