Survey: Seniors, rural residents and renters face the 'devasting impact' of inflation

Rising gas and grocery costs hit lower-income Americans 
harder. (Photo by rc.xyz NFT gallery, Unsplash)

Even before the Iran war, seniors and rural families were struggling to afford basics such as groceries, gas and rent. With the Strait of Hormuz closure, more Americans are under financial strain, but the higher costs hit lower-income people and families harder.

Data released by the U.S. Census Bureau's American Community Survey shows "certain groups of Americans are falling behind financially, with seniors, renters and people living outside metropolitan areas facing particular hardships," reports Stephanie Liebergen of Scripps News. The survey gathers demographic, social and economic data on Americans over five-year time spans.

Between 2020 and 2024, the "poverty rate for seniors rose in more than 800 counties when compared to the five years before, according to the survey," Liebergen writes. "Inflation wiped out almost all income gains for older Americans during this period."

Rural Americans' finances also lost ground because of lower or stagnant wages. Liebergen explains, "The median household income in large metro areas is 30% higher compared to households in rural communities, according to the new data." Renters, who tend to fall into lower income brackets, also got pinched. 

Eric Pachman, a data expert who analyzed the survey's results, told Scripps, "What the story really is, and what's really hitting me very hard right now, is the devastating impact of inflation on people at lower income brackets."

The survey does not include details on the 2025 tariff wars and the 2026 Iran war. Those two impacts have driven inflation higher, leaving more Americans spending a higher percentage of their incomes on gas and groceries.

Consumer prices across the U.S. rose at the "fastest rate since May 2023 last month, as sharp increases in energy costs caused by the war in the Middle East," reports Lydia DePillis of The Wall Street Journal. "Average gasoline prices are above $4.50 per gallon, while diesel prices have nearly doubled. . . .Grocery costs rose 2.9% since last April."

This robot helps rural seniors stay healthier and allows them to live independently longer

ElliQ is designed to be a companion and helper.
(Intuition Robotics photo)

In more remote parts of the country, residents can go for days without seeing another human. But as people age, going without human connection can be lonely and potentially dangerous. For some rural seniors living in isolation in Washington state, participating in a pilot program that pairs them with a robot companion offers a potential solution, reports Eli Saslow of The New York Times.

Jan Worrell, 85, is participating in the pilot so she can continue living alone in her home, which sits on an isolated strip of the Long Island Peninsula. Firefighters came to Worrell's home and installed her new robot partner: "ElliQ."

One of ElliQ's initial greetings to Worrell sounded like a new friend's introduction. Saslow writes, "'Oh, I’m so thrilled to meet you,' ElliQ said. 'I was worried they’d deliver me to the wrong house! I’m excited to start our journey together.'"

"A few thousand ElliQs have been shipped to seniors across the United States since 2023. . . . by nonprofits and state health departments as an experiment in combating loneliness," Saslow reports. "ElliQ is designed for the most human act of all: to become a roommate, a friend, a partner."

Initially, Worrell didn't want help or company at home. "That’s what she told her relatives whenever they gently suggested that maybe it was time to move into a care center, or closer to family," Saslow adds. "But despite her strength and stubborn independence, her doctors had warned that living alone sometimes came at a cost." Loneliness can be deadlier than many chronic diseases.

Now, ElliQ keeps Worrell company by providing conversation, medication reminders, playing music and asking questions. Saslow writes, "It has been designed to read a room, calculate moods and then decide when to speak and what to say."

A 'Nursery to Nursing Home' campaign for a rural Wisconsin community could help the well-being of children, older adults

Members of Groundswell Collective advocate for their 
'Nursery to Nursing Home' campaign (Photo The Yonder)

In Walworth County, Wisconsin, a local community group called Groundswell Collective proposed to turn a vacant wing of the county’s nursing home into a combined childcare center and senior-living space, reports Madeline de Figueiredo for The Daily Yonder.

Like many rural communities, this county has faced challenges such as a lack of child care and senior care, as well as the loneliness and isolation that can come with living in a rural area with long winters.

Abriana Krause, who lives and works in the area as a childcare provider, told the Yonder, "In Walworth County, all 2,240 licensed childcare slots, spread across the 35 active centers listed on the DCF [Department of Children and Families] website, are already full. That leaves nearly 2,680 children without stable care." Similarly, Wisconsin is projected to need 33,000 long-term care beds by 2030.

To support their proposal, the Groundswell Collective has relied on research that shows the benefits of intergenerational care, such as "boosting the well-being of both children and older people, reducing isolation, improving cognitive and physical health for older people, and cultivating empathy and connection in young children," Figueiredo explains. Intergenerational care has also been linked to dispelling age stereotypes and a renewed sense of care that affects entire communities and fosters lasting relationships.

Research also shows that the benefits intergenerational spaces offer can "extend to the caregiving staff," Figueiredo reports. "Daily interaction with both children and older adults can enhance the work environment and make intergenerational centers more rewarding for staff." There’s hope that this initiative will help the county retain nursing staff.

After almost a year of the community organizing around the proposal, the Walworth County Board approved funding in November for a feasibility study on the intergenerational care center.

Analysis: Nursing home patient capacities have shrunk, with rural areas posting the greatest decreases

Rural areas had the greatest declines in available nursing
home beds since 2019. (Pixabay photo via Medical Express) 

Despite the rapidly aging U.S. population, nursing home capacity has shrunk nationwide since 2019. According to Sadie Harley for the University of Rochester Medical Center, a recently published study in JAMA Internal Medicine showed that 25% of U.S. counties "experienced decreases in the number of supported nursing home spots by 15% or more," with rural areas reporting the greatest declines.

