Families living with advanced disease in rural communities have unique problems, including geographic isolation and added care giving and financial responsibilities. When the disease advances to the point of disability, the entire family structure feels the strain of increased responsibilities. Resources that are taken for granted in urban settings are scarce in rural settings. Professional caregivers as well as patients and their families are often isolated from the resources needed to help care for themselves.

• Develop a community assessment of local resources and a needs assessment through the closest university. 
• Advocate for increase in services to meet the unique needs of the rural communities. For example: Arrange respite care or volunteer participation in care for the caregiver activities, using the community. 
• Educate family members and caregivers to provide proper care, manage changing situations, face challengers, access available community resources.
• Develop strategic rural care plans with other experienced rural providers, like Government Primary Health care Centres.

The first Palliative Care project was drafted by DEAN Foundation and handed to the then Tamil Nadu Mission Director, NRHM  Ms. Girija Vaidyanath IAS, in 2009 December. 

DEAN Foundation was the very first NGO to receive the grant from NRHM to begin the first Hospice and Palliative Care Pilot project in Tamil Nadu, in Kancheepuram District. For Palliative Care - a historic move in the State of Tamil Nadu. On 4 March 2010, Tamil Nadu's first Rural Palliative Care Centre saw the light of the day, in the Thirupukuzhi Upgraded Primary Health Center Baluchetty Chatram, Kancheepuram District. 

The Project is in collaboration with the Health and Family Welfare Department, Govt't of Tamil Nadu, under National Health Mission. DEAN Foundation has operational responsibility for Hospice and Palliative Care including planning, delivery and ongoing management of services. 

Medical Personnel from DEAN Foundation visit the Government Arignar Anna Memorial Cancer Institute on Tuesdays and Thursdays to assist in their Palliative Out-patient Clinic. The value of Out-patient and Home Based Care is better outcomes, lower costs and more patient-centered care - thereby maximizing independence.

Rural Outreach Hospice & Palliative Care, Geriatric Support and Rehabilitation Services is underway at Karamadai, which is about 30 Kms from Coimbatore. The beneficiaries are those suffering from irreversible, incurable, life-limiting illness living in the rural areas. This community had no access to Palliative Care service until SBI Foundation's Project Anugraha stepped in to cater to the rapidly expanding population of individuals living with serious and complex chronic illnesses, and the realities of the care responsibilities faced by their families. SBI Foundation's Anugraha in Karamadai, Coimbatore District, is SBI's first flagship Hospice & Palliative Care Project in India that offers Home based treatment, informs patients, families and health professionals about the benefits of palliative care and the services that are available, linking community resources, thereby creating compassionate communities. For the Elderly, therapists provide skilled service that achieves the hospice goal of promoting safety, independence, meaning and quality of life, despite the physical and mental decline. This project functions on one acre of land that belongs to the Trust. The building and other infrastructure is in need of financial support.