Worldwide, the family is the major caregiver of healthcare, generally without professional caregivers, consultation, guidance or supervision. There are 22 million (22m) family caregivers in the United States (National Alliance for Caregiving 22). Nearly one in four (1 in 4) US households include at least one caregiver who provides unpaid care to help someone at least 50 years of age to take care of himself/herself. Thirty-three percent (33%) of elderly persons stay alone; and one-third are experienceing some limitations in activities of daily living (ADL - grooming, bathing, walking unassisted, et al., CJ Farran 1994).
In the USA, there were 61 million Americans who lived in rural areas in 1990; it is projected that an increas of 3.9 million by2010(HHS Rural Task Force Report to the Secretary, July 2002). Rural residents experience relatively poorer health and social welfare outcomes. The most dramatic health-related disparities between rural and urban residents are in the areas of mental health, substance abuse, public health outcomes, and oral health (NCHS 2001). Human services-related disparities include greater poverty and higher rates of unemployment (C. Fluharty, 2001). Fifty percent (50%) of the elderly have family incomes bello 200% of poverty; 30% of the rural adults are women; 27% of the women smoke and 37% of men smoke. Over 50% of the elderly have 1to 3 chronic conditions (diabetes, arhritis, asthma, high blood pressure, dementia, alcoholism, depression) and over one-third are designated as partial (HPSA). There are inadequate healthcare workforces in the rural area, the pay is low, and the reimbursement by Medicare/Medicaid is less than it is in urban areas; therefore, the specific health and social welfare outcomes are also related to inadequate access, regulatory barriers, poverty, distance to travel for healthcare, and poorly trained healthcare providers.
In that the family is the major caregiver, I am proposing that models for family caregiving intervention be developed--aimed specifically at enabling the skills and competencies of the caregiver and focus on self-care of the recipient. Most women spend more time in Parenting their parents then they did in parenting their children. Many family caregivers become the "hidden" patient.
Most models in family caregiving are intended to reduce stress of the caregiver, skill training and respite. New models must help to better understand dynamic relationship among caregivers, care recipients, and the impact of family functioning, culture, role and fostering competence of the caregiver and self-care by the patients.
Back to S064 Health Care of the Elderly in the Rural and Frontier Areas (Globally and Domestically)
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