The result is a multicultural population of diverse ages, economic status, educational levels, marital status, religion, race, and social attitudes. An example of diversity appears in statistics of deaths each year in Florida's counties, with counties that attract elderly people reporting many more deaths per 1,000 residents. It is evident that to improve palliative care, some areas of the State will require more educational programs than others. Furthermore, the diversity of the State's population indicates that no single standardized program will meet the needs of all residents. It is a truism to state that the traditional family in America no longer exists.
Families move many times and members of many nuclear families live many miles apart.
A frequent occurrence in Florida is the couple who moved from a distance to Florida to retire, then within a year one partner dies leaving a new widow or widower with little connection to the community. It is often difficult for the caregiver to identify the person who serves as part of the family support system. Often the patient who is chronically ill considers the closest neighbor, friend, or nursing caregiver as more of a family than his or her own blood relatives. They may call the physician at inopportune times and find the response unsatisfactory. Unfortunately, some physicians lack the knowledge of how to communicate openly with the patient and family.