Rural Patients Still Lack Palliative Care Access
Access to palliative care is an ongoing challenge for rural Americans with chronic diseases, the authors of a recent literature review concluded.1
“Funding and resources are needed to improve palliative care access and delivery and prevent health disparities within the rural communities,” says Nasreen Lalani, PhD, MScN, RN, the study’s lead author and assistant professor at Purdue University’s School of Nursing.
Lalani and a colleague analyzed 28 studies on barriers and facilitators to palliative care access in rural areas from 2010 to 2020. They identified these barriers:
- Communication gaps between providers and patients. “Healthcare providers do not feel comfortable talking about advance care planning or death and dying issues with the patients and families,” Lalani explains.
- Cultural values and preferences often are not addressed in the care approach. “Therefore, family caregivers experience a huge burden of caregiving,” Lalani notes.
- Inadequate knowledge of palliative care. “Despite multiple efforts toward palliative care awareness and education, providers still face difficulty conceptualizing palliative care,” Lalani laments. Palliative care is confused with end-of-life care. In most cases, palliative care starts at the end of life or at the advanced stages of illness. “It should start when a person is diagnosed with any advanced chronic illness,” Lalani asserts.
- A poorly structured palliative care system overall. “There is a strong need to integrate palliative care within primary care settings, rather than limiting it to the hospital and hospice settings,” Lalani says.
- Cai Y, Lalani N. Examining barriers and facilitators to palliative care access in rural areas: A scoping review. Am J Hosp Palliat Care 2022;39:123-130.
Funding and resources are needed to improve palliative care access and delivery and prevent health disparities within rural communities.
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