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Telehealth Needed for Rural and Native American Caregiving

A daughter speaks about caring for her father from 400 miles away

Watching a loved one struggle with an illness from afar is devastating for caregivers, and it becomes even more complicated when the patient is in a rural area. Distance can make medical treatment extremely challenging, as AARP South Dakota Executive Council Member Karla Abbott found. Until recently, Abbott, a member of the Cheyenne River Sioux Tribe, struggled to care for her father, Richard Zacher, 82, who lived 400 miles away on the reservation where he was born and raised. 

Zacher was first diagnosed with prostate cancer in 2002, went into remission, and then had a recurrence about four years ago. Zacher is not Native American and received his medical treatment through the Department of Veterans Affairs. He has had many different courses of treatment, including IV chemotherapy, which was 90 minutes from his home. This made every doctor's visit a whole-day affair, Abbott tells AARP. Zacher also suffers from macular degeneration and eventually required transportation to his appointments. Telehealth, where care involves the remote diagnosis and treatment of patients by medical experts who may be miles and even states away, could have made a huge difference in their lives, Abbott says.

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As a cardiac specialty nurse in Sioux Falls, Abbott has experience with telehealth for her patients. She says having that option for her father on the reservation "would have been wonderful. ... My father could have stayed in his own home longer if [we] had had that option. If his physician was connected to him and to me."

Unfortunately, Zacher's health took a turn for the worse, and he now has a prognosis of only a few months to live. Without many nursing home options near the reservation, Abbott moved him to a facility closer to where she lives in Sioux Falls to continue caring for him. Leaving the reservation where he had lived his entire life was devastating for her father, Abbott says. "He is still mourning that fact right now. I can’t imagine being born, raised and living my whole life in one community, so I’m probably not appreciating it as much as someone else who has lived like that." 

Abbott believes that increasing telehealth options in rural areas, including Indian reservations, could be the key to keeping older people in their own homes and allowing for remote caregiving. "As an adult child who moved away, I would be at such peace that I could connect with my father’s care." While acknowledging that it's a complex and costly issue, Abbott feels that it could really work, even for reservations.  "Most people think the reservations don’t have internet, but our tribe does, they have their own network," Abbott says. "Telehealth would have worked." 

"I know my dad today would rather be sitting in his favorite chair looking out the window at the sun shining," Abbott says. "There’s just a spring in his step when he is there; he is happier when he goes home." 

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