People who live in rural and remote areas have additional issues to consider when managing life-limiting illnesses. This includes delayed access to services, transport, distances to travel, time away from home for investigations and treatment. Isolation and loneliness can also be a very real issue for those in rural and remote areas.
Rural nurses also have additional considerations such as fewer resources and often access to the wider multidisciplinary team. Gaps in service provision, including hospice, mean that families often have no choice in taking on the caring role.  Families and carers require support from health professionals to continue caring. 
Within small communities patients and health professionals may be neighbours or friends. This can be both comforting and confronting. At times, privacy and confidentiality can be a challenge.