Who provides care for people dying of cancer? A comparison of a rural and metropolitan cohort in a South Australian bereaved population study

Abstract

Background: People in the rural and remote areas often have disparities in access to services and specific challenges when called upon to provide care. In order to plan and resource palliative care services, it is important to know what levels of service are available and what are the perceived unmet needs of caregivers for people at the end of life. Purpose: To examine and compare urban and rural palliative care service availability and patterns of care from randomised, population-based surveys of caregivers of people at the end of life. Methods: Survey responses on the death of ‘someone close’ from 23,588 interviews of South Australians conducted between 2001 and 2007 are analysed exploring palliative care service availability, caregiving provided, and characteristics of the deceased and caregivers. Results: There was no difference in reported rates of accessing specialist palliative care services between rural and urban respondents (in unadjusted and adjusted analyses) nor did the proportion of people for whom cancer was their life-limiting illness. There was greater reliance on friends than first degree relatives in hands-on care provided at the end of life in rural settings. The rates of reported need for more support did not differ between urban and rural respondents for caregivers of people at the end of life. Conclusion Use of palliative care services was similar for rural and urban caregivers for someone close at the end of life with similar levels of met and unmet needs.