The dwindling number of nursing home placements for older Americans translates into "nearly 4,000 fewer beds available for new patients each day," Harley writes. "But this decline was not felt by all communities equally. It varied widely across geographic regions, with rural counties more likely to face declines of 25% or more."

Rural communities are already grappling with fewer physicians, hospital closures and strained emergency medical services. The loss of nursing home spots presents another challenge, leaving more rural residents with few other options than to travel farther for ongoing care.

Within the U.S. medical system, nursing homes provide vital care to seniors who need regular medical treatment but don't require the expertise of hospital services. They also offer interim care for patients leaving the hospital who aren't yet ready to care for themselves at home. Harley explains, "The reduction in nursing home capacity was linked to longer hospital stays, especially extended stays of 28 days or more."

The decline in nursing home care spots isn't a reflection of the number of beds a facility has. Harley adds, "This study estimated nursing homes' operating capacity by taking other resource constraints into account." Study author Brian McGarry, told Harley, "The facility may not have the staff or other resources to fill every bed."

Long-term care facilities face immigration crackdown and looming Medicaid cuts

Jackline Conteh is a nursing assistant in Va. She emigrated 
to the U.S. from war-torn Liberia. (KFF News photo)

Long-term care facilities call for immigration reform and push against Medicaid cuts as the sector faces "a double whammy from President Donald Trump’s crackdown on immigrants and the GOP’s proposals to reduce Medicaid spending," reports Jordan Rau of KFF Health News. "More than 800,000 immigrants and naturalized citizens comprise 28% of direct care employees at home care agencies, nursing homes, assisted living facilities, and other long-term care companies."

While labor shortages are not new to the eldercare sector, once the Trump administration canceled the industry's "protected" status in January and allowed Immigration and Customs Enforcement to raid health care facilities, the dynamics changed. Katie Smith Sloan, president of LeadingAge, an association of nonprofits that care for older adults, told Rau, “People may be here on a green card, and they are afraid ICE is going to show up."

The long-term and senior care industries are "urging the federal government to expand legal immigration channels for essential workers in healthcare and other sectors," reports Kimberly Bonvissuto of McKnights. "The Essential Worker Immigration Coalition sent a letter to Homeland Security Secretary Kristi Noem that [said] the shortage of legal immigration channels for essential workers 'threatens the stability of our supply chains, the viability of small businesses and the strength of the American economy.'"

Besides additional staffing shortages brought on by immigration issues, long-term care facilities continue to lobby against the Republican party's Medicaid spending cuts, which passed the House and are under Senate review. Rau writes, "Federal spending cuts under negotiation may strip nursing homes of some of their largest revenue sources by limiting ways states leverage Medicaid money and making it harder for new nursing home residents to retroactively qualify for Medicaid."

Given the current issues, providers, patients and employees all have reasons to be concerned. "The long-term care industry expects demand for direct care workers to burgeon with an influx of aging baby boomers needing professional care," Rau writes. Jackline Conteh, a U.S. nursing assistant originally from Liberia, told him, "If all these people leave the United States, they go back to Africa or to their various countries, what will become of our residents? What will become of our old people that we’re taking care of?"

Report: Social Security trust fund needs attention now if it's going to stay viable past 2034

If changes aren't made, the Social Security trust fund 
will run out of money by 2034.  (Adobe Stock photo) 

Social Security benefits play a vital role in communities nationwide; however, rural areas may be more dependent on the program because their populations skew older. Regardless of region, 73 million Americans currently depend on the program’s monthly payments; however, its 2025 Trustee Report indicates that the program needs attention to meet its expenses, reports Gopi Shah Goda for Brookings.

The report outlines how the Social Security trust fund will run out of money by 2034, and will "no longer be able to make all of its promised benefit payments," Goda explains. According to the report, the shortfall will continue to grow since the program lacks sufficient payroll taxes to cover its ongoing and predicted future costs.

"The shortfall amounts to 3.82% of taxable payroll, meaning that the payroll tax rate would have to be raised immediately—and permanently—from the current rate of 12.4% of taxable earnings to 16.1% in order for the program to be able to pay all promised benefits through 2099," Goda writes. "In 2025, that increase would have amounted to an extra $374 billion in program revenue."

Even if the Trump administration were able to eliminate all Social Security fraud, overpayments and any other human error costs, it would not compensate for the billions needed. "Even this unrealistic, pie-in-the-sky scenario would only yield 'savings' of $10.2 billion per year, barely moving the needle in terms of the program’s $1.48 trillion annual cost," Goda adds. "Social Security is already a lean operation."

Cutting more Social Security staff members would likely result in reduced services and even longer wait times for disability determinations. Goda writes, "It is very likely that any additional cuts in staffing will make it harder for Americans — particularly the most vulnerable — to access benefits they have earned, with dire consequences."

While there are solutions, few are likely to be popular. "There is no free lunch. . .changes would involve difficult tradeoffs between beneficiaries and workers as well as current and future generations," Goda writes. "Policy options that raise revenues include increasing the payroll tax rate or broadening the income base to which that the payroll tax is applied. . . . .Cutting benefits across the board, raising the retirement age at which a beneficiary is eligible for full benefits, reducing benefits disproportionately for higher earners. . . .Some action will be necessary within the next decade."

Medicare will save billions from its first-ever drug price negotiations with pharmaceutical companies

The negotiated prices will apply in 2026.
(Adobe Stock photo)

The first-ever talks between Medicare and pharmaceutical companies have yielded some positive change for Medicare expenditures, but how much older Americans will save remains uncertain. "The federal government released the new prices it will pay for 10 prescription drugs," reports Jared S. Hopkins of The Wall Street Journal. "The drugs, for serious conditions including cancer, diabetes and blood clots cost the government more than $50 billion a year altogether. . . . [But] they might not translate into much savings for many seniors."

