Navigating care in rural areas: Strategies employed by older adults with continuing care needs and their impact on social exclusion.

ABSTRACT

The literature recognizes the great diversity of care arrangements among rural-dwelling older people. However, little is known about the complex relationships between spatial, social and infrastructural characteristics of place and the strategies that older people develop to navigate care. Even less is known about how navigating care impacts social exclusion from the perspective of older adults themselves. To fill this gap, in this secondary analysis we draw on data from twenty-one in-depth interviews from two studies conducted in rural environments in Germany and Poland. We identify three main strategies of navigating care in the rural environment adaptation to circumstances, making use of the environment, and shaping circumstances. We present details from four cases that exemplify how strategies are interconnected with characteristics of place. The relationships between place and navigating care in rural environments is discussed with reference to the overall level of social exclusion experienced by rural-dwelling older adults with continuing care needs.