Innovation to Support Rural Older Adults

Piloting solutions to support rural seniors

America is aging rapidly – and rural communities are feeling it first. Nearly 20% of rural residents are over age 65, compared to 16% in urban areas, and this share is rising fastest outside metropolitan centers (U.S. Census Bureau, 2023). Rural adults over the age of 65 experience higher rates of chronic illness, disability, and premature mortality, and are more likely to live alone or without nearby family support (Health Resources & Services Administration, 2024). Meanwhile, Since 2020, at least 774 nursing homes have closed, displacing 28,421 residents, further reducing access to support (AHCA, 2024).

This growing gap between need and capacity makes senior care one of the most urgent challenges facing rural America today.

AscendRural’s next impact theme is focused on piloting impactful solutions to address some of the most critical challenges facing rural older adults. We’re looking to partner with rural organizations and startups to pilot forward-thinking technologies that help:

  • Strengthen care systems and workforce capacity

  • Enable social connection and engagement

  • Support daily living, safety, and aging at home

Opportunity Spaces

Through extensive discovery with community partners, providers, and national experts, three critical areas of need emerged within the aging space for pilot opportunities. We are now seeking both innovators and local partners to pilot solutions within the following focus areas:

  • Across rural regions, senior-care providers are at a breaking point. Rural nursing homes and home-care agencies are turning away clients because they simply can’t find enough staff to meet demand (National Rural Health Association, 2024). Chronic workforce shortages, reimbursement barriers, and administrative overload have left many organizations “doing more with fewer and fewer people”.

    Staff spend valuable time on manual documentation, non-clinical tasks, scheduling, and compliance – time that could otherwise go to meaningful engagement with residents. 

    The community’s message is clear: sustainability depends on workforce efficiency. Technology that automates repetitive, non-clinical work – like documentation, manual care coordination processes, cleaning, medication management, or meal preparation and delivery – can relieve staff strain, improve care quality, and make limited budgets go further. When tools are interoperable, easy to use, and low-lift for small rural operators, they don’t just extend capacity, they safeguard access to dignified, person-centered care for rural older adults.

  • Nearly one in four adults aged 65 and older report feeling socially isolated, and those in rural areas are significantly more at risk due to transportation barriers, limited broadband, and fewer community spaces (National Academies of Sciences, Engineering, and Medicine, 2020). Research shows that loneliness and social isolation increase the risk of premature death by 26% and 29%, respectively – comparable to the health risks associated with smoking up to 15 cigarettes a day (U.S. Surgeon General, Our Epidemic of Loneliness and Isolation, 2023).

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    Organizations across Central Minnesota echoed these realities: even where community programs exist, staff struggle to reach those most in need. Many older adults live miles from town centers without access to transportation, rely on limited access to devices, or lack the confidence to engage digitally. As one provider shared, “we know people are out there in need of support - we just can’t reach them consistently.” The result is a crisis of disconnection that undermines both emotional and physical health.‍ ‍

    Technology can help rebuild these connections when designed for accessibility, intuitiveness, and emotional relevance. Solutions that enable communication, meaningful engagement, and participation in community can improve quality of life and prevent decline.

  • Across the U.S., older adults overwhelmingly want to age in place – more than 75% of adults over 50 wish to remain in their current homes as they age (AARP, Home and Community Preferences Survey, 2024). Yet in rural areas, the supports that make this possible are eroding. In Minnesota, a larger proportion of adults 65 years and older living in the metro counties are receiving home and community-based services (HCBS) instead of institutional services (84.5%) compared to Greater Minnesota residents (66.6%) (National Rural Health Resource Center, Aging in Rural Minnesota, 2024).

    Local partners across Central Minnesota described long waitlists, rising care minimums, and limited tools to manage safety and daily tasks efficiently. Staff and families alike are “constantly reacting when we should be preventing.”

    Technology that combines prevention, early detection, and task automation, such as passive sensors, remote monitoring, or robotics, can help older adults stay safe and independent while easing pressure on rural care systems. When simple, affordable, and built for low-connectivity settings, these solutions have the potential to transform aging in place from a challenge into a reality.

  • While these three opportunity areas reflect what we’ve heard most strongly from community partners so far, AscendRural remains open to innovative technologies outside these categories.

    If a solution aligns with the criteria of our rural partners and demonstrates potential for meaningful impact in rural communities, we are happy to evaluate and explore it further through our Rural Readiness Accelerator.

