Cancer home care in Montana

Availability of health care services in sparsely populated areas may be limited by fewer health care organizations and geographic separation. The purposes of this study were to identify unmet needs of individuals and families managing cancer in rural areas and examine cancer-related home care in rural areas. Issues of staffing, caseloads and service area for home health agencies (HHAs) and hospices were examined. HHAs registered with the Montana Association of Home Health Care Agencies and licensed hospices in Montana were mailed questionnaires with 92% of the HHAs and 90% of the hospices returning the questionnaires. Health providers identified a variety of unmet needs including personal care and respite. Agencies were small with approximately four full-time equivalent registered nurses for HHAs and one full-time equivalent registered nurse for hospices. Similarly, caseloads were also small with an average of 50 clients per month for HHAs and 11 clients per month for hospices. HHAs and hospices had large service areas with two of the HHAs each serving seven counties. Implications of these findings for research and practice are discussed.