Comparison of hospice use by European Americans, African Americans, and Latinos: a follow-up study.

This study investigated the rate of hospice use by Latinos and African Americans relative to their prevalence in the general population between 2004 and 2010 as a follow-up to a previous investigation. Archival data (N = 2625) were collected on patients' race/ethnicity, gender, marital status, length of stay in hospice, and reason for discharge. In contrast to previous findings, African Americans were more likely to utilize hospice services, but Latinos were less likely to use hospice services compared to the other groups. There were no differences among the racial/ethnic groups in terms of length of stay or disposition at termination. Strengthening efforts to reach a larger racial/ethnic representation in hospice programs may increase the rate of hospice use by some racial/ethnic groups but not others.

Acculturation and attitudes of Latinos toward hospice.

The relationship between acculturation and attitudes of Latinos toward hospice was examined in a sample of 380 Latinos from southern New Jersey. A survey design, using self-administered questionnaires, including a bi-dimensional acculturation scale, examined attitudes toward hospice. The sample represented a cross-section of socioeconomic groups and various nationalities of Latinos. Findings revealed that education and income were significantly related to attitudes toward hospice but acculturation was not. Findings also revealed that more than one-half of participants were unfamiliar with the word "hospice" prior to the study. Respondents with higher incomes, higher levels of education, and who were older were more familiar and had more positive attitudes. Overall, despite respondents' limited knowledge of hospice, the majority would use it. These findings underscore the need to intensify hospice education in Latino communities taking into account Latinos' socioeconomic status.

The experience of physicians who refer Latinos to hospice.

This study explores the referral experience of physicians who refer Latinos to end-of-life care and challenges associated with the referral process. Qualitative data were collected in New Jersey through semistructured, open-ended interviews. Six physicians participated in this study: 1 oncologist, 2 internists, 1 gerontologist, and 2 infectious disease specialists. The study reveals that language barriers, level of family involvement, and generational group of the patient and the family contribute to the complexity of the physician's experience. Physicians' comments evidence the importance of culturally competent training in medical school and continued education on this topic for physicians who did not receive such training. Bilingual bicultural hospice admissions' staff available at the physician's office could enhance the referral experience.

Hospice and Latinos: a review of the literature.

Research on hospice use by Latinos, although increasing since the late 1990s, remains sparse. This article presents a review of the recent available literature on this topic within the past 15 years. The main aspects discussed are access to hospice care and various factors that researchers suggest affect Latino utilization of hospice care. These factors include beliefs about health care, death and end-of-life care, lack of insurance, lower referral rates by health care professionals and the hospice caregiver requirement. Overall, Latinos underutilize hospice but the reasons remain unclear. No evidence exists to indicate that Latinos are dissatisfied with services once they receive them. Also, no evidence exists to indicate they want services but cannot obtain them. Implications for social work practice and research are discussed.

Practical recommendations for ethnically and racially sensitive hospice services.

Hospice providers have long understood that hospice services are disproportionately utilized by Caucasians compared with racial and ethnic minorities. In fact, it is clear that this disparity is increasing with time despite the development of literature that recommends making services more culturally sensitive and accessible to minority groups. This suggests a need for more concrete and practical recommendations to make hospice services accessible and amenable to minority groups. For implementation in hospice service organizations, standard recommendations require enhancement to increase outreach, improve understanding of cultural issues related to death and dying, improve communication with non-English speaking populations, and implement cross-cultural training programs. In addition, the self-awareness and ethnic identity of hospice workers themselves are elements of culturally sensitive care that frequently are overlooked when discussing hospice organizations. This article outlines some specific objectives for meeting the goal of improving hospice services for ethnic and racial minorities.

Comparison of hospice use and demographics among European Americans, African Americans, and Latinos.

The goals of this study were to compare the rate of use of hospice services and other relevant characteristics of European American, African American, and Latino hospice patients. Information on length of stay in hospice, marital status, age, disposition at termination, living situation, caregiver, referral source, and payment method was collected on patients who used hospice care in southern New Jersey between the years 1995 and 2001 (N = 1958). African Americans and Latinos were both found to use services at significantly lower rates than European Americans. In addition, African American use of hospice declined significantly during this time period, while European American use increased. Differences were also found among the groups in marital status, living situation, caregiver, referral source, and payment method. These differences highlight the need for hospice providers to recognize issues unique to minority groups. The reasons for these disparities need to be clarified by further research.