OBJECTIVE To describe family caregivers' experiences with palliative care s
ervices in rural communities.
DESIGN Qualitative study.
SETTING Manitoulin Island, Ont.
PARTICIPANTS Thirteen family caregivers of 12 deceased patients who had rec
eived palliative care services.
METHOD Twenty-five family caregivers were recruited by mail and local newsp
aper. Eight were excluded because they lived off the Island or were too rec
ently bereaved; one declined an interview; and three were excluded by resea
rchers. Initial contact was by telephone; those retained (13 people) were i
nterviewed at home. Interviews were conducted by the same researcher using
a semistructured interview guide. All interviews were audiotaped and transc
ribed, and content was analyzed.
MAIN FINDINGS Three interwoven themes were identified: access to services,
quality of services, and support and caring. Hospital and community-based s
ervices were accessed with ease at the local level; difficulties were noted
when accessing services in tertiary care centres. Participants were genera
lly grateful for and pleased with services received. Two areas of concern r
aised by participants were communication and pain and symptom control. Part
icipants suggested to the Ministry of Health ways to improve rural palliati
ve care services. More public funding for in-home palliative care services
was identified as a priority.
CONCLUSION Participants thought good services and supportive care at the lo
cal level made up for difficulties in accessing and using palliative servic
es in tertiary care centres. Community spirit and culture were seen as maki
ng situations more bearable.