Evaluation of Hospice Care by Family Members of Hispanic and Non-Hispanic Patients

Abstract

The Hispanic older adult population is increasing rapidly and past research suggests that this demographic group underutilizes hospice services, highlighting the need to improve our understanding of their needs in end of life. This study relied upon information from the family evaluation of hospice care survey provided by 2980 caregivers, 152 of whom cared for a Hispanic patient and 2828 who cared for a non-Hispanic patient. Caregivers of Hispanic patients were more likely to report that hospice was inconsistent with the patient's wishes, and that they received more attention than desired for emotional issues. Caregivers of Hispanic patients were also more likely to express that emotional/spiritual forms of support were insufficient. Similar levels of satisfaction were reported for caregivers of Hispanics and non-Hispanics regarding dignity/respect, information received, care coordination, and overall satisfaction.

Integrative Review of the Literature on Hispanics and Hospice

“…46 Researchers used mostly convenience sampling, which introduced an unknown amount of bias and error in their numerical results. 4,38,[40][41][42][43][44][45] In contrast, 3 studies introduced randomization through random assignment of participants to control or intervention arms 46 or random selection of phone numbers for telephone-based surveys. 37,39 Patient-reported measures were used in most reviewed studies.…”

“…The Family Evaluation of Hospice Care (FEHC) is an established survey routinely sent from hospice facilities to family caregivers after a hospice patient has died (Table 4). 42 It is unclear whether the FEHC was available in Spanish, and there was no discussion of instrument validity with Hispanic populations. Moreover, only survey results in which ethnicity was self-reported were included in the analysis, which may have biased samples.…”

“…Five articles discovered in citations were added. Case studies were removed to result in a final 21 articles for review or 10 qualitative [27][28][29][30][31][32][33][34][35][36] (Tables 1 and 2) and 11 quantitative 4,[37][38][39][40][41][42][43][44][45][46] (Tables 3 and 4). Acknowledging the research focus of the review, the qualitative and quantitative articles are presented separately.…”

Quality of Hospice Care at Home Versus in an Assisted Living Facility or Nursing Home

“…Other studies have explored differences in clinical characteristics of individuals in hospice in different settings of hospice care, but we found limited prior research examining perceived quality of hospice care across settings. In field‐testing of the hospice CAHPS survey, reported experiences of care were typically worse in NH than home settings .…”

“…Similar studies evaluated family member satisfaction based on characteristics such as race and ethnicity. Family members of African‐American and Hispanic individuals in hospice reported more concerns about quality of care in the areas of care coordination, honoring individual's wishes, and emotional and spiritual forms of support …”