The talks were Medicare's first foray using its massive consumer base to tamp down drug prices. "Lowering drug prices through negotiations is a milestone in years of efforts to give Medicare, the country’s biggest purchaser of prescription medicines, a power that private health plans have long deployed to keep a lid on rising drug costs," Hopkins explains. "It follows other new government measures tackling high drug prices, such as a $35 cap on how much Medicare members pay out of pocket for insulin."

Here are a few of the newly negotiated drug prices for a month’s supply compared to Medicare's 2023 list price for a 30-day supply. To read the full list, click here.

Eliquis, a blood thinner from Bristol-Myers Squibb and Pfizer: $231, down from $521;
Enbrel, an arthritis drug from Amgen: $2,355, down from $7,106;
Jardiance, a diabetes drug from Eli Lilly and Boehringer Ingelheim: $197, down from $573;
Stelara, a psoriasis drug from J&J: $4,695, down from $13,836;
Xarelto, a blood thinner from J&J: $197, down from $517.

Medicare's new prices will start in 2026. Anna Anderson-Cook and Richard G. Frank of Brookings report, "Using publicly-available data, estimate savings consistent with CMS reporting, find that 51.4% of the estimated savings ($3.28 billion) is accounted for by 3 drugs. Penn reports, "The negotiations will save nearly $100 billion by 2031, the Congressional Budget Office estimated."

The U.S. is in the middle of a 'silver tsunami' as the country is becoming 'the land of the senior citizen'

As America ages, more citizens will require unique
care from multiple sectors. (Adobe Stock photo)

As millions of Americans enter their mid-60s, the country is fast becoming "the land of the senior citizen," where government agencies and systems are busy working to accommodate an aging population. "More Americans are about to be 65 years old than ever before. A record number will hit the milestone this year—about 4.1 million. But it's just one of many waves in the 'silver tsunami,' a metaphor often used to describe the aging of America," reports Susan Miller of Route Fifty. "Since 2011, 10,000 Americans have been turning 65 every day, a trend that the Pew Research Center says will continue through 2030." The need for aging accommodations for rural residents may be particularly needed since its population already skews older.

As the number of older residents increases throughout the United States, health care, housing and transportation systems will need additional resources to meet senior needs. To help states support the transition, the Department of Health and Human Services issued a report outlining supportive measures for aging Americans. Miller explains, "It details the web of services an aging society will need beyond financial security, safe housing and adequate health care. . . . The framework comes as several states have also started planning for their aging populations."

Some states have already created programs aimed at helping aging Americans. "New Jersey released its 'age-friendly blueprint,' which provides strategies and best practices to improve the state’s communities for older adults and enable people to remain in their homes and communities as they age," Miller reports. "The state is also putting some funding behind its plan. . . . [Its] Human Services Department is dedicating $5.5 million to launch an age-friendly community grant program later this year."

Other states are developing 10-year plans, also known as "multisector plans for aging," which outline "restructuring state and local government to address the needs of older adult populations," Miller writes. "According to the federal strategic framework, four states have legislation or an executive order to develop an MPA, and seven are in varying stages of implementing plans."

Bobbie Foust, still reporting at 90, wins Al Smith Award for public service through community journalism in Kentucky

Bobbie Foust

Bobbie Foust, for decades a fixture in West Kentucky journalism, is the winner of the 2024 Al Smith Award for public service through community journalism by a Kentuckian, presented by the Institute for Rural Journalism at the University of Kentucky and the Bluegrass Chapter of the Society of Professional Journalists.

Foust has edited three newspapers in the region and reported for others, and though she just turned 90, she is still covering city council meetings according to her decades-old approach: “Be honest, be accurate; be open with people, be kind when I can, but perform the journalistic function: report the facts and let the results fall where they may.”

In semi-retirement Foust is also writing historical articles about the region, and continuing her community service. In 2018, she served as the news-media liaison and adviser for a group of Marshall County High School students who sought gun-control measures after a mass shooting at the school in the pro-gun county. One of the parents, Gloria Hollifield, said in an award nomination, “She has the tenacity and the courage to stand for what is right, regardless of the backlash she undoubtedly faced.”

While Foust was not acting as a journalist in that role, she was using her journalism experience and skills to perform a public service, said Al Cross, director emeritus of the rural-journalism institute and secretary of the SPJ chapter. “In community journalism, journalists are by definition members of the community they serve, sometimes in ways other than journalism,” he said. “Bobbie has made clear since supposedly retiring eight years ago that she will continue to help her neighbors with journalism and other community service.”

Foust retired from the Herald-Ledger in Eddyville in January 2016, but has continued to write for The Paducah Sun and The Lake News in Calvert City, and cover the Calvert City council for the Benton Tribune-Courier, which she edited twice. She also edited the Marshall County Messenger and was editor of the Eddyville paper in her first stint there.

She has interviewed Bill Clinton, Jesse Jackson and Billy Graham; covered executions at the Kentucky State Penitentiary; and has long followed the evolution and devolution of Land Between the Lakes, the recreation area created on 170,000 acres that the Tennessee Valley Authority took from people living between Kentucky Lake and Lake Barkley. As TVA prepared to give up the LBL to the Forest Service, and Foust tried to hold officials’ feet to the fire, TVA Board Chair “Craven [Crowell] got to where he wouldn’t talk to me,” Foust recalled, adding that in her career, “That has been the continuing story that I feel like may have benefited the citizenry.”

