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Published on: June 11, 2012
Palliative Care in Rural Communities
Tracy Fasolino1, Megan E Mayfield, Kathleen Valentine
1Tracy Fasolino is a professor and Distinguished Palliative Care Leader at the Clemson University School of Nursing in Clemson, SC, where Kathleen Valentine is a professor. Megan E. Mayfield is a doctoral student at Emory University in Atlanta. William E. Rosa is assistant attending behavioral scientist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City. Anne Koci is professor emerita of nursing at Texas Woman's University in Denton. Contact author: Tracy Fasolino, tfasoli@clemson.edu . The authors have disclosed no potential conflicts of interest, financial or otherwise.
Abstract:
Rural communities in the United States are frequently marginalized and misrepresented. These communities face unique challenges, such as limited access to health care, nutritious food, and clean water, that contribute to persistent health disparities. This article presents the CARE (Complex, Access, Resourceful, Extraordinary) framework, which illustrates the dichotomy of rurality-its negative and positive aspects-in order to inform the development of palliative care delivery in rural settings. Various palliative care models are described that address access gaps, bolster provider capacity, and increase the provision of specialty palliative care. However, workforce shortages and reimbursement structures restrict the expansion of these services. Nurses, the largest segment of the health care workforce and the most trusted professionals, must partner with interdisciplinary colleagues and rural communities to advocate for equitable and inclusive care.
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