Recent demographic trends highlight the increased prevalence of older populations in rural America. The trends result from multiple demographic patterns, such as being ‘left behind’ as younger residents leave rural areas and the migration of older adults drawn to rural areas for amenity or lifestyle considerations. Policies aimed toward keeping older adults in their homes as long as feasible (the ‘aging in place’ movement) means Americans are residents in their communities for longer periods of time but with potential growing needs for assistance. The spatial and institutional organization of rural areas coincides to create significant challenges for an aging population. Rural areas lack many essential services for an older population, particularly health care. Transportation in rural areas is highly automobile-dependent, yet older adults face challenges with driving. Additionally, demographic trends indicate that older adults have fewer family members living near them. This chapter highlights innovations in land use planning and service provision for an aging population, emphasizing housing affordability and availability, multi-modal transportation options, recreational opportunities, and environmental sustainability. The chapter also describes governance issues shown to have success for organizations and land use planning agencies moving toward planning for an aging population
