Older Adults Story Archives - West Virginia Public Broadcasting

Aging in Appalachia: Isolation and Loneliness in Older West Virginians

Cheryl Powell lives in senior housing in Nitro. She’s 63 years old and has been receiving Meals on Wheels for a couple of years.

“Because I’ve had strokes and different things wrong with my body,” she explained.

After her strokes, Powell really couldn’t get out to grocery shop. Or go anywhere for that matter.

“I’m blind in this eye and I’m getting cataracts in this one, so it’s hard,” she said.

In some ways, Powell is lucky. She’s extroverted and although she doesn’t walk well, she leaves the door to her apartment unlocked and some neighbors stop by and chat when they feel like it.

For other seniors in rural Appalachia, meal delivery programs like Meals on Wheels may be the only contact they get with another human on a day-to-day basis.

“The things about the home delivery program is if our driver is five minutes late, the senior is calling them. And that lets me know exactly how important the interaction is with that senior,” said William Carpenter, president of the West Virginia Directors of Senior and Community Services Association.

“You know it’s not just delivering a meal, it’s a friend showing up at the door every day. And to me that’s the most important aspect of that program,” he continued.

The new National Report on Healthy Aging found that 1 in 3 American seniors report being lonely. This is huge in terms of the potential impact on health. Laurie Theeke, a nursing professor at West Virginia University who has conducted studies on loneliness, said isolation and loneliness can have a big impact on human health.

“We know that loneliness has a negative impact on human health — let me just say that,” she said. “And it also is linked quite clearly to inflammatory problems like hypertension, coronary artery disease, stroke and depression. And we know it leads to functional decline and overall mortality in older adults samples… from many countries.”

Theeke said loneliness in seniors may be worse in Appalachia in part due to how rural the area is, but there isn’t a ton of data to back that up.

“Nationally the prevalence [for loneliness] is 16-17 percent for adults age 50 and older,” she said. “And so in West Virginia we’re seeing that, for example, in one study we did of older adults, we only had one person who was technically not lonely. Many, many of our older adults had some perception of loneliness.”

Debbie Young works for the Kanawha County home meal delivery program as a driver. She said she used to deliver to a gentleman who had a huge spider web across his front porch. She’s rather short, so she was able to duck under it when she delivered his meal. The spider web wasn’t broken for weeks. And she said she doubted any other visitors were ducking.

“Some of them I know I’m the only one who sees them….at all,” she said, by way of explaining that the cobweb example wasn’t unusual.

Health professionals say simple interactions, such as chatting with the mailman or a meal delivery person, can have some impact on loneliness. But the amount of impact varies from person to person.

Carpenter said he suspects it’s a lot, though.

“It means so much for a very simple program to those seniors,” he said.

Yet across the state, home meal programs like Meals on Wheels struggle with funding. Meals on Wheels gets funding from both the federal and state governments. But the federal reimbursement rates haven’t changed in years, while the cost of providing the service — wages, gas, maintenance on vehicles — has risen. The state has increased its portion to try and make up the difference — which Carpenter said has helped — but it’s not enough. Fundraising also helps a little. But still, some programs have had to move from delivering five days a week to three.

“In Lincoln County we have about 25 people on the waitlist,” said Carpenter. “However, our funding has been so low for such a long time we haven’t actively recruited people. I guarantee you that if I went in Lincoln County and looked, I could come up with 100 people. And that’s the situation we’re in. We love what we do, but without funding we can’t promote the services to the seniors for fear they’ll use them. Because of cost. And that’s a sad situation.”

And for senior West Virginians for whom the Meals on Wheels driver is the only person they have regular contact with, reducing delivery days means they literally won’t see an actual human being that day. With 27,000 West Virginians turning 60 every year, the burden on programs like these is only expected to grow.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.

Aging in Appalachia: Seniors Want to Stay at Home as They Age — But is That the Best Option?

The percentage of West Virginia adults aged 60 and older is growing more rapidly than any other part of the population. And most of them, like 91-year-old Paige Omohundro, want to stay home as they age.

Omohundro has lived in her modest two-story brick home for 54 years and wants to stay as long as possible. But she can barely handle steps these days — which is a big problem because once you get into her home you HAVE to climb stairs. The front door opens onto a small landing leading onto a split staircase. She said she’s thought about buying a stairlift, but would have to buy two — one for each side — and they’re expensive, costing more than one grand, sometimes several thousand, apiece.

“I just don’t go downstairs very much,” she said. “I go when I have to — my laundry room is down there. Usually when my daughter comes over, she’ll carry my laundry down for me or bring it back up, so that’s a big help.”

But staying in her home is vital to her sense of well-being.

“I guess I’ve always been independent, and I do not want to go into a nursing home or anything like that unless I absolutely have to,” she said. “You lose [independence] when you have to go live in assisted living or a nursing home and that would be hard for me.”

But is staying home the best option for older adults? Well, we actually don’t know.

