Contemporary Hospice Rural Social Work Practice

Abstract

The author examines the current inequities found in the practice of hospice social work in rural settings. The inter- section of these inequities, in the face of social development, with the hospice philosophy, and the values embedded in the profession of social work are examined. The role of social work education is explored as it relates to reducing and eradicating the inequities found between rural and urban populations receiving hospice care. Specific implications for social work education including curriculum, research, and advocacy are presented. 1. Background Popular assumptions suggest that the quality of life in rural areas is preferable to that in urban areas, as personal and social interactions in rural areas are warm and supportive. Yet Cuellar and Butts (1999) write that the romanticized vision of a tranquil and harmonious rural lifestyle is often refuted by hidden realities: economic deprivation, inadequate housing and transportation, limited access to health professionals and community-based programs, and un-addressed physical and mental health problems. Bull (1998) alludes to various bar- riers to social and health services in rural areas: geographic isolation, economic deprivation, and poor human infrastruc- ture. Compared to urban caregivers, rural caregivers use fewer formal services (Dwyer & Coward, 1991), including end of life care services such as hospice and palliative care. Related to these areas are the challenges experienced by hospice social workers when they attempt to deliver hospice psychosocial services in rural America. The current hospice psychosocial health care inequities and disparities expe- rienced by rural dwellers warrant attention in the literature and prompt response from social work programs.