The experiences of rural and remote family palliative caregivers who commute with a family member for advanced cancer care at an urban center

Commuting for advanced cancer care represents an important option for rural families who require palliative care. Few studies have focused on the experience of traveling for cancer care, and fewer still illuminate family palliative caregivers’ (FPCs) perspectives. The purpose of this qualitative study was to describe the experiences of rural FPCs who supported patients in commuting to a regional cancer centre for palliative care. Semi-structured interviews were conducted with 15 FPCs (27-73 yrs) who were involved in commutes ranging from 24-774 km one way. FPCs in this study had the key responsibility for their family members’ personal needs as they sought palliative treatment and consultation. Data analysis revealed important contextual factors influencing FPCs’ experiences including the independent nature of rural dwellers, rural support networks, and familiarity with long distance travel. The dedication of FPCs to making the commuting experience as positive as possible for their family members was a central theme. Accordingly, FPCs were involved in extensive preparations for trips, managing the financial implications of commuting, taking extra precautions - just in case, monitoring the impact of travel on both the patient and themselves, and providing comfort and support during commutes. The work of commuting was stressful, tiring, and sometimes pushed FPCs beyond comfortable limits. Despite these challenges, FPCs spoke of the importance of “making the best it” by taking full advantage of the time spent with their family member and incorporating other activities to make each trip worthwhile. Participant recommendations for supporting FPCs involved in commuting for care targeted the importance of self care. Practice recommendations, therefore, include a holistic assessment of the FPC and the family member and their needs as they continue to commute for palliative care. Policy changes to support financial needs and plan treatment visits that will minimize commuting are indicated. Finally, research initiatives are indicated in order to focus attention on diversity issues such as gender and ethnicity among rural and remote palliative caregivers. Commuting for care as a FPC is still emerging as an area of research study.Health and Social Development, Faculty of (Okanagan)Nursing, School of (Okanagan)Graduat