Rural America varies from areas of struggling subsistence agriculture to growing, relatively affluent retirement meccas. In general, however, rural/frontier areas suffer disproportionately from poorer health status indicators. The health status of rural residents is shaped by numerous factors that differentiate rural/frontier environments from more urbanized areas. Some of the rural factors include:
· Less availability of public transportation, making access to healthcare services more difficult;
· More limited supply of community-based services, such as hospice and respite care;
· Stronger traditional belief in self-sufficiency and communal support;
· More limited understanding of available resources and supports;
· Out-migration of traditional caregivers, such as adult children; and
· Government healthcare financing policies that typically reimburse rural healthcare providers at lesser rates.
Recent innovations in service provision and reimbursement policies hold promise for improving the plight of rural seniors’ health. Many of these innovations recognize the pivotal role of family caregiving in rural areas and are beginning to create policies and practices that undergrid family and community efforts. Many of these innovations have been encouraged by the National Family Caregivers Support Act, passed by the US Congress in 2001, which recognizes and builds on the strengths of rural families and communities as they improve the quality and quantity of senior caregiving. Some of these innovations include:
· Enhanced educational efforts that specifically target rural media and caregivers, such as nutrition information from the Cooperative Extension System;
· Training delivered through local collaboratives, such as area Agencies on Aging that understand the unique qualities of their clientele;
· Mobile adult day services that rely on nurses to provide neighborhood and in-home care;
· Greater use of technology, such as interactive televideo and the Internet;
· Organizing volunteers, especially through the faith communities, to provide support for home-based seniors and their caregivers; and
· Consumer-directed models of service and funding that support family members of Medicaid recipients.
Important elements of efficient and effective supports for rural caregivers of seniors must include involvement of the local community, mobile services, non-family caregiving, flexible hours, and creative partnerships and funding.
Back to S064 Health Care of the Elderly in the Rural and Frontier Areas (Globally and Domestically)
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