Wyoming tough?

 

A recent article in Time magazine reported that the best place to be an old person is a city, primarily because of easy access to health care. If Time’s experts on aging are correct, those of us who choose to live in remote Western places will feel increasing pressure to urbanize, abandoning the landscapes that we love to find the health care that we need.

My husband and I moved to the Denver area from a small Wyoming community for this very reason. When we did, we gave up our dream of living out our lives in an old homestead in the High Plains of Wyoming. We gave up so much -- our view of the Wind River Mountains, our harsh winters and glorious summers, the land’s strong sense of history and our daily intimacy with nature.

We understood that the way we chose to live might seem weirdly tough to others -- heating with woodstoves, driving 50 miles to the nearest grocery store, gardening in spite of a 42-day growing season. In fact, we lived – and relished – a way of life not all that different from that of the pioneers who built our place in the early 1900s. We reveled in our independence, and the last thing we ever wanted to do was live in a crowded city. 

We would still be toughing it out in that homestead if my husband’s Alzheimer’s hadn’t made our old-fashioned lifestyle increasingly difficult and finally, impossible to manage. He was no longer able to do the work needed to maintain our place, but he resented anyone we hired to do it. He’d get lost on our property, a place he’d known like the back of his hand. He couldn’t be left alone.

Our children, visiting from out of state, were shocked. They helped me realize that our self-reliance had morphed into a need to rely on others. Friends and family could only do so much. We needed professional help, and I started looking for it.

There wasn’t much. Although our community’s excellent, and free, ambulance service and volunteer EMTs could get us the 50 miles to the nearest hospital, the closest specialists were 200 miles away in Salt Lake City. To get in-home respite care or certified nursing care was nearly impossible. Our local population was only about 500. I found one person with Alzheimer’s care training, but she was only occasionally available. In the nearest town, there were some qualified people, but they were not willing or allowed by the agencies they worked for to make the 100-mile round trip to my house. Alzheimer’s care facilities were rare even in larger Wyoming towns; nursing homes didn’t offer the right kind of services for Alzheimer’s sufferers. 

So I learned firsthand the truth of an Alzheimer’s Association report that listed among its major challenges “ill-equipped communities.”

While facing this major medical problem with a limited family support system, I also found a flimsy safety net. A 2007 report on older adult health in Wyoming didn’t even include Alzheimer’s on its list of “major concerns for seniors.” If Alzheimer’s had been a concern then, perhaps what we experienced later wouldn’t have been so disheartening.

Wyoming’s small population and lack of state income tax might explain why health-care resources are inadequate, although there’s considerable evidence that other Western states face similar problems. Because we Westerners tend to see ourselves as rugged individualists, capable of handling the toughest challenges, we are unusually reluctant to admit it when we need help.

Maybe it is just a romantic notion, this longing of Westerners to remain independent, but my husband and I imagined we could always tough it out, like the settlers who built our home decades ago. Ironically, the hard physical challenges we valued were exactly the things that eventually made living in a remote place impossible, and this at a time when remaining in our home would have meant the most to us.

For us, it turned out that the toughest part of living in Wyoming was being forced to leave it. The experts were right to say that health care is better in cities. But I think many Westerners faced with the choice we had to make might agree, as I do, with these lines from poet Stephen Vincent Benét:

Go play with the towns you have built of blocks

The towns where you would have bound me!

(Let me) sleep in my earth like a tired fox,

(Until the) buffalo have found me.

Marcia Hensley is a contributor to Writers on the Range, a column service of High Country News. She lives in Westminster, Colorado.

Note: the opinions expressed in this column are those of the writer and do not necessarily reflect those of High Country News, its board or staff. If you'd like to share an opinion piece of your own, please write Betsy Marston at betsym@hcn.org.