Senior Population, Demand for In-Home Care Growing in Low-Density Areas

With an increasing number of older adults calling rural and suburban communities home, home care in low-density areas must grow in order to catch up, according to a new Harvard report.

Older adults who live in less populated areas are less likely to have access to the services they need to age in place, the report says. Yet aging populations are growing there faster than in urban areas.

From 2000 to 2016, the number of adults 65 or older living in low-density metro areas increased by more than 6 million people, totaling about 15 million. Additionally, another 8 million seniors live in non-metro areas, according to the report. Meanwhile, the percentage of seniors living in dense urban neighborhoods fell.


Homeowners’ desire to age in place was a driving force for growth in rural and suburban areas, according to the report. In 2017, less than 4% of those over 65 had moved in the past year.

But still, offering home care in low-density communities comes with its own unique set of challenges. For example, in rural areas, caregivers often must travel farther, sometimes for hours, to get to patients.

“The geographic dispersion of older households is significant because lower-density areas are more difficult to service and typically provide few housing options other than single-family homes,” the report says.


In the past, Medicare’s rural add-on payments have helped home health providers overcome obstacles that come with operating in rural areas.

In 2018, rural home health agencies across the country received a 3% rural add-on payment increase. But in 2019, rural add-on payments will start to change — and decrease — until they go away entirely in 2022.

With 10,000 baby boomers turning 65 every day, a growing number of seniors will need access to supportive services.

And as baby boomers begin to turn 80 in the decade ahead, growing numbers of seniors will need affordable, accessible housing as well as supportive services. It’s up to state and local governments, as well as private and nonprofit sectors, to help make it possible, according to the report.

Written by Bailey Bryant

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