Supporting Informal Caregivers
In many rural areas, low population combines with lack of health services, poverty, underserved areas, and geographic isolation. Particularly with the elderly, family members, neighbors, and friends often fill the service gap, providing both direct and indirect caregiving services. Adding to the situation are adult children who migrate to larger, urban areas due to education, employment, and opportunities. This often reduces the number of family members available to provide care and elderly people must rely on friends, their church, and neighbors for informal services. The need to support informal caregivers is a rural health care issue.
Caregivers provide emotional, financial, nursing, social, homemaking, and other services on a daily or intermittent basis. Most family caregivers volunteer their time, without pay, to help with the physical and emotional needs of a loved one. Duties vary and may include providing personal care, feeding, toileting, dressing, bathing, carrying out medical procedures such as suctioning an injured person every hour every day, assisting with activities of daily living, and managing a household. Caregiving may involve learning about hospice, giving medication, driving the person to doctor appointments, delving into a person’s personal financial situation, or paying bills.
Other ways caregivers can help is to make meals, clean house, shop for groceries, mow the lawn, and make regular phone calls to check on someone. You can also offer to help make home modifications such as installing grab bars in the shower, a stool riser for the toilet, or a wheelchair ramp by the front door.
For information on specific illnesses or diseases, there are several useful websites, including:
There are organizations that will assist you in locating available services in your area. Some of these are:
The Meals on Wheels Association of America is the oldest and largest organization in the United States representing those who provide meal services to people in need. This program provides one hot meal per day to seniors. The guiding principle to which it subscribes is to help those men and women who are elderly, homebound, disabled, frail, or at risk. The Meals on Wheels program has recently expanded into rural parts of our country due to the ability to offer individually packaged, frozen meals with foods that are simple to reheat as needed and can be ordered a month at a time. This program also gives cash grants to local senior meal programs throughout the country to assist in providing meals and other nutrition services. The Meals-on-Wheels website allows you to search by city and state to find a listing of all programs in your area.
Some Meals-on-Wheels programs provide congregate meals in addition to home delivered meals. Congregate programs are simply programs that serve at senior centers, where seniors can come and eat their meal in the company of others. While this is not a rare type of program, it is certainly less common so you should check with your local program to see whether or not they have a congregate program.
The USDA Child & Adult Care Food Program (CACFP) is a Federal program that provides healthy meals and snacks to adults receiving day care. It plays a vital role in improving the quality of day care and making it more affordable for many low-income families. Nonresidential, functionally impaired adults who are receiving adult day care in an eligible day care facility, or aged 60 and older may qualify.
The Family and Medical Leave Act, which passed in 1993 and was amended on January 28, 2008, is the first U.S. national policy designed to assist working caregivers in meeting their work and caregiving responsibilities. The act allows employees to take up to 12 weeks of unpaid leave to care for a newborn child or an ill family member. There are specific guidelines in order to take advantage of this act.
Respite care is care provided by a substitute provider. This can be for a few hours to a few days. The purpose of respite care is to give time off to the regular caregiver. An example is adult day care. Adult day care provides respite for caregivers and a welcome change of scene for seniors. Adult day care programs follow either a social model or medical model. Social programs may focus on providing companionship or on hobbies or other special interests, while medical programs may focus on providing therapies such as dialysis, ventilation, and rehabilitation.
Adult day services are community-based group programs designed to meet the needs of functionally and-or cognitively impaired adults through an individual plan of care. These programs provide a variety of health, social, and other related support services in a protective setting.
Medicaid may pay for some services, such as respite care. Medicaid Home and Community-Based waiver programs vary by state and are online. For specific questions, see Medicaid's pages on:
Information on transportation options for the disabled and the elderly should be available at local human service offices, local transit authorities, community and faith-based organizations, and regional planning organizations. Contact your local county social service agency, your community action agency, and/or call 2-1-1 if this service is available, to find out what programs are in your area. If at the local level you are not finding out sufficient information, call your state Rural Transit Assistance Program (RTAP) manager.
The National Volunteer Caregiving Network (NVCN), formerly called Faith in Action, has over 1,000 programs throughout the country. This volunteer program provides many services, including transportation to doctor appointments, errands, and picking up groceries.
Each state has a transportation office. These offices can assist in helping answer questions and locating what transportation programs are in your area. The U.S. Department of Transportation provides a state-by-state directory to provide contact information for each of the state transportation managers and associations.
Citizens or groups wanting to implement a transportation program in their rural community should visit with their state office listed above. Your state representative can tell you what can be done and how to do it. They may also have the means at the state level to offer grants to purchase vehicles.
Community Action Agencies can also provide citizens with information on transportation in rural areas.
The American Public Transportation Association contains a listing of local public transportation systems. This listing provides a state-by-state display of state, regional and county transportation services available. They also provide a listing of public transit in your community.
For further information on rural transportation programs, please see the RAC Transportation Topic Guide, particularly the frequently asked questions section.
Last Reviewed: 1/22/2014