Rural-urban differences in end-of-life care: implications for practice.
Most older adults with advanced illnesses express the wish to die at home. Home-based care from home health and hospice agencies makes this possible, but there are great geographic variations in utilization. Interviews and focus groups with key constituents in home health and hospice agencies across the 8-county region of Western New York State were used to explore how rural-urban location and agency type (home health or hospice) influence variations in end-of-life care. Emergent themes were: Rural-Urban Differences (geographic challenges, market forces, and programming issues) and End-of-life Care Issues (macrosocial, mezzosocial, and microsocial factors). Implications for social work practice are discussed.
Waldrop
Deborah
D
University at Buffalo School of Social Work, Buffalo, NY 14260, USA. dwaldrop@buffalo.edu
Kirkendall
Abbie M
AM
D000368:Aged; D002908:Chronic Disease; D017144:Focus Groups; D006699:Home Care Services / Q000458:organization & administration; D017051:Hospice Care / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D009518:New York; D012424:Rural Population; D013727:Terminal Care / Q000458:organization & administration*; D014505:Urban Population