Tiny Iowa Farm Town Offers Nation a Glimpse at Future of Elder Care

Margaret Feld sent her regrets that she was unable to make it to lunch, so the others went on without her. The six friends are all widows and they get together often, in big groups and small, for a cup of coffee, a game of canasta or a trip to the mall. Getting along in years, they have only each other.

This is a town full of lonely old women. The farmers’ wives who have raised children, buried their husbands and grown old and gray and unsteady live alone in this rural community in central Iowa, where cornfields and prairie stretch to the horizon.

One in every five households in Rockwell City and surrounding Calhoun County is occupied by someone 65 or older, living alone. That ratio is more than double the national average and is the highest of anyplace in the country, according to Census figures. Nearly half of all county residents are over 65, according to a 1997 Iowa State University survey.

“Come Sundays,” said Gladys O’Tool, 71, a widow for three years, “you go to church and you just glance around and you see entire pews filled with nothing but widows. There’s a lot of us around.”

Rural Communities’ Aging Population

In the coming decades, there will be many more widows across the United States. With Americans living longer, the Baby Boom generation inching toward retirement and wives outlasting their husbands by seven years, on average, the number of seniors spending their twilight years in solitude has increased dramatically since 1970. Nearly 10 million of the roughly 25 million Americans living on their own in 1997 were 65 or older; 70% were women.

Midwestern towns such as Rockwell City provide an early glimpse of what the rest of the nation can expect as the young desert these small, dying farm communities to find jobs and opportunities elsewhere, leaving behind their parents and grandparents. Of the 10 counties in the United States with the greatest percentage of elderly living alone, nine are in rural communities throughout the Great Plains region and two are in Iowa.

The result is that these tiny, out-of-the-way hamlets have gotten a jump on the rest of the nation in calibrating precisely what it takes to care for their older neighbors, people at once fiercely proud and increasingly vulnerable, clutching their independence even as their ability to do everyday tasks slips away.

“I’m not moving,” said 91-year-old Florence Heid, a widow for 20 years. “I don’t want to go live in some nursing home. The undertaker gets me next.”

An Army of Public Health Personnel

Calhoun County is a close-knit community of about 11,000. Nearly all have either tried their hand at farming or are related to someone who did. The county focuses its social service and public health efforts on helping Heid and other seniors stay in their houses for as long as possible. The county’s two nursing homes are more costly and are viewed by the elderly and the county’s bureaucracy as a last resort for the most feeble and forgetful, who are no longer safe in their homes.

Almost one-third of the county’s $4.8-million annual budget is spent by the Public Health Department, which administers virtually all government services for the elderly. Only schools and roads consume a bigger chunk of the county’s finances, and the board of supervisors here siphons a portion of the county’s property tax revenue to help send a small army of public health nurses and aides into the homes of the aged to draw their baths, cook, clean and even clip their toenails when arthritis or a bad hip leaves them unable to reach their feet. The visits also provide the elderly of Rockwell City and its neighboring towns with the comfort of company and the blessing of conversation. Perhaps as much as any physical ailment, depression and loneliness are often the sharpest pain for the aged living alone.

“Well, of course I’m depressed,” said Ruth McClure, 85, who lives with her cat and spends her days in a recliner, watching “The Price is Right” on television and doing crossword puzzles. “I sit in the house and can’t get out and no one comes to see you. You get so lonesome.”

Since her stroke nearly five years ago, Virginia Pierce, 79, has had an aide to help her get dressed in the morning and do some of the household chores.

When Pierce fell and broke her hip two years ago, the doctor urged her to move into a nursing home. She did not, deciding that she was happiest in her own house.

“Oh, my son asked me to move in with him, but you know how that goes,” she said, a telling smile stretching across her face. “You just get along better living on your own.”

As she speaks, the county home care aide, Cheryl Pearson, is moving about the house. She cooks, cleans, helps Pierce with her physical therapy and even does the older woman’s hair. “It took me a while to get her bangs the way she likes it,” Pearson said.

Twenty years ago, seniors in failing health would have been considered unfit to live alone, said James Sykes, assistant director of the Institute on Aging at the University of Wisconsin. But in recent years, gerontologists have come to believe it is better for many older people--certainly better for their mental health--to stay in their homes as long as they are physically able.

“It’s not always best to snatch up your roots and move to someplace that’s completely unfamiliar just because your children live there or it’s sunny,” Sykes said. “Once they’ve reached 65 or 70, they are completely familiar with that house, that neighborhood, that community, and that then becomes a good place to grow old. What’s typical in small Iowa towns today is going to be typical all over the country tomorrow.”

Officials in Calhoun County have found that helping seniors remain independent is a complicated undertaking. And one that can be difficult to achieve. When cuts in federal and state aid threatened the county’s home aide program a few years ago, county officials dipped into property tax revenue to help plug the shortfall, rather than drastically reduce services they provide the elderly.

Yet strangely, the fiscal burden of caring for so many widows has not produced the kind of generational wars feared elsewhere. Voters here don’t seem to mind. So many either rely on the county for help or have parents who do that even those with school-age children don’t complain about how their tax dollars are spent.

“It’s never been an issue,” said Dean G. Hoag Sr., vice chair of the county’s board of supervisors. “I would look forward to running against someone who tried to make it an issue.”

In fact, instead of hardship, a sort of “silver industry” has emerged in Rockwell City. Grocery stores deliver, banks sponsor day trips for elderly depositors and apartment buildings are synonymous with retirement communities.

“The fact that the elderly stay in their homes gives a lot of us jobs,” said Jane Condon, administrator for the county’s health department. “We help each other survive when there really isn’t much to survive on out here except beans and corn.”

Even after their husbands die, few wives leave Calhoun County for warmer climates or move in with their children. Their existence has for so long revolved around the seasons, the rhythms of the soil, watching first their fathers, then their husbands disappear into the fields, that they simply don’t want to leave. Joined by both the land and their loss, the women band together in informal support groups, consoling each other with laughter or daily card games.

Bim Yeazel’s husband of 52 years died in August, and it seemed as if half of Rockwell City knew what she was going through. “All the widows come to you,” she said, tears welling up in her eyes. “They really reached out to me.”

Yeazel joined three friends at Mary Gregory’s home for lunch one day last week. All are widowed, and they and two others socialize regularly. The women talk about their diets, exchange recipes, brag about their children. They car-pool to church and rummage through garage sales.

“Remember when we held that umbrella over us in a rainstorm so we could finish our card game?” said Dortha Roske, 77, a widow for 23 years.

On trips out of town, “we would stop at a motel over a long weekend and we would always look under the bed to see if there was a man hiding under there,” said Janice Hanson, a 65-year-old widow. “We never found one.”

So the widows of Calhoun County get by with humor and each other and occasional visits from their children. “But you have to understand,” said Lori Wirtz, Gregory’s daughter, as she leaves the gathering of older women at her mother’s house, “they’d all really rather be with their husbands.”