Adjunct Associate Professor Maree Bernoth
Charles Sturt University Three Rivers Department of Rural Health
A symbiotic relationship exists between older people living in rural areas and their home communities. This interdependency evolves from a lifetime of growing, working and contributing to their community's life, relationships and land. The rhythms of life are determined by the seasons and the social life within the community and are integral to a sense of agency for older rural people.
Consider the trauma when an older community member has to be transported elsewhere to access aged care services or accommodation. The wrench to the individual is like being "forced into exile", one older rural resident shared with us. [1]
The Royal Commission recognised the right of those living in rural areas to "be able to access aged care in their community equitably with other Australians"; (p245) [2] however, delivering on this aspiration is proving challenging. Attracting and retaining a skilled workforce, providing timely assessment and delivering services – community and residential – are essential to respecting the rights of older rural people to age in the communities where they feel at home and safe. Again, the Royal Commission recognised the inadequacy of service provisions in rural areas and called for supplementary services to respect rights; the Regional Stewardship Teams is an example of a work in progress initiated Commonwealth Government to improve support services in the country.
Rural communities have a higher proportion of older people as younger people leave to seek employment and experience the world. It is estimated that one-third of Australia's population lives in regional, rural and remote areas, with older people more likely to live outside larger cities. Further, there is growing diversity within the older rural population, including First Nations peoples, farmers who have succeeded their properties to a younger generation, those experiencing a change in roles from paid work to retirement and a growing number of older people from culturally diverse backgrounds. These changes in life experiences can generate feelings of loss, displacement and alienation. Loneliness and mental ill health are prominent issues, especially among older rural men, and it is this group who are the most likely to commit suicide. [3] However, mental health services in rural areas are sparse and difficult to access services relevant to individuals in need of support.
Rural communities are resilient and creative, and their community-driven initiatives are making a difference. Rural older men support each other through organisations such as Older Men: New Ideas (OM:NI). Coolamon (NSW) has adopted a community approach to attracting and retaining an aged care workforce for their residential facility. Charles Sturt University Department of Rural Health has several initiatives to support and encourage undergraduate health students to experience, contribute, and return to rural communities.
However, it will take ongoing commitment, collaboration and flexibility from government, service providers, professional groups and communities to make ageing in rural areas possible and sustainable.
*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.