Older Latinos' Attitudes toward and Comfort with End-of-Life Planning

Heyman, Janna C.; Gutheil, Irene A.

doi:10.1093/hsw/35.1.17

Cited by 28 publications

(33 citation statements)

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“…Other interventions aimed to improve understandings of and influence attitudes towards EoL care were through culturally-tailored material for family members and older persons approaching EoL [ 110 – 113 ]. Culturally-tailored print and online resources (e.g.…”

Section: Resultsmentioning

confidence: 99%

A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

et al. 2016

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BackgroundMultiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool.MethodsTo explore attitudes, behaviours and patterns to utilization of EoL care by culturally and spiritually diverse groups and identify gaps in EoL care practice and delivery methods, a scoping review and thematic analysis of article content was conducted. Fourteen electronic databases and websites were searched between June–August 2014 to identify English-language peer-reviewed publications and grey literature (including reports and other online resources) published between 2004–2014.ResultsThe search identified barriers and enablers at the systems, community and personal/family levels. Primary barriers include: cultural differences between healthcare providers; persons approaching EoL and family members; under-utilization of culturally-sensitive models designed to improve EoL care; language barriers; lack of awareness of cultural and religious diversity issues; exclusion of families in the decision-making process; personal racial and religious discrimination; and lack of culturally-tailored EoL information to facilitate decision-making.ConclusionsThis review highlights that most research has focused on decision-making. There were fewer studies exploring different cultural and spiritual experiences at the EoL and interventions to improve EoL care. Interventions evaluated were largely educational in nature rather than service oriented.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0282-6) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

et al. 2016

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“…Thus, efforts to increase knowledge about end-of-life care options will need to be sensitive to language barriers and require clear communication when (7) 11 (7) 13 (8) 6 (5) 18 (9 using translators. [34][35][36][37] It is also possible that consideration of health literacy and/or access to Latino providers could enhance communication of and education about hospice. 34,38 However, our result that knowledge was not independently related to intentions to use hospice suggests that translation and communication of information is important but not sufficient to increase access of Latinos to hospice care.…”

Section: Discussionmentioning

confidence: 99%

Hospice Knowledge and Intentions among Latinos Using Safety-Net Clinics

Selsky

Kreling

Luta

et al. 2012

Journal of Palliative Medicine

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Background: Hospice use is low in Latinos but we know little about explanations for this pattern. Objective: To describe factors associated with knowledge of and intention to use hospice for cancer care. Methods: We conducted a Spanish-language, interviewer-administered cross-sectional survey of 331 Latino immigrants from Central and South America in safety-net clinics. Hospice intentions were measured using a hypothetical scenario. We used logistic regression and multiple imputations to test associations between cultural values, social acculturation, and other variables and knowledge and intentions. Results: Only 29% knew about hospice and 35% would choose hospice care (once it was defined). Collectivist (group-focused) views (odds ratio [OR] 1.06 per 1-point increase, 95% confidence interval [CI] 1.01-1.12, p = .05), endorsing family-centric values (OR 1.03 per 1-point increase, 95% CI 1.01-1.04, p = .004), and higher education were associated with greater hospice knowledge after considering covariates. Greater social ties were also independently associated with greater knowledge, but knowledge was not related to hospice intentions. Individuals who believed in maintaining secrecy about prognosis were 19% less likely to choose hospice than those who did not endorse secrecy (OR 0.81, 95% CI 0.67-0.99, p = .038). The most socially acculturated individuals were significantly more likely to choose hospice than those with less acculturation (OR 1.19 for each 1-unit increase, 95% CI 10.6-1.34, p = .004). Conclusions: Hospice knowledge may be necessary but is not sufficient to increase hospice use among immigrant Latinos. Latino social networks and organizations may provide a natural leverage point for interventions. Interventions to increase hospice use may need to consider culturally related values.

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“…Given the likelihood that economic circumstances will result in the family's inability to care for their older relatives, cultural protocols have subtly changed the ways in which Hispanics define care obligations in the face of economic vulnerability. For example, there has been a shift away from the obligation of adult children caring for their parents to the obligation of ageing parents to not be a burden to their children (Heyman and Gutheil 2010). Recent scholarship has found that the direction of dependence is shifting downwards as more Hispanic adult children are dependent on ageing parents (Treas 2009).…”

Section: Literature Reviewmentioning

confidence: 99%

“…At the same time, adult children may worry that such conversations would make their parents anxious by "tempting fate" (Gutheil and Heyman 2006). Resistance to address end of life, fatalism, and a strong belief that God and prayer will provide for the well being in later life can deter difficult conversations between generations such as will and testament preparations (Edgell and Docka 2007;Herrera et al 2009;Tait et al 2011, Heyman andGutheil 2010). As a result, research shows that, compared to other ethnic and cultural groups, Hispanics are the least informed about long-term health care issues and end-of-life planning (Caralis et al1993;Delgadillo et al 2004).…”

Section: Literature Reviewmentioning

confidence: 99%

Ageing and Long-Term Care Planning Perceptions of Hispanics in the USA: Evidence from a Case Study in New London, Connecticut

Cruz-Saco

López-Anuarbe

2016

Ageing Int

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This paper explores the ageing attitudes and long-term care planning behavior of adult Hispanics in New London, Connecticut, a town with 30 thousand inhabitants that is rapidly ageing. We conducted six focus groups and had 37 participants share their ageing perceptions and long-term care needs. Our main findings suggest that informal care arrangements are vulnerable and unsustainable especially since women have historically and disproportionately provided most family eldercare even at their own personal and financial expense. Though male participants expected their female relatives to care for them when they age and need personal assistance, female participants did not necessarily expect the same from their relatives including their daughters. Also, both formal and government long-term care systems lack cultural competence and can be prohibitively costly. Therefore, Hispanics plan for ageing within their circles of family care and their resilience in a context of cultural exclusion and socioeconomic disadvantage epitomizes strong intergenerational values. These support networks may help explain why may outlive whites (the "Hispanic paradox") who, on average, have higher wealth and education levels. Long-term care planning is a complex process that cannot be relayed to families only. Adequate training for family members from other relatives, and from private and government entities to appropriately convey this type of planning is vital to ensure that Hispanic families understand their options.

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Older Latinos' Attitudes toward and Comfort with End-of-Life Planning

Cited by 28 publications

References 0 publications

A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

Hospice Knowledge and Intentions among Latinos Using Safety-Net Clinics

Ageing and Long-Term Care Planning Perceptions of Hispanics in the USA: Evidence from a Case Study in New London, Connecticut

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