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

Demographics: With 20% of its households occupied by someone 65 or older, typically a widow, Rockwell City finds it pays to provide extra services.


ROCKWELL CITY, Iowa — 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.

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