Unmet Informal Caregiver Needs in Rural Areas: A Care Management Perspective

Vollständiger Abstract

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Background: Caregivers of older adults in rural settings face distinct challenges shaped by environmental factors, including longer travel distances, limited support networks, and fewer resources. Addressing these unmet needs is critical to reducing burnout and negative health outcomes. Methods: We surveyed care managers to compare rural caregivers’ needs with urban caregivers. A convenience sample of care managers completed a survey developed by geriatrics professionals. The survey included multiple-choice and seven optional open-ended questions. Participants were recruited via email and word of mouth (March–June 2025). Inclusion criteria required completion of more than half the survey, providing a practice ZIP code, and employment in North Carolina. Quantitative data were analyzed descriptively; qualitative responses were analyzed by a hybrid deductive-inductive thematic approach. Results: The participation rate was 16% (62/387) before exclusions. The final sample included 36 participants, 89% of whom completed the entire survey. Most were aged 25–34 (38.9%), held a master’s degree (55.6%), had 1–5 years of experience (52.8%), and practiced in rural settings (50%). A total of 89 open-ended responses were analyzed; six responses were reported as “Unsure” and not included in the theme development. Two themes emerged: (1) there are fewer resources for caregivers in rural compared with urban communities, and (2) care managers in rural communities face additional barriers beyond limited resources. Conclusion: Rural caregivers, and the care managers who support them, face distinct challenges. This exploratory work informs future research to expand to other regions, standardize rural definitions in research, and develop and evaluate system-level interventions to better support both caregivers and care managers.