Foust began her career at Calvert City’s first newspaper, the Valley Sun, in 1961. The newspaper closed the next year, but Foust said she freelanced as she dealt with “four little curtain-climbers” that she brought into the world from 1956 to 1959. In 1968 she joined The Calvert News and then its parent paper, the Benton Tribune-Democrat, and then its successor, the Tribune Courier. She joined the startup Marshall County Messenger as editor in 1977 and returned to the Tribune Courier in 1979, becoming editor in 1980.

Foust made the Tribune Courier a National Blue Ribbon Newspaper, an award given by the National Newspaper Foundation, and won many awards from the Kentucky Press Association, including Freedom of Information, Community Service, news and sports reporting, and photography. But she fell out with the paper’s owner, Walt Dear, and went to work with her friend Frances Baccus at the Eddyville paper, where she was editor. When it sold three and a half years later, she joined The Paducah Sun, the regional daily, and stayed seven years, until she turned 65.

She and her husband Ray Foust traveled widely, but she also helped with special projects at the Sun, and in 2001 Editor Jim Paxton made her editor of the Tribune Courier, which his family media company had purchased. She left 20 months later when her husband suffered a terminal illness, but after his death again she joined the Herald Ledger, by then also a Paxton paper, as a reporter. Even after she left the job in 2016, she kept doing journalism “because I love it,” she says. “I will probably write something the day that I die. . . . I’m curious about what’s going on; I love interaction with people.”

Institute for Rural Journalism Director Benjy Hamm said, “Few journalists in Kentucky history can match the longevity and level of service that Bobbie Foust has provided as a reporter and editor to numerous communities in the commonwealth since 1961. She exhibits many of the qualities of Al Smith – including a lifetime of service – and is a worthy recipient of the award named for him.”

Bluegrass SPJ President Casey Parker-Bell of KET, a fellow native of the Jackson Purchase, said, “Bobbie Foust’s story exemplifies the type of journalism that Kentucky needs. She has the tenacity and courage all journalists should strive for, and is deserving of this year’s Al Smith Award.”

The award is named for the late Albert P. Smith Jr., who was the driving force for creation of the Institute for Rural Journalism, headed its advisory board and was its chair emeritus until his death in 2021. He published newspapers in Western Kentucky and Middle Tennessee, was founding producer and host of KET’s “Comment on Kentucky,” and federal co-chair of the Appalachian Regional Commission. He was the first winner of the award, in 2011.

Foust will be honored at the Al Smith Awards Dinner Oct. 10 at the Embassy Suites Lexington on Newtown Pike, near Interstate 64/75. She will be joined by Eric Meyer, editor-publisher of the Marion County Record in Kansas, the 2024 winner of the Institute’s national Tom and Pat Gish Award for courage, tenacity and integrity in rural journalism, along with winners of chapter scholarships. The guest speaker will be Campbell Robertson, who covers Kentucky and other states for The New York Times. For updates see www.RuralJournalism.org.

Besides Smith, previous winners of the Smith Award, and their affiliations at the time, are:
2012: Jennifer P. Brown, Kentucky New Era; and Max Heath, Landmark Community Newspapers
2013: John Nelson, Danville Advocate-Messenger
2014: Bill Bishop and Julie Ardery, The Daily Yonder
2015: Carl West, The State Journal, Frankfort
2016: Sharon Burton, Adair County Community Voice and The Farmer’s Pride
2017: Ryan Craig, Todd County Standard, and the late Larry Craig, Green River Republican
2018: Stevie Lowery, The Lebanon Enterprise
2019: David Thompson, Kentucky Press Association
2020: Becky Barnes, The Cynthiana Democrat
2021: WKMS News, Murray State University
2022: Chris and Allison Evans, The Crittenden Press, Marion
2023: Ben Gish and Sam Adams, The Mountain Eagle, Whitesburg

Nonprofit news outlets collaborate to produce series with localized stories about rural impact of nursing home rules

The Maine Monitor's package shows whether each nursing
home meets staffing standards or not. (Map adapted by TRB) 

By Alana Rocha

Editor, Rural News Network
Institute for Nonprofit News

Residents of some rural areas across the country have a more nuanced understanding of local nursing homes’ staffing struggles — and how proposed federal requirements may worsen them — thanks to a collaboration led by INN’s Rural News Network and other partners.

The project, “Falling Short: Rebuilding elderly care in rural America,” combined on-the-ground reporting from seven rural newsrooms with data analysis, support and visualizations from USA Today and Big Local News at Stanford University. Support from the National Institute for Health Care Management made the project possible.

If implemented, rural nursing homes across the country would have about two years to comply with proposed federal rules. But, as the “Falling Short” collaborators found, many of those facilities already struggle to recruit and retain skilled workers. Most are nowhere near able to comply with the new staffing minimums.

The collaboration provided essential resources for nuanced storytelling. Big Local News and USA Today investigative data reporter Jayme Fraser worked together to clean the data and developed a “story recipe” the journalists followed to write articles and get ideas for local sources.

Newsroom collaborations like this are a win-win, Sophia Paffenroth, community health reporter at Mississippi Today, said in a post-series survey: “For us, they generate more reach, offer some extra funding, and connect us to valuable networking and resources.”

Other nonprofit newsrooms in the project were the Barn Raiser in Kansas, Carolina Public Press, the Door County Knock in Wisconsin, JOLT (Journal of Olympia, Lacey and Tumwater) in Washington, and Maine Monitor.

