Bridging the gap: a scoping review of family caregiver roles in rural health settings

Early Abstract:

Background: Rural health systems depend on family and other unpaid care partners to bridge gaps created by distance, workforce shortages, and limited infrastructure, yet evidence about their delivery-facing roles is dispersed. Therefore, the objective of this study was to map how unpaid caregivers contribute to rural health delivery, identify common enablers and barriers, and summarize reported outcomes for patients, caregivers, and health systems.
Methods: We conducted a scoping review in accordance with PRISMA-ScR guidelines. We searched MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Web of Science Core Collection, and ProQuest from January 2000 to September 2025. Eligible English-language studies examined unpaid caregivers supporting individuals of any age in rural/remote/frontier settings where caregiver activities intersected with health service delivery.
Results: Forty-five studies were included. Eight recurring domains described caregiver work: coordination and navigation, medication and treatment management, telehealth mediation, monitoring and early triage, transport and home or environmental adaptation, cultural and linguistic brokerage and trust-building, palliative, disability, and long-term support, and caregiver competence and burden. Barriers included device gaps, fragmented handoffs, limited respite, and travel costs. Programs integrating caregivers reported improved adherence, continuity, and earlier escalation.
Conclusions: Unpaid caregivers are important members of rural care teams. Formal recognition, resourcing, and measurement, alongside investments in coordination infrastructure, broadband, respite, and financial supports, are essential for sustainable and equitable rural care.
Keywords: care coordination, family caregivers, informal caregiving, rural health services, telehealth.