Palliative and end of life care in remote and rural areas

Palliative and end of life care in remote and rural areas

There is high demand for palliative and end of life care in remote and rural areas but there is inequity in the care that people can access. Hospice UK would like to see the committee include a focus on palliative and end of life care within its inquiry into healthcare in remote and rural areas. Only a third of hospice and palliative care staff felt that people in Scotland can access palliative and end of life care that meets their needs regardless of their geographic location. The challenges were particularly felt in remote and rural areas, and this was identified as one of the greatest areas of unmet need for palliative care in Scotland (Hospice UK survey, 2020). Across Scotland, the demand for palliative care is predicted to rise by 17% in the next 25 year. Rural areas have a higher proportion of people aged over 65 compared to urban populations, and the proportion of older people is also growing at a faster rate in rural areas. This means there is likely to be an even higher need for palliative care in remote and rural communities. As people are living longer with multiple conditions, the care they are needing is also becoming more complex. Challenges around long distances to travel to health care, poor public transport, digital connectivity, difficulties accessing medication and out of hours care - are all exacerbated when someone is at the end of life. Most specialist palliative care services are located in or near cities and it can be difficult to support people in rural communities. GPs, community nursing teams and social care services provide vital support for people with palliative care needs, alongside more specialist palliative care services for those who need it. But staff delivering palliative care in rural areas face challenges around recruitment, sustainable workforce models and rotas, out of hours cover, travel time, and accessing professional support and skills development. The cost of living crisis has disproportionately affected people living in rural communities. Many terminally ill people experience a vicious cycle of fuel poverty. After receiving a terminal diagnosis, people should be able to concentrate on the things that really matter –they shouldn’t have to worry about whether they can afford to keep their house warm or the cost of running essential medical equipment. Social isolation and loneliness can be more prevalent in remote and rural areas and caring for a loved one at the end of life, and experiencing bereavement, can add to this feeling of isolation. However there is also a lot we can learn from remote and rural communities about how communities can support people at the end of life and into bereavement.


Because: end of life is an issue which affects everyone in Scotland deeply; the number of people dying and the complexity of the care they need is growing; there is no systematic gathering of data which captures the experiences people have of end of life care; there is a chance to feed findings into the new palliative care strategy which is in development.

There is no hospice near me and, the nearest one, is so far away that the people |I know locally could not travel to visit me, or others they love, there; all because we live in a remote rural area. I don't want loads of people saying they will come to my home - I want the same choices as others in urban areas have, but in my remote rural area.

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