It’s no secret that patients prefer to receive health care at home. For those who live in rural communities, this preference can be especially strong. But is it realistic? How well can our health care system really support rural home care?
The truth is, rural patients don’t always receive care that meets their needs or aligns with their preferences. Too often, they have to make compromises that diminish their quality of life.
Policymakers are in a position to improve the home care sector in rural communities. But they’re not the only ones. Service providers also have the power to bring about transformation.
Are you a frontline worker or decision-maker? Do you work in a care provider agency that serves a small community? On the other hand, you may work for clients in the city.
Whatever role you play, there may be steps you can take to make care better in some of Canada’s underserved regions. In this post, we’ll explore the future of rural home care – and what providers across the country can do to improve it.
Understanding Rural Patients
Rural patients face a unique set of health care challenges. If you’ve ever provided services in a remote region, you understand what we mean.
Accessibility is, of course, one of the biggest obstacles to high-quality care. Generally speaking, those who live in less-populated areas can’t immediately benefit from treatment in a state-of-the-art medical facility. And due to nursing, specialist, and doctor shortages, they may not receive the same level of care as urban patients.
Travelling can help bridge this gap. But for many patients, flying far from home is a very unappealing option. This is where some people will begin making tradeoffs.
What do we mean by tradeoffs? A recent study shows that many rural patients view their health care decisions in this light. For some, travelling to an urban centre in order to receive the best possible treatment amounts to a sacrifice.
If you’re a home care professional, you know how critical empathy is to quality care. It’s not just about putting yourself in the shoes of your patients. It’s about relating to and trying to understand the people you care for.
What motivates them? What are their values? And what are they most worried about? When you know the answers to these questions, you can help help take the stress out of the decision-making process. Ultimately, you become better equipped to provide patient-centred care.
Rural dwellers have chosen their homes for a reason. Often, they take pride in their lifestyles and the work that they do, which is frequently connected to agriculture. To state the obvious, these aren’t jobs that can be done remotely. Many patients also value their communities, which can be great sources of support.
And when staying close to home is a very high priority, some people will avoid seeking outside help altogether.
Spotting the Barriers
There’s a common misconception that at-home care is a necessary, but not optimal, solution. In fact, the opposite is often true. Home care is well-suited to the needs and preferences of many rural patients.
Unfortunately, it isn’t a perfect rural health care solution. Accessibility still poses major challenges for patients, their families, and care providers.
Worker scarcity is one of the biggest problems. Outside of cities, shortages of qualified nurses and personal support workers (PSWs) can negatively impact patients. Often, they don’t receive timely care, or enough care to meet their needs.
And what about doctors and medical specialists? It’s clear how an insufficient number of nurses can pose an ongoing threat to rural home care. But even if this problem were solved tomorrow, other types of expertise would still be missing from many communities.
Wound care. Endocrinology. Respiratory therapy. These are just a few of the types of medical knowledge that are often missing in rural areas.
This brings us back to the idea of tradeoffs. Rural home care patients frequently sacrifice their independence, their comfort, and the ongoing support of their communities order to receive the treatment they need. In some cases, they reluctantly leave their farms that provide their livelihoods. In others, they choose to stay, which can lead to serious health consequences.
Of course, there are times when travelling to receive treatment is absolutely necessary. Immediately following a serious adverse event, for example.
But what about regular appointments with specialists? Should rural patients have to worry about making frequent, stressful trips to the city?
As always, continuity of care is also a concern. And when geographical distance is involved, providing seamlessly-coordinated care can be especially challenging. Unfortunately, when members live in different locations, it’s all too common for lapses in communication to occur within a circle of care.
Overcoming Rural Home Care Challenges
It’s clear that rural patients prefer to receive care in their communities. But is it realistic? Given the challenges that accompany this type of care, many people would say no. We believe they’re wrong.
Do you provide rural home care services? Are you a decision-maker or frontline care professional in the city? Either way, there may be steps you can take to help.
Of course, provincial policymakers have a chance to make a real difference. In the years ahead, government and provider organizations must work together to solve some of our biggest rural health care challenges.
Filling nursing and PSW shortages is one of these challenges. Looking at unexplored barriers to employment in the field may lead to creative solutions. For example: could providing bicycles to jobseekers who are interested in care work lead to more professional caregivers?
But policymakers aren’t the only ones who can make a difference in rural communities.
Those who provide rural home care can help by adhering closely to best practices that improve patients’ abilities to remain independent. Consider the role that education can play. By taking the time to clearly demonstrate simple at-home procedures, professional caregivers can make it simpler for patients to care for themselves.
In general, home care professionals can improve the lives of rural patients by embracing collaboration. Physicians should engage in direct follow-up care with patients from a distance. when possible, specialists should coach rural nurses through unfamiliar procedures, passing on valuable knowledge for the future.
Care team members should stay in close touch, sharing patient information and providing continuous updates. Without this commitment to continuity of care, rural home care patients can’t receive the same quality of care as their urban counterparts.
Of course, achieving these goals when team members are spread out geographically can be a huge challenge in and of itself. But with the right technologies, it doesn’t have to be.
Telehealth makes it possible for patients to connect face-to-face with circle of care members – wherever they are. And with the right mobile app, health care professionals can update care plans and patient information on the go.
The result? The entire process of caring for rural patients can be improved – from follow-up, to monitoring, to self-care education.
Digital tools for information-sharing and communication can greatly improve rural home care delivery. These technologies are rapidly becoming more convenient and easier to use.
The Future of Rural Home Care
There are many reasons why rural patients want to stay in their communities and inside of their homes. By making these possibilities feasible, rural home care workers are providing an extremely valuable service.
That said, a major gap between rural and urban quality of care remains. Increasing accessibility will go a long way toward closing it. But it’s going to require effort from care providers working ion both sides of the rural-urban divide.
Empathy and collaboration are going to be key. Improving communication across circles of care – and geographical distances – is a critical first step.
Feature image courtesy of Michael Coghlan
