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Aging in Rural Areas

Rural areas present a distinct challenge to providing services to individuals who are visually impaired and blind, and especially to those who are older.

I have had the experience of working in an urban area and in a very rural area. The barriers to individuals with visual impairmetns in rural areas seem to far exceed those of individuals living in urban areas.

Some of the major challenges and/or barriers to services that I have noticed over the years included:
• Access to transportation
• Access to additional social services, such as Meals on Wheels, senior centers, etc.
• Less frequent vision rehabilitation services, and/or fewer sessions/services
• Access to health care/eye medical

Most of you provide at least some services to rural areas.

What do you see as the most challenging barrier to services, and what is the greatest challenge for individuals who are visually impaired in your rural areas.

And, what are some creative techniques or resources you have utilized or accessed to help ensure those living in rural areas get high quality services?


Bill Tomlin's picture

Here in MA, we face similar challenges in the rural areas. I would say that transportation is the primary challenge for our consumers who live in the outer regions. The Senior Centers have vans to transport, but don’t cross over town lines in many of the remote areas. It makes it difficult for them to get to low vision supports groups, which are happening in all regions in MA. Uber and Lyft are options, but our seniors aren’t comfortable with this option. The one other big challenge in one western region is that there are no low vision doctors to provide evaluations that are so needed for OIB programs. What we have done is to try to get 5-7 consumers at a time, for example, in the Springfield area and have a low vision specialist from the Boston area (Carroll Center) travel out there to assess 5 – 7 at a time at a senior center. He spends the entire day there, which has been extremely effective. In MA, we continue to partner with the MA Council on Aging in creating “Low Vision Tech Centers”. The MA COA came to us with an idea a few years ago where they would provide funding for the equipment and have MCB recommend the different types, based on consumer needs. (CCTV, video magnifiers, i-phone, i-pad, etc.) We then found volunteers from our consumer base who had technology backgrounds and skills, so that they could help train seniors in the centers on technology and the equipment. They are given a small amount of money to do the training and to be there during certain hours. I think this was a 3 year “pilot” that if successful, may become a template for other town’s senior centers. One of our contractors began to grow the number of locations, some of which are in rural areas. It not only helps with learning technology, but it gets our consumers out and socializing at the same time. There are many Lions Clubs who have volunteer drivers to help with transportation as well.
Bill Tomlin's picture

All four items you list are issues for Older Blind Living in rural areas. I would also add isolation and access to technology. The greatest challenge seems to be transportation. Transportation affects their ability to access medical care, it’s an issue for access other services, and creates problems with isolation. Many seniors have to move to more urban areas due to the lack of transportation. Our VRT’s and assistive tech person do some remote technology training. One issue with remote training is lack of infasturcture for technology in remote areas. There are rural communities where the internet is only available with dial-up or through cell service if it is available. The companies that provide those services are reluctant to expend money to put in the lines, cell towers, etc. when they know the return will be less than the expense due to the low population.
Bill Tomlin's picture

Sylvia, I have to agree with the information you’ve already received in this string of emails with an emphasis on the isolation. While some smaller rural communities might have a support system of friends and neighbors looking out for some of the elderly who have vision loss or other health issues; there are many instances where consumers are living remotely and are truly alone with no family or friends living nearby any longer. And in some instances, the support system of friends and neighbors that are helping are people whose health is also failing or they are significantly older than the person with the vision loss. Yes, transportation is also a barrier for many seniors to need to access specialty services or healthcare needs. Even if they move to a more urban area, city wide transportation might be limited or not available for door to door service.
Bill Tomlin's picture

Beverly has it completely right. Also in Minnesota, with the way our vendered training model works, we have areas of the state where we don’t have any COMS or rehab teachers. We have moved to an in-house model for AT, but with only two guys, they are scheduled at least 7 weeks out or more. Our senior partnership program called Aging Eyes helps a lot. We have partners who provide simple, introductory, low vision services for folks who have simple needs and are new to vision loss, mostly Mac D.
Bill Tomlin's picture

In Nebraska we face these same challenges. Transportation is a major issue. Along with the services, you’ve listed, affected by lack of transportation is also, access to a grocery store. Many small towns do not have even a basic store with groceries. People need to travel some distance to get groceries.
Bill Tomlin's picture

In Virginia, we also face these same challenges. We have had success providing regional. training activities in each of our five outlying areas as well as at the rehab center in Richmond. These activities bring together a small group of seniors for two or three days to have intensive training sessions. The week at the rehab center is called a senior retreat and it involves a senior with a plus one who can be a partner, family member or friend to go through a week of intensive training. The senior retreat happens each year during the last week and August and has been very successful. We use OBG funding. These “community training events“ were written into the original OBG grant more than 20 years ago. Obviously we limit it to consumers who are currently open for services.