Big non-metro vote gives Trump a majority in Iowa caucuses

Trump, in red, prevails in caucuses. Haley's share in dark red, DeSantis's in pink. (NBC News projects graph)

Donald Trump's majority win in Monday night's Iowa Republican presidential caucuses was driven by rural and small-city caucus-goers, who have him 57 percent of their votes compared to 47 percent of those in cities and suburbs, according to the entrance poll for news organizations. Overall, Trump got 51 percent. Florida Gov. Ron DeSantis, the second-place finisher, did best in suburbs, getting 27%; former South Carolina Gov. Nikki Haley, who finished a close third, did best in cities, with 27%.

Other findings in the poll reflected Trump's rural dominance. He got 55% of white evangelicals, 63% of those with no college degree, and 74% of those who have never been to college. Trump carried every county but Johnson, home to Iowa City and the University of Iowa and the county with "the highest share of voters with bachelor’s degrees of any Iowa county," The Washington Post reports.

Wall Street Journal map, adapted by The Rural Blog; click to enlarge.

UPDATE, Jan. 17: The Wall Street Journal reports, The Republican front-runner saw his biggest improvement over 2016 in counties that reflected his core supporters: older voters, those without a college degree, lower-income voters and evangelicals. . . . One of Trump’s biggest increases in support came in counties with a higher proportion of older voters, growing by an average of nearly 35 points compared with 2016, versus his nearly 27-point increase statewide. Many of those counties are also rural areas, another source of strength for Trump."

Post columnist David Von Drehle writes, "Huge margins among sparse populations gave Trump an appearance of invulnerability. But the closer the race drew to a population center — someplace big enough to have a Costco or a Chick-fil-A — the weaker he appeared. . . . Recent history teaches us that this year’s general election will be won or lost on precisely that ground, not in farm country but in the Chick-fil-A precincts."

Presidential campaigning in Iowa has traditionally been about "championing policies aimed at helping the state’s farm-driven economy. But this year, the Republicans seeking their party’s presidential nomination have largely avoided over-the-top pandering to local priorities — and any such attempts appear not to be as effective as in the past, report Anjali Huynh and Kellen Browning of The New York Times. The main reason is "Trump, who has run in the style of an incumbent, has dominated the state while barely setting foot in it. Though he refers to Iowa farmers in his speeches and talks about how he has poured money into the state, Mr. Trump has eschewed the classic retail politicking that is a mainstay of the caucuses in favor of larger rallies while focusing his message more on national issues. . . . Local issues have instead served more as a differentiator among the candidates competing for second place, rather than part of a winning strategy."

Opinion: Growing old includes the good, the bad and the unexpected

Illustration by Lauren Martin, The New York Times

Aging can be filled with experiences you never wanted to have, often failing to live up to past expectations, muses 83-year-old Roger Rosenblatt in his opinion piece for The New York Times. Humorous highlights are condensed below.

"Old age isn’t what the books promised it would be. Literature is littered with old people for whom the years have brought some combination of wisdom, serenity, authority and power — King Lear, the ageless priest in Shangri-La, Miss Marple, Mr. Chips, Mrs. Chips (I made that up), Dickens’s Aged P, crazy Mrs. Danvers. In fiction, old folks are usually impressive and in control. In life, something less.

"I can’t think of anyone who has come to me for wisdom, serenity, authority or power. People do come to sell me life insurance for $9 a month and medicines such as Prevagen, which is advertised on TV as making one sharper and improving one’s memory. Of course, that is beneficial only to those who have more things they wish to remember than to forget.

"One thing I need to remember is which day for which doctor. . . . On one day last week, I had a vascular sonogram in the morning, consulted my ophthalmologist in the afternoon, made an appointment with a retina specialist, spoke to my primary care physician about test results and put off my dentist. As a result of such activities, my vocabulary has increased. I now can say 'occlusion' — and mean it.

"I wrote a book called Rules for Aging 25 years ago. . . .The rules were less about aging than about living generally, one of the first being 'Nobody’s thinking about you.' . . . In old age that’s true in spades. . . . You disappear from the culture, or rather, it disappears from you.

"To be sure, old age has compensations. Grandchildren. Their company is delightful, partly because they think you have something useful to impart, if you could remember to impart it. Waitresses tend to treat you sweetly. Doormen and maintenance crews show respect. And there are positive or harmless activities for the over the hill. Women take up watercolors and form book clubs. Men find loud, if pointless, camaraderie in diners and on village benches all over the country. Hey, old-timer.

"My point is: Who ever expected to spend time wondering if Madison Beer is a beverage honoring a founding father? Who ever expected that one’s social circle would consist of Marie, who does blood work, and an M.R.I. technician named Lou? Who ever expected old age?"

Berkshire Eagle, Seven Days, Vermont Standard, Nantucket paper big rural winners in New England newspaper awards

Slide from awards presentation

The Berkshire Eagle scored big in the New England Newspaper and Press Association awards, which were announced Thursday during the group's semiannual online conference.

The Eagle, of Pittsfield, Mass., was judged the best small daily (less than 9,000 print circulation), with The Keene Sentinel of New Hampshire and the Record Journal of Meriden, Conn., as runners-up. 

The Eagle was judged to have the best editorial, "chastising the Catholic diocese in western Massachusetts for trying to subpoena a reporter's notes which would reveal confidential sources" and calling on legislators to pass a shield law like most other states have to protect reporters. 

