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Barriers to Quality End-of-Life Care for Latinos: Hospice Health Care Professionals’ Perspective

Cruz-Oliver, Dulce M. MD, CMD; Sanchez-Reilly, Sandra MD, FAAHPM

Journal of Hospice & Palliative Nursing: December 2016 - Volume 18 - Issue 6 - p 505–511
doi: 10.1097/NJH.0000000000000277
Feature Articles

Hospice is an option that serves the care needs of terminally ill patients. However, promoting awareness of pursuing end-of-