New census estimates show Iowa's most rural counties continue to lose population. Be it from death or out-migration, seventy six of the state's 99 counties have lost residents.
According to the 2005 U.S. Census Bureau, nearly 15% of Iowa's population is over 65. The percentage of people 85 years and older is Iowa's fastest growing age group.
59 percent of Iowa caregivers for elderly family members are still in the workforce. And 15 percent of the family caregivers in Iowa live an hour or more from the family member needing assistance.It is a lot of numbers to keep track but by any measure, one thing is clear -- resources need to be available for both Iowa’s aging population -- and their caregivers.
Laurie Lybarger, Director, Heartland Adult Day Center: "Most of our people that come, come through word of mouth. A lot of times we don't see people until they're desperate."
In the seven years Laurie Lybarger has been director at the Heartland Adult Day Center in Ames, she has heard a lot of stories of despair. Most of them needed immediate attention.
Laurie Lybarger, Director, Heartland Adult Day Center: "It gets to a point in their life where something tragic happens. It always seems to be some tragic accident or some kind of event has occurred that children, adult children, say, 'Okay, now what are we going to do'."
For Ames resident Elizabeth Buchwald, the "tragedy" was a stroke suffered by her mother-in-law last Thanksgiving.
Elizabeth Buchwald, Ames: "And found that she should not be home alone ever again, that she needed a care provider and so it was just kind of natural that she'd come to our house."
Buchwald's mother-in-law, Katherine Buchwald, did two things she never thought she would do …
Katherine Buchwald, Ames: "I always said when I was young, I'd never live with my kids, wouldn't want to live there, but I like it."
She moved in with her son and daughter-in-law just before Christmas … and by February, she was attending an Adult Day Center in Ames three days a week.
Katherine Buchwald, Ames: "I thought, 'What do you mean? I can get along by myself!' But I'm glad I came. I love this place. They got the best meals you ever ate."
In addition to serving a noon meal and snacks, the Day Center has a registered nurse on duty, certified nursing assistants, among other things, help give clients showers, and a beauty shop open once a week.
There are also exercise classes and entertainment.
Laurie Lybarger, Director, Heartland Adult Day Center: "The participants who get to come, they get to socialize. Key number one factor is they need to socialize and keep the brain stimulated in a whole array of different activities that we do."
Laurie Lybarger adds, the Day Center is not just good for the mental health of the seniors they serve, but also for the caregiver.
She says the Heartland Adult Day Center staff tries to be as accommodating as they can to fit the needs of the family ... which can even include providing door-to-door bus transportation of the clients.
There are costs involved, but they are a fraction of the price of assisted living or nursing home care. While there is a sliding fee, full price for a bus ride is $5.00 and for the Center -- $50.
But the option of placement in an Adult Day Center -- and living with relatives -- is generally just one of the first stops in caring for a parent or aging relative -- not the last.
Laurie Lybarger, Director, Heartland Adult Day Center, Ames: "We do quarterly progress reports on all of our participants and do family care reviews with the families. If we see difference in changes, we can let them know and alert them, but the families deciding to go to the extended care and long-term care is really hard."
It is a decision Elizabeth Buchwald -- who cares not just for her mother-in-law but also her mother-in-law's sister -- has yet had to make.
Elizabeth Buchwald, Ames: "The only thing that would cause them not to be able to stay with me is if they can't get out of bed with assistance. And so if it reaches that point, they'll have to go into a nursing home."
Buchwald says she has not yet researched nursing homes, but when the time comes, she -- as many caregivers before her -- will face another set of tough decisions.