“Staying Close to Shore”: A Context for Older Rural Widows' Use of Health Care

Access to health care has been considered central to understanding older rural adults' utilization of health services. Access has been measured in terms of distance to care, use of care, and barriers to care; because older persons' relevant perceptions have received little attention, the validity of the typical access constructs is questionable. During a phenomenological study of their experiences of living alone at home, eight older rural widows shared perceptions about the locales where they received primary care and specialty care. A facet of their life-worlds, "staying close to shore," was seen as a frame of reference for their perceptions and as a general context for health care utilization. The implications of "staying close to shore" are discussed in relation to conventional conceptualizations of access.