In rural Kansas, restricted entry to house companies leaves seniors and households wanting

TOPEKA – Joellen Schmidt has spent much of her life helping people in need when they need it most.

With her husband Jerald, she raised seven children, welcomed 25 foreign exchange students into their home and helped 50 foster children who needed temporary housing. She worked as a teacher at Caldwell and inspired many students on the path to induction into the Kansas Teachers Hall of Fame.

But that all changed a few years ago when Jerald died after battling Alzheimer’s. Then, in 2020, doctors told Joellen she had an inoperable brain tumor.

In a small, rural town like Caldwell, access to domestic services is scarce, and when found, it often doesn’t last long.

“She gave her whole life to take care of people who needed it when they needed it and now she’s in this boat and it’s a struggle,” said Martin Schmidt, one of Joellen’s sons. “We realize the last thing that could happen is that you go into a nursing home and that’s not what she wants to do.”

A new United Health Foundation report about elder care reflects the reality many families in Kansas face due to a lack of geriatric providers and home care resources. The report highlights key areas where the state is lagging behind the rest of the nation.

For Martin and his brother Kevin, who live in Caldwell, taking care of their mother means changing their daily routine. Both have full-time jobs — Martin as an NCAA official and Kevin as an educator in addition to a part-time job — but to keep Joellen at home, where she’s most comfortable, they’ve made sacrifices.

As their needs grew, particularly after a recent fall related to a urinary tract infection, Kevin and Martin sought home healthcare services. But those providers never lasted more than a few weeks, Kevin said.

They currently have five people helping out at different times, but Kevin says there’s no guarantee they’ll last longer than others.

“Even with the people we hired, Martin and I still have a responsibility to put her to bed every night until she can do it on her own,” Kevin said. “We still have to spend time every day going there to do those chores because she just needs little things to make life comfortable.”

Despite these difficulties, Dan Goodman, executive director of Kansas Advocates for Better Care, said Joellen is one of the lucky ones to have family close by who will take care of them and allow them to age in place. Many are forced into foster homes without family care.

Goodman said this is partly because the state supports institutional care and nursing homes more than it does community-based care. He pointed to the state’s 47th place in low-care nursing home residents in the United Health Foundation’s 2022 report.

Residents in need of care require less physical support with bed mobility, moving, going to the toilet or eating. Most would not need to be placed in nursing homes if other options were available.

Goodman said Kansas also ranks 40th in geriatric providers and food insecurity for Kansans age 60 and older. He said many Kansans could choose a nursing home to have access to three meals a day.

“The community-based option isn’t really an option for many people in rural and border areas,” Goodman said. “The pandemic has only exacerbated this problem because right now many people have taken the opportunity to change careers or leave low-paying positions. I don’t think it really rebounded like everyone was hoping.”

A monthly survey conducted by the National Healthcare Safety Network in 2021 found nurse and support staff shortages in 25-30% of responding long-term care facilities.

Earlier this year, the state allocated $51 million from the American Rescue Plan Act to Medicaid home and community-based service providers starting this month. The bonuses benefit about 24,000 direct aid workers in the state, and each caregiver could receive a bonus of up to $2,000.

In addition, agencies will receive an additional $1,500 per hire to attract more direct support agents to the field.

Rep. Jarrod Ousley, a member of both the state Senior Care Task Force and the House Children and Seniors Committee, said the state has room to grow to meet the needs of its elders.

“The most important thing I’ve heard in all my years with children and seniors is that older adults want to age in place,” the Merriam Democrat said. “They don’t want to be in a nursing home. They want to stay in their homes for as long as possible.”