    Our goal is to ensure that promising innovations — even those beyond these themes — can still be considered for potential pilot opportunities in rural settings.

  • “Most of the time they're spending is in front of a computer... your best nurses are looking at a computer all day or most of the day... a lot of it has to do with paperwork, you know, and things we have to do documentation wise. And that consumes the time that could be better spent with a nurse face-to-face with a resident."

    Senior Living Provider

  • “People are staying in their homes longer. It's better for everybody, other than the social isolation aspect of it, which in our County we see that a lot. That's one of probably the biggest things that drives people into the nursing home and into the assisted living is, you know, they're on the farm that they've been on for 100 years, and the neighbors are half mile away and maybe they're the same age and they can't or don’t socialize. So, they start to decline physically and cognitively and a lot of that's driven through the lack of social interaction. And what we've come to realize is that people don't score [socialization] high enough as far as how important that is to people and their health.”

    Senior Living Provider

  • “If we can gather that data early, before it actually presents itself, we can deal with the underlying health condition faster and we're avoiding hospitalizations or we're avoiding falls and all of those things are very costly”

    Senior Living & HCBC Provider

  • “Even when there are, for example, home care services available, because there's such a shortage of staffing, what we're seeing is that home care agencies, for example, are increasing the number of minimum hours that a person can go out to the home. And so what that does is it leads individuals needing care, purchasing more care than what they actually need, and then they spend all their resources quicker too. So, you know, I think it has an impact on people going on to medical assistance often prematurely because they're purchasing more services than they need or because they can't get the services in the home, they're prematurely moving to assisted living.”

    Aging Support Organization

  • “Looking at under 50 residents in a nursing home, I probably have three or four with a smartphone... Some of them may have never even had a cell phone. So again, generationally, that's where we're at"

    Senior Living Provider

  • “I can't count how many things I've seen implemented and it's a great idea and people are excited and then. You look at usability 30 days down the road, and no one's using it anymore. And typically the reason is they have to go to an extra platform. They have to check an extra thing. Like it's not interoperable.”

    Senior Living & HCBC Provider

  • "Don't even get me started on interoperability around data, especially in rural communities... Please help us, there has to be a way to solve for this.”

    Aging Support Organization

  • “There are even challenges with some of the fall detection technology in rural communities, or even GPS and location tracking for people where different cellular networks operate... and if someone wanders beyond that then the location tracking devices stop working."

    Senior Living & HCBC Provider

  • "If I can spend $50,000 and it gives 10 more hours of resident staff time for quality conversation of just sitting down and saying, you know, let's talk about the weather or whatever… those personal interactions are kind of priceless.”

    Senior Living Provider

  • "My focus and how I speak to people as far as the return is, you'd have to measure resident satisfaction because if I'm saving money that’s great... But are we getting better resident care is my focus.”

    Senior Living Provider

Criteria for Solutions

Designing technology for rural aging populations requires an understanding of the unique barriers these communities face. Solutions must not only work in geographically dispersed settings – they must also be trusted, intuitive, and sustainable. These criteria reflect what rural providers and aging support organizations emphasized as critical to success:

  • The solution must be user-friendly and intuitive, specifically designed for an older audience or one with less technological comfort. It must accommodate users with limited digital literacy or those who express a fear of technology, scams, or exploitation.

  • The technology must require minimal behavioral change for staff and providers, aiming to maximize adoption and minimize implementation friction.

  • Solutions must be designed to integrate or work well with existing processes, IT infrastructure and systems (e.g., EHRs, internal platforms), avoiding the creation of separate log-ins or dashboards that staff lack the bandwidth to monitor.

  • The technology must function effectively despite challenges in the rural environment, addressing issues such as inadequate broadband access or unreliable cellular networks.

  • Technology should be used to enhance the quality of human interaction and care conversation, enabling staff to spend more time on direct, quality care rather than entirely replacing the human element.

  • There must be a clear business model that proves the sustainability and value of the solution beyond the pilot phase, ideally showing quantifiable and aligned ROI – ultimately leading to the ability to sustain a solution long-term and better outcomes.

  • The solution should align with existing or emerging long-term funding mechanisms, such as Medicaid waivers, or philanthropic support. Solutions must meet current regulatory requirements and be ready to implement in highly regulated environments.

  • The technology must be adaptable and scalable for widespread implementation across various rural settings and organizations.