Implementation Challenges

There are many possible challenges that can arise when implementing a program to support aging in place in a rural community. Although challenges are specific to each program, broad challenges that may be encountered include:

• Funding or financial sustainability. In order to implement an aging in place program, it may be necessary to have funding for staff salaries, community outreach and engagement activities, space, and supplies. Other funding challenges in aging in place programs include:
  • Cost of home modification, renovation, or construction
  • Cost of appropriate aging in place medical equipment, including mobile health monitoring technology
  • Cost of travel for program participants and program staff
  • Medicaid waivers and Medicare reimbursement for services and non-standard care
  Possible Solutions: Partnerships, Financial Resources.
• Long-term care workforce shortages due to low wages, limited benefits, poor career advancement opportunities, and potentially difficult and unsafe work environments. This shortage impacts the availability of home healthcare and other programs to support aging in place. The vacancy and turnover rate for paraprofessional direct care staff is increasing, which forces some family members to quit their jobs to support their ailing family members. Without system-wide funding or policy solutions, long-term care providers are left with high vacancy rates, and these issues are particularly difficult in rural areas.
  Possible Solutions: Financial Resources, Staff Training and Education.
• Infrastructure challenges such as:
  • Limited public transportation services
  • Poorly maintained sidewalks
  • Poor design
  • Lack of compliance with Americans with Disabilities Act (ADA) guidelines
  • Lack of streets that accommodate multiple forms of transportation, which fail to accommodate all community members, regardless of age and ability.
  Possible Solutions: Financial Resources, Partnerships.
• Acceptance of a new program or strategy requires buy-in from community residents, community organizations, and healthcare providers. If aging in place models are not embraced by community members, then successful implementation of the aging in place program may become restricted. Programs should make it easy for communities to support older residents' health, well-being, and independence as well as their social and civic engagement.
  Possible Solutions: Partnerships