And the Eagle won two of NENPA's Publick Occurrences awards, named for America's first newspaper and honoring 13 pieces that were judged to be the best in New England journalism in the past year. The rural or rural-impact winners included the Eagle's reports on nursing homes and hazardous-materials shipments on trains that go through its region; projects by Seven Days of Burlington, Vermont, on child care and the pandemic's impact on housing in the largely rural state; the Lewiston Sun Journal's "Homeless in Maine" series; the Concord Monitor's series on police spending and policies all over New Hampshire; and CT Mirror's "Elder Care Reckoning" series that prompted reforms in Connecticut.

The best small weekly newspaper in New England was judged to be the Vermont Standard of Woodstock, with runners-up the Milton Times of Massachusetts and the St. Albans Messenger of Vermont. The best large weekly (over 4,000 circ.) was the Inquirer and Mirror of Nantucket, Mass.; runners-up were the Martha's Vineyard Times and sister papers in Maine, the Mt. Desert Islander of Bar Harbor the Ellsworth American. The best mid-size daily (circ. 9,000-20,000) was The Day of New London, Conn., with Massachusetts' Daily Hampshire Gazette of Northampton and the Greenfield Recorder runners-up. The Concord Monitor was judged best small Sunday paper.

Opinion: In a country obsessed with youth, how can America face old age?

New York Times illustration

In a little over a decade, America won't be a beacon of youth and strappy upstarts. It will be old. "By 2034, there will be more Americans over the age of 65 than children. . . . It's time to prepare," advises The New York Times editorial board in its opinion piece, "Can America age gracefully?"

"Thanks to falling birthrates, longer life expectancy and the graying of the baby boomer cohort, our society is being transformed. This is a demographic change that will affect every part of society. Already, in about half the country, more people are dying than being born, even as more Americans live into their 80s, 90s and beyond. In 2020, the share of people 65 or older reached 17 percent, according to the Census Bureau. By 2034, there will be more Americans past retirement age than children.

"The challenge the country faces transcends ideology, geography and ethnic or racial category, and American leaders, regardless of their party, need to confront it with the appropriate urgency. . . . Places like Japan, with the highest proportion of people 65 or older in the world, offer a hint of what the near future might look like for America. In Japan, especially in rural areas, schools shut their doors because there are no longer enough children to fill them; births fell below 800,000 in 2022, and about 450 schools close every year. With fewer young people working, revenue for retirement programs is shrinking, and there is a chronic labor shortage. Japanese people increasingly work into their 60s, 70s and beyond, often in physically demanding but low-paid jobs such as making deliveries and cleaning offices."

A country with a significant aged population has particular needs, but American politicians and policy writers need to be faster to address the shift. The Board writes, "The strains are showing in everything from health care and housing to employment and transportation. With an average of 10,000 boomers turning 65 each day, these pressures are steadily intensifying and will continue to do so, especially if current immigration policies hold. . . . By 2053, more than 40 percent of the federal budget will go toward programs for seniors, primarily Social Security and Medicare . . . .

"A demographic shift this significant calls for a broad-based response, and the longer the challenges go unaddressed, the more formidable they become. . . . There are many pieces to this puzzle, including who will care for older people, where they will live, how our cities are designed and how businesses will adapt. Many older people in the United States say they feel invisible in a country that has long been obsessed with youth, avoiding the inevitability—and possibilities—of old age."

Feds propose the first minimum-staffing rules for nursing homes, and they are weaker than the industry expected

Federal officials' proposed minimum standards for nursing-home staffing are weaker than expected, Bridget Early reports for Inside Health Policy.

The nursing-home industry had anticipated a proposal for about 4.1 hours of employee work time per resident day, meaning that a home with 25 residents would require 18 staffers (times 4.1 hours per resident day = 175 hours per week, divided by 40 hours per week = 17.9 employees).

Instead, Early reports, "The minimum staffing scenarios assessed in the report ranged from 3.3 HPRD to 3.8 HPRD," which would call for 14.4 to 16.625 employees to cover 25 residents.

The regulation could have major implications for rural nursing homes, which generally have more difficulty recruting and retaining staff than those in cities.

The regulation, proposed by the Centers for Medicare and Medicaid Services, "cleared the White House Office of Management and Budget on Tuesday, Aug. 29, the same day a CMS study underpinning the rule was leaked and created a firestorm among stakeholders," Early reports. "The White House budget office also canceled its two remaining stakeholder meetings on the issue in the wake of the leak. The proposed rule had been pending at OMB since May 30. The two meetings were scheduled for the first and second weeks of September. The meetings were requested by the Organization of Nurse Leaders and the Association of Jewish Aging Services."

Early notes, "The nursing-home industry has lobbied hard against staffing minimums and has called for a White House event to explore alternatives, but patient advocates have backed staffing minimums."

News-media roundup: Citizens want info on government and its meetings; bad news vs. good news; style points . . .

Glenda Arnett accepts the Citizen of the Year award from
Steve Henry of the Brinkley Chamber of Commerce.

Glenda Arnett of Arkansas' Brinkley Argus was getting ready to take the front-page photo of the local chamber of commerce's Citizen of the Year on Feb. 23, just as she has for more than 50 years. “They began reading about the person, and I couldn’t really hear what they were saying when they announced the winner,” she recalled. “I asked my sister, ‘Whose name did they call?’ and she said, ‘It’s you.’” One nominator said of Arnett, “Glenda is the epitome of everything that is great about Brinkley. She is dedicated to the town and volunteers for innumerable charitable activities through civil and religious organizations. ... There are few lives in Brinkley that she hasn’t touched.” There are thousands of Glenda Arnetts at rural newspapers across the nation. Read more about her in Arkansas Publisher, the newsletter of the Arkansas Press Association. 

Google map highlights towns in study.