A 2017 review of aging-in-place literature in the journal Social Work Research found that there isn’t much analytical research about whether aging-in-place is better than, say, moving to a retirement community and adapting. Another review published in 2017 found the same.

Anecdotally…it depends.

“Philosophically, it’s a question about balancing independence or autonomy and safety,” said Ginnie Prater, a geriatrician at the University of Alabama at Birmingham. Prater said older adults like Paige often want to stay home, while their families want to move them to a facility, citing safety concerns.

“In general, if a person is able to care for themselves or arrange for an alternative — say, family members or neighbors who can come and check on them, or even pay sitter services, especially if they’re not required around the clock, just intermittently — those often are better choices than going to a long-term care arrangement,” Prater said.

But whether or not independence outweighs safety often comes down to resources, Prater added.

“If someone has enough resources, they can set up essentially a nursing home in their own home,” she said.

But most people don’t have those kind of resources, especially in Appalachia.There are some state resources to help, but the percentage of West Virginians aged 60 and older is growing faster than any other portion of the population. It’s a silver tsunami that may be already cresting. And yet, amidst the drug epidemic and foster care crisis, no one is really paying attention to it.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.

Sedentary Adults May Be More Likely to Develop Dementia

A new study has found that older adults who weren’t sedentary did better on thinking and memory skills tests. Exercise didn’t have to be complicated – it could be walking or even moderately physical housework, but the researchers found that movement may be essential to preserving thinking and memory skills when there are signs of dementia in the brain.

The study looked at more than 450 older adults – about 40 percent of which had dementia. The participants were given physical exams and thinking and memory tests every year for 20 years. All agreed to donate their brains for research upon death.

Researchers found that people who had better movement and coordination also had better thinking and memory skills. And that the more active they were, the more impact it had on their brain.

About 19 percent of West Virginians are over the age of 65.

The study was published this week in the online issue off Neurology.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health and Charleston Area Medical Center.

Keeping Mentally Sharp in Old Age May Be Related to Maintaining Fitness

A new study has found that the combination of low muscle mass and high fat mass in older adults may be an important predictor in cognitive function later in life.

Loosing muscle mass is a natural part of aging, as is gaining some weight. But both conditions also have negative impacts on overall health and cognitive function and together they may have a greater threat – surpassing individual impact, according to a new study published today in the journal Clinical Interventions in Aging.

Researchers used data from a series of aging and memory studies of around 350 participants with an average age of 69. They found that people with both low muscle mass and obesity were the most likely to have the lowest cognitive performance on working memory, mental flexibility, self-control and orientation.

In a press release, researchers cautioned that changes in body muscle and weight gain are a significant public health concern among older adults since they may lead to various negative health outcomes including cardiovascular and neurodegenerative diseases.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.

Eat a Mediterranean-Like Diet to Prevent Brain Shrinkage, Study Suggests

Eating a diet rich in vegetables, fruit, nuts and fish may help older adults prevent age-related brain shrinkage.

The study, published this month in the online medical journal of the American Academy of Neurology, suggests that diet can impact brain volume – and people with greater volume have been shown to have better cognitive abilities.

Brain shrinkage is an unavoidable part of aging. But significant brain shrinkage is associated with memory loss and loss of mental sharpness as well as premature death.

The study was conducted by researchers in the Netherlands and included more than 4,000 people with an average age of 66 who did not have dementia.

Researchers found after adjusting for age, sex, education, smoking and physical activity that a better diet – defined as a diet composed of vegetables, fruit, nuts, whole grains, dairy and fish, but a limited intake of sugary drinks – was linked to larger total brain volume, when taking into account head size differences.

Those who consumed a better diet had an average of two milliliters more total brain volume than those who did not. To compare, having a brain volume that is 3-in-a-half milliliters smaller is equivalent to one year of aging.

Researchers said the link between better overall diet quality and larger total brain volume was not driven by one specific food group, but rather several food groups.

Researchers also stipulated that their research showed an association between better diet and brain volume and said that further studies are needed to confirm the results.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.

Study Finds that Exercise Can Reverse Heart Damage in Older Adults

A new study has found that moderate exercise can reverse heart damage caused by age and a sedentary lifestyle – if it’s begun early enough and performed with enough frequency.

Researchers at the University of Texas Southwestern studied a group of about 50 participants over the course of two years.

The study found that in order for exercise to help reverse heart damage, the exercise regimen needs to start before the age of 65 when the heart retains some plasticity – meaning it is still able to remodel itself.

The study varied the kind of exercise participants did, including 30 minutes of high-intensity interval training, an hour of moderate cardio, such as walking or biking, and strength training. Researchers found the key is frequency – exercise needs to be done four or five times a week in order to reverse heart damage – anything less wasn’t enough.

Heart disease is the second leading cause of death in WV.

The study was published this month in Circulation, a journal of the American Heart Association.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.