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Rural Caregiver

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Rural Caregiving
By Liza Berger, Staff Writer

(Page 2 of 7)

The government-funded PACE program, which has a total of 62 programs across the country, coordinates a spectrum of home- and community-based services to people over 55 who are eligible for nursing home care.  As a result of a lack of home- and community-based services, nursing homes tend to be the only option for seniors as they become unable to care for themselves. There are more nursing home beds per 1,000 people (66.7) in rural areas than in urban areas (51.9). That is according to “The 2004 Report to the Secretary: Rural Health and Human Service Issues.” The report comes from The National Advisory Committee on Rural Health and Human Services (NACRHHS).

Transportation Roadblock

Transportation represents another major hurdle for caregivers in rural areas.  A total of 40 percent of rural residents live in areas with no public transportation system, 80 percent of rural communities have no public bus service, and 57 percent of rural residents do not own a car, according to the NACRHHS report. Rural elderly, as a result, are dependent on family members, friends and neighbors for transportation.

Low population density also makes the caregiving situation more difficult. The rural elderly population is spread out over 80 percent of the country. The proportion of elderly in rural counties (14.7 percent) is higher than in urban areas (11 percent), the NACRHHS report found. This is largely due to younger people migrating to urban areas.

A consequence of this migration is there are fewer young family members available in the area to provide care. As is the case with transportation, many elderly must turn to friends, their church, and neighbors for informal services. Fewer young people coupled with a lack of transportation in these areas have made the elderly population more isolated generally across the country.

Still another issue plaguing rural areas is poverty. About 11 percent of rural caregivers report annual incomes under $15,000, according to the “Caregiving in Rural America” report. Rural elderly also are more likely to have poor health and certain chronic conditions. This could be because the rural elderly tend to be less educated and earn less.

Also concerning is that rural caregivers often face significant financial hardships. Rural caregivers (27 percent) report experiencing a moderate to high level of financial hardship. That compares with 23 percent of urban and 19 percent of suburban caregivers, the “Caregiving in Rural America” report said. Many have to make workplace accommodations, such as take time off and/or leave a job early.

One point to consider is that cultural habits also may prevent rural caregivers from taking advantage of available care. They may be more attached to their homes and, therefore, less willing to seek help outside them. Many also may be more self-reliant and, therefore, less open to the idea of receiving help.


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