“In most of the United States, families help with driving, shopping and activities of daily living as their relatives age. When adult children leave their rural homes, a key component of elder care goes missing.

‘There’s a question of whether people have to go into nursing homes prematurely’ because they lack family caregivers, Dr. Glasgow said.

In their absence, neighbors and churches can play compensatory roles. Her research in rural areas has shown that older adults actually prefer to accept services from their churches rather than from government programs.

Satellite clinics and telemedicine can help bridge some of the health care gaps. For digitally adept older adults, the Internet already allows easier shopping, entertainment and social interaction.

Dr. Glasgow, among others, has called for better transportation options and for more senior housing, so that rural communities can bring services to clusters of people who need them.”