Maine’s population is the nation’s oldest. The median age of its island communities is even higher. Geographically isolated, with the delivery of basic services complicated by limited transportation and increased costs, Maine’s islands are struggling with how to care for their small, aging populations.

The best solution is one that enables seniors to remain in their own communities, ideally in their own homes or in local residential care facilities where they can live and be near families and friends. But that’s not an easy task.

The cost of providing such care is high, and current state and federal reimbursements for low-income residents do not cover expenses.

“The money is just not there,” said Neal Martin, administrator of the eight-bed Ivan Calderwood Home on Vinalhaven, which records an operating loss of about $100,000 annually.

Constant fundraising is a fact of life for the islands’ small, nonprofit care providers.  So, too, are discussions of how to deliver essential services at affordable prices.

Earlier this year, administrators of senior care programs on Chebeague, Vinalhaven, North Haven and Swan’s Island asked the Island Institute to identify eldercare as a critical sustainability issue and to designate an Island Fellow to work with them in an attempt to find workable solutions to common problems.

That challenge will fall to Maddey Gates who arrived as a Fellow on Chebeague Island in September. After three months at Chebeague’s Island Commons, the island’s eldery housing facility, she will spend three months each on the three other islands. Gates is the first Island Institute Fellow to focus on eldercare issues. (The Island Fellows program is partially funded through an AmeriCorps national service grant.)

“Eldercare facilities on islands are under tremendous pressure as funding becomes more uncertain and demand for service increases,” said Rob Snyder, president of the Island Institute. “We wanted to be responsive to requests from island eldercare facilities to share solutions across the islands that can incorporate new approaches to providing services while increasing financial viability.”

And sharing solutions between islands to solve this challenge is key. The Maine Seacoast Mission, a nonprofit based in Bar Harbor, has been an asset for islands in supporting eldercare issues. For the past several years the Mission has been convening and facilitating regular meetings to develop an island network of support for this work.

For Gates, from Frankfort, Kentucky, the move to Maine—and especially its small island communities—was appealing. She has worked in several elder outreach programs in her home state. The daughter of a folklorist, she also is eager to learn more about the islands’ history and heritage by getting acquainted with its seniors.

“I feel as though I am here for a reason,” she said.

“The Island Institute’s focus on preserving the island way of life is something that really attracted me,” she said. But of equal importance to her is the fact that the eldercare facilities themselves identified a need and then solicited the Island Institute’s help to find solutions.

“It’s what the community wants versus what an organization thinks a community needs,” said Gates, a 2014 graduate of Western Kentucky University.

Community support is “the deciding factor” in the success of any program, says Lindsey Beverage of Southern Harbor Eldercare Services in North Haven.  North Haven hopes to open a six-bed adult family care home there in 2016 or 2017.

Amy Rich, administrator of the Island Commons, a seven-bed residential care facility that has been operating since 1996, is eager to have Gates on her staff as a fellow. Gates will do community outreach.

“I hope she will visit island elders who don’t leave their homes very often, and learn more about the services they may want or need,” said Rich. Based on those conversations, Rich believes the Commons can effectively tailor services to local needs, be it residential care, day or respite care, meals, or the Commons’ newest venture, in-home care.

“What impressed me most about Maddey,” said Rich, “is that she’s a good listener.”

Donna Wiegle of Swan’s Island is eagerly awaiting Gates’ arrival in March. Wiegle is in the process of launching a new nonprofit, Eldercare Outreach of Swan’s Island, to provide services to that island’s elderly population.

“Our folks want to stay here, they don’t want to leave,” said Wiegle.

Many need assistance with transportation, personal grooming and housekeeping but otherwise are able to live independently on the island, which has a year-round population of about 350.

Wiegle hopes Gates will organize a “buddy system” of daily phone calls to islanders living alone.

Beverage and her counterparts believe that eldercare must become a key issue in any discussion of island sustainability.

“How can we take care of the people who have spent their entire lives working to develop our communities to the point where we can attract young families and have affordable housing?” she said. “Without them, none of the groundwork would have been laid.”

The needs of island elders have often been “pushed aside” for other priorities, according to Wiegle.

“They have been paying their taxes and contributing to the community for many years, and we aren’t giving anything back to them.”

Susan Q. Stranahan is a member of the board of the Island Commons Resource Center on Chebeague Island.