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Telehospice: Supporting the Well-Being of Caregivers in Rural Areas
Life is a progression from birth to death, and until the early 20
th
century, death could
occur at any age, usually from acute infectious disease or accident (Stillion, 1995). Death in
childhood is rare today, however, because of antibiotics and immunizations. An adult child is
much more likely to provide care for an elderly parent who is slowly dying from chronic illness.
Added to the stresses of advancing is that of financial constraint and access to services.
Patients and their families are faced with rising healthcare costs and insurance providers that
reject claims as "not medically necessary" or "noncovered benefit" when in fact the person
reviewing claims works for the insurance company, has never seen the patient and probably is
not a healthcare practitioner (Vogin, 1999). Furthermore, for people living in rural areas just
getting access to the services they need may prove to be a significant challenge (Buckingham,
1996; Buehler & Lee, 1992). In addition, the United States is facing a widespread critical
nursing shortage. Projections estimate that by the year 2020 the number of registered nurses
working in America will be 20% below the estimated need (Brownback, 2002). According to
the American Hospital Association, hospitals around the country today have 126,000 nursing
vacancies, or 12 percent of capacity (Janofsky, 2002). Health industry experts predict the
number could triple over the next decade as baby boomers age.
Increased cost, difficulty accessing services, and the shortage of nurses and other
providers mean that families and neighbors are taking on more of the responsibility for providing
care to patients near the end of life. While the role of caregiver has many benefits for both the
patient and the care provider, it places considerable stress on the relationship and on the
individual lives. Becoming a caregiver places the individual in a unique position on two spectra
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Convention