Rural Older Adults’ Previous Help and Support Experiences: Influences on Attitudes about Current and Future Assistance

We investigated the extent to which earlier life experiences with informal and formal services might influence older adults’ views of getting assistance in the future. In a short-term longitudinal follow up of telephone interviews with a representative sample of rural, community dwelling elders (N = 532), we conducted face-to-face interviews with a subsample (n = 84) who were originally receiving informal assistance only, formal services only, both forms of support, or no assistance. We examined changes in assistance over 18 months and inquired about previous and current use of community resources (restaurants, hired help, overnight travel), home-based nursing or personal care, and formal services, as well as plans for future care needs. Past and current acceptance of external (nonfamilial) sources of support are associated with willingness to rely on formal services in the future. However, most participants expressed a strong preference for maintaining as independent a lifestyle as possible, even while expecting a need for greater assistance in the future. Whereas a minority have made arrangements for some type of formal care such as long term care insurance or nursing home placement, most intend to rely on family members for help. Few endorse depending on friends, neighbors, or other informal helpers except for occasional assistance. The results of this study have implications for research and public education on family caregiving, as well as for planning and delivery of informal and formal community services in rural areas.