Home Is Where Their Health Is: Rethinking Perspectives of Informal and Formal Care by Older Rural Appalachian Women Who Live Alone

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The purposes of this qualitative descriptive study were to describe the perceptions of rural, older Appalachian women who live alone regarding systems of informal and formal care and to understand if traditional cultural norms influence attitudes and decisions to access these two systems. Older Appalachian women in this study defined themselves and their health in terms of their homes and as women who care for themselves informally and value independence and privacy. Five major themes emerged from the data for informal care, and three related to formal care or use of it. The findings support a reconceptualization of informal and formal care and point out reasons why these women chose to use or not use these two systems of care. Furthermore, they reveal how changes in the formal care system could support health promotion and prevention strategies grounded in everyday ways of maintaining health within the context of home.