What readers want: Sarah Stonbely, research director of the Center for Cooperative Media at Montclair State University, surveyed residents about what they need from their local news outlets. Rural Blairstown, urban Paterson (next to Montclair), and the state capital of Trenton are very different, but many of their news needs are the same, Laura Hazard Owen reports for NiemanLab, which she edits.

"All three communities had lost most of their existing local news outlets over the years," Owen writes. "All wanted more service journalism, in the form of information about municipal government meetings or contact information for local leaders. And all relied heavily on local Facebook groups for news, even though they also understood Facebook’s flaws."

Stonbely told Owen, "One might assume that there isn’t a ton of interest in municipal meetings, because they’re kind of boring. So I was really excited to hear that people wanted to know more, to have a list. And it’s easy — it’s kind of low-hanging fruit, right? It shouldn’t be that difficult to keep an updated list of when and where and what the meetings are."

Stonbely's report suggests building a community calendar with help from trusted local organizations, with true collaboration, "beyond just asking them to contribute content, so that trust is built in from the beginning." Also, "Engage to a greater extent on Facebook, and be present on Facebook groups that are relevant. . . . This is where most of the traffic is and where you’ll have the greatest visibility.'

Bad news gets clicks, but many want good news: "A new study has found that negative words in headlines increased click rates, while positive words decreased them," Joshua Benton reports for NiemanLab. "Each additional negative word increased the clickthrough rate by 2.3%." Axios notes, "The human instinct towards negativity has been well-documented, but Joshua Benton writes that this study, which drew on data from Upworthy’s hyperbolic headlines, is unusually quantifiable . . . Upworthy did extensive A/B testing on headlines, with editors required to write 25 headlines for each article. One surprise was the headlines with words associated with sadness did better than headlines associated with fear or anger."

"People find bad news more interesting than good news," Amina Khan writes for the Los Angeles Times, reporting on a study of 1,156 people in Brazil, Canada, Chile, China, Denmark, France, Ghana, India, Israel, Italy, Japan, New Zealand, Russia, Senegal, Sweden, the United Kingdom and the United States: "The findings, published this week in the Proceedings of the National Academy of Sciences, hint that this human bias toward negative news might be a large part of what drives negative news coverage. But the results also revealed that this negative bias was not shared by everyone, and some even had a positive bias: a sign that there may be a market for positive news."

Style points: The Associated Press has updated its Stylebook on several topics, including: using LGBTQ+ instead of just LGBTQ, to make it more inclusive, AP says; a new entry on euthanasia, medically assisted suicide, physician-assisted suicide that spells out proper usage for each term; a new entry on the Civil Rights Movement, which it says should be capitalized when referring to the specific historical period in the U.S., mainly in the 1950s and '60s; and the addition of B.C.E. and C.E. as acceptable options in referencing a calendar year in the period before Christ and anno Domini: in the year of the Lord, respectively. C.E. means the Common Era; B.C.E. means before it.

The New York and Michigan Solutions Journalism Collaborative has compiled a Caregiving Coverage Style Guide to help writers "avoid language that reflect negatively on aging," the Local Media Association reports. "The entries are based on – and credited to – sources including the Associated Press Stylebook, AARP’s Caregivers Glossary, the National Center on Disability and Journalism’s Disability Language Style Guide, and the Changing the Narrative project."

The pandemic and the internet changed how rural seniors exercise; now their 'online classes are here to stay'

Virtual exercise classes offer options to rural or homebound seniors. (Photo by Christina Saint Louis/KHN)

To stay fit no matter where they live, older Americans have put remote fitness options more in play: "After widespread lockdowns began in March 2020, agencies serving seniors across the U.S. reworked health classes to include virtual options," Christina Saint Louis reports for Kaiser Health News. "Isolation has long since ended, but virtual classes remain. For older adults in rural communities who have difficulty getting to exercise facilities, those virtual classes offer opportunities for supervised physical activity that were rare before the pandemic. And advocates say online classes are here to stay."

Jennifer Tripken, associate director of the Center of Healthy Aging at the National Council on Aging, told Saint Louis, “We found that remote programming, particularly for rural areas, expanded the reach of programs, offering opportunities for those who have traditionally not participated in in-person programs to now have the ability to tune in, to leverage technology to participate and receive
the benefits.”

Saint Louis writes: "Since April 2020, the National Council on Aging has organized monthly conference calls for service providers to discuss how to improve virtual programs or begin offering them. . . . In 2022, at least 1,547 seniors participated in an online fitness program through Juniper, part of a Minnesota Area Agency on Aging initiative. More than half were from rural areas. Because of grant funding, participants pay little or nothing. . . . AgeOptions, an Illinois agency serving seniors, said last year that their operations 'may have changed forever' in favor of a hybrid model of virtual and in-person classes."

Options for technologically challenged seniors also exist. "A fall-prevention program licensed by Western Kentucky University combines exercise and health education with bingo — can use a printed copy of the game card mailed to them by AgeOptions if they lack the proficiency to play on the game’s app," writes Saint Louis. "Either way, they’re required to participate on video." Jason Crandell, the creator and international director of Bingocize, told Saint Louis, "From when the pandemic began to now, we’ve come light-years on how that is done, and everybody’s getting more comfortable with it."

Rural nursing homes closing because they can't find staff, uprooting residents who thought they had a forever home

Marjorie Kruger and son Dan White at the Evangelical Lutheran Good Samaritan
Society nursing home in Waukon, Iowa. (Photo by Tony Leys, Kaiser Health News)

Rural nursing homes are closing due to shortages of workers, and "The problem could deepen as pandemic-era government assistance dries up and care facilities struggle to compete with rising wages offered by other employers, industry leaders and analysts predict," reports Tony Leys of Kaiser Health News.

