title: Forced into exile: the traumatising impact of rural aged care service inaccessibility.
abstract: BACKGROUND
  The shortage of residential aged care places is especially acute in rural areas and this results in many older people who live in these areas being forced to leave their home communities to access care in distant communities. This article reports on one aspect of a larger study that explored family and caring community members' experiences when someone they cared for needed to access residential aged care away from their rural communities.
  
  
  METHODS
  This qualitative research project, informed by phenomenology, was conducted in rural communities of New South Wales (NSW), Australia. Participants were recruited from media coverage of the proposed research. Indepth interviews were conducted, audiotaped and transcribed.<strong> </strong>Thematic analysis was undertaken by two researchers independently analysing the themes and then cross-checking these to ensure their strength.
  
  
  RESULTS
  The 21 interviews conducted revealed that inaccessibility of residential aged care places caused many to experience loss, loneliness and a sense of social disconnectedness. The affected rural older person is exiled from their home community only to return to be buried. There are implications for the family and the rural community who are distanced by kilometres, transport and finances and, more significantly, by the emotional ties that bind families, friends and communities.
  
  
  CONCLUSIONS
  The participants whose experiences were explored in this article described a sense of being in exile when residential aged care services are inaccessible in their local communities. The sense of exile is felt not only by the person moving away but also by their family, friends and neighbours. For this reason, rural residential aged care service delivery should be based on the identified needs of the older person and those who love and care for them.
authors.affiliation: Charles Sturt University, Wagga Wagga, New South Wales, Australia. mabernoth@csu.edu.au
authors.forename: Maree A
authors.initials: MA
authors.lastname: Bernoth
authors.forename: Elaine
authors.initials: E
authors.lastname: Dietsch
authors.forename: Carmel
authors.initials: C
authors.lastname: Davies
mesh_terms: D000368:Aged; D005190:Family; D006297:Health Services Accessibility; D006707:Homes for the Aged / Q000191:economics / Q000592:standards / Q000600:supply & distribution*; D006801:Humans; D007407:Interviews as Topic; D008132:Loneliness / Q000523:psychology; D009517:New South Wales; D009735:Nursing Homes / Q000191:economics / Q000592:standards / Q000600:supply & distribution*; D036301:Qualitative Research; D012424:Rural Population; D012934:Social Isolation / Q000523:psychology*