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For rural elderly, a patchwork of care

Posted: Tuesday, January 13, 2004

WHEATON, Minn. Alice Heggen just turned 100, but she still lives on her own in an apartment here, getting by on natural grit, some good friends and neighbors, and the charity of small-town Minnesota.

One meal is brought to her home each day. The grocery store and local pharmacy drop off food and medicine, and a young man from church brings a tape of the weekly sermon on Sunday afternoons. A county health worker visits twice a week.

Heggen is grateful for the independence. ''I wouldn't have it any other way,'' she said.

Neither would most of the older residents living in this aging region of Minnesota. But accommodating them can be tricky.

Here in Traverse County, there are more residents 75 years old and older, per capita, than almost anywhere else in Minnesota 14.1 percent compared with 5.6 percent in the state's largest county, Hennepin, where Minneapolis is located, according to Census 2000. That has created a local demand for assisted-living apartments and, for those determined to remain in their homes, services like lawn-mowing and snow-shoveling.

Demographers have long predicted a stressed health care network when baby boomers hit their golden years. But here on the western edge of Minnesota, those days are here brought on not by baby boomers but by their parents.

''What other parts of the state will experience in two or three decades, we are experiencing right now,'' said Evie Rinke, the county's aging services coordinator.

Wheaton and the nearby town of Browns Valley each have a nursing home and an apartment building for seniors, but the four facilities' total capacity is only 130. That leaves the other 400-plus residents over the age of 75 in this county of 4,100 scattered throughout four towns and farming communities.

''There is always a waiting list for independent living,'' said Chere Riki-moto, the administrator of the Traverse Care Center, a nursing home and independent living complex in Wheaton.

Moreover, the state Legislature, sparing few programs as it erased a $4.2 billion budget deficit earlier this year, cut funding and tightened restrictions for the Alternative Care Program that counties rely on for a smorgasbord of elderly services.

Two years ago, to give lawmakers some idea of the shortcomings in elderly care, the Human Services Department surveyed every Minnesota county to identify their needs. The state projects the number of Minnesotans 85 years-old and older to swell from about 86,000 now to 163,000 in 2030.

Traverse County officials found a need for more chore and companion services. In interviews with The Associated Press in August, health care workers said the county also needs a 16-unit assisted living home with 24-hour staffing, more independent living beds and specialized care for people with dementia.

The Legislature, however, has done little with the information in the surveys, said Sen. Linda Berglin, who has worked on health care issues for 30 years.

The Democrat from Minneapolis has sponsored legislation that would have the state sell bonds to help finance assisted-living development in rural areas. But the idea hasn't found much support.

''We have services we can plug in if we can get the housing built,'' she said. ''But without government assistance, it just gets to be way too expensive for most of the elderly residents.''

Rep. Torrey Westrom, a Republican from Elbow Lake, has a different take, pointing to some positive developments in his western Minnesota city, such as an assisted-living facility that adjoins the local hospital. But he's more interested in strengthening support services like Meals on Wheels than subsidizing housing development.

''It's key that state government not think it can regulate and have a solution for everything,'' he said.

LaRhae Knatterud, an advocate for the aging at the Health Department, said the surveys showed the smallest, most rural counties had basic, similar needs: transportation, chore services and caregiver support.

In the meantime, the tapestry of relatives, churches and nonprofit groups that typically provide those services is getting harder to weave in Traverse County. These days, many of the volunteers are nearly as old as the people they serve.

''One of the things in rural areas is the tremendous importance of that network, and things that affect it, like people moving away and lost population. That informal network is really incredibly important,'' Knatterud said.

Sherwood and Stella Berkness, both 77, have been slowed in recent years by various health problems. He's had a knee replaced; she's had a hip replaced. Now a health worker visits their home on Lake Traverse once a week, and they drive to Browns Valley once a day to pick up prepared meals.

''People here are fiercely independent more so than in other places, I think,'' said Rinke, the coordinator of aging services, while showing a reporter around the county. ''Maybe they've been living way out in the country for a long time, so they're used to it.''



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