Why is Hospice and Palliative Care an issue in rural areas?
Not all areas of rural America have hospice programs available. For those rural areas that do have this service, there are numerous challenges. • Lack of family caregivers. Hospice care is based on the idea that individuals who want to remain in their homes have either family or informal caregivers. In many rural areas, the children and younger caregivers have moved to larger, urban areas. • Financial hardships. Under the Hospice Medicare Benefit, programs must provide an array of services under a per diem mechanism. A low volume of patients creates financial hardships in spreading the risk of high-cost patients. • Lack of qualified staff. Rural areas face an increasing health workforce shortage, including nurses. Hospice licensure requires specially trained interdisciplinary professional staff and 24/7 coverage. Small hospice programs have difficulty finding qualified personnel to share the 24/7 burden. Rural areas may not have funding for palliative training, especially for nurses. •