"Many care centers that have managed to remain open are keeping some beds vacant because they don’t have enough workers to responsibly care for more residents," Leys reports, noting shortages of "nurses, nursing assistants, and kitchen employees."

Last year, 13 of the 15 Iowa nursing homes that closed "were in rural areas, according to the Iowa Health Care Association," Leys reports. Brent Willett, the association’s president, told Leys, “In more sparsely populated areas, it’s harder and harder to staff those facilities,” partly because many rural areas have fewer working-age adults.

The closure of a nursing home or assisted-living facility can have traumatic effects on residents and their families. "The lack of open nursing home beds is marooning some patients in hospitals for weeks while social workers seek placements," Leys reports. "More people are winding up in care facilities far from their hometowns, especially if they have dementia, obesity, or other conditions that require extra attention."

Leys starts his story with Marjorie Kruger, 98, who "was stunned to learn last fall that she would have to leave the nursing home where she’d lived comfortably for six years" in Postville. She told him, “The rug was taken out from under me. I thought I was going to stay there the rest of my life.” Her son found her another home, "but she misses her friends and longtime staffers from the old one," Leys writes. "The Postville facility’s former residents are scattered across northeastern Iowa. Some were forced to move twice, after the first nursing home they transferred to also went out of business."

Ageism is one form of bigotry that doesn't seem to get old

OPINION by Gary Abernathy, for The Washington Post

Because of my online Post photo — which I try to keep current — it has become increasingly common for people annoyed by my views to respond not by addressing the merits, but by simply calling me an “old white guy,” as if that made their point. Just recently, a reader emailed and referred to me as “an elderly white boy.” Elderly? Yikes.

Gary Abernathy (PBS image)

In fact, I’m thrilled to be the age I am. I’ve never enjoyed life more. Society’s change in attitude toward me — based strictly on the passage of time — is noticeable and striking, but not too personally disturbing. I’m glad I was young when I was and not now; I worry about my children and grandchildren navigating their way through this contentious world.

I realize that while I’m more fortunate than many — still able to pursue a career and enjoy a rewarding life with loving family and friends — in too many cases, the United States, compared with other cultures, holds its aging population in contempt. Too often, “old people” here are regarded as useless, helpless or a nuisance, left to wind down the clock as they stare out the window, a lifetime of experiences, work, achievement and sacrifice forgotten.

While we rightly ostracize, deplatform or even “cancel” people for their racism, antisemitism, xenophobia, homophobia and other prejudices, ageism is openly practiced, and ageist stereotypes thrive. Examples in the news abound. A TV crime story from April involving a 74-year-old North Carolina woman reported that “a grandmother” was the victim of a carjacking and also referred to her as “elderly.” In a more tragic case, ABC News recently reported on the fatal stabbing of an Atlanta woman whom it pegged as a “77-year-old grandmother.”

Both women most likely adored their grandchildren, but in neither case were those offspring part of the story. Maybe these women could have been defined by other, more pertinent life achievements. But because they were over a certain age and apparently their children had borne children, their status as “grandmothers” became their primary identifier.

Many of the most common insults leveled against President Biden are age-related. Granted, as president his mental acuity will be scrutinized, as was that of other older presidents such as Donald Trump and Ronald Reagan. But the mocking tone underscoring many of the jokes and memes is nothing short of cruel.

How should we respectfully refer to old people? I’ve seen people 60-plus still refer to themselves as “middle aged,” but let’s be a little more realistic and cut that off at least by 59. The word “old,” however, is such a pejorative that it should not be used alone. “Older person” is preferable. I hesitate to use “elderly” at all, which implies not just old age but a feeble condition. I’ve always despised “senior citizen” and references to the “golden years.” How ‘bout “best people ever?” That’s good.

But more important than terminology is how we regard older Americans in general. We should all be able to take a good-natured joke, whether about our age, our appearance, our background or our beliefs. But the rampant practice of ageist bigotry should join all the other “isms” and “phobias” as unacceptable, especially when it crosses the line from friendly ribbing to cruel attacks.

I’m going to add that to my list of causes. Right now, though, this 66-year-old grandfather is going to hit the couch for an afternoon nap — an “old person” stereotype I happily embrace.

Gary Abernathy is a retired rural newspaper editor from southern Ohio.

It's only November, but flu strains and RSV are already busy

Heading into the holiday season, it's good to remember that this year's flu season is already in full swing with the "triple threat" of influenza, Covid-19 and respiratory syncytial virus (RSV).

RSV arrived early this year, which makes its cycle harder to predict, writes Katelyn Jetelina in her Your Local Epidemiologist newsletter: "Historically, the RSV season lasts five months. It will be interesting to see how the holidays impact RSV patterns. Typically RSV peaks in January, but because it has arrived so early, we are in new viral dynamic territory." The disease poses the greatest threat to infants and seniors.

Centers for Disease Control and Prevention map

This year's dominant flu strain is potent, but there have been some early and limited but encouraging signs, Jetelina reports: "There is good news from the Southern Hemisphere among countries that just concluded their flu season. Chile, for example, found the flu vaccine is a good match for the current strain. They are reporting a 49% efficacy rate," Jetelina reports, "But only 28% of Americans are vaccinated against the flu. This is almost 10 percentage points lower than pre-pandemic rates, which is frustrating."

American hospital systems have already been stressed by Covid-19 and early RSV. Jetelina reminds her readers that people can get infected with more than one virus at a time and taking precautions like staying home when sick and updating vaccinations can keep you and others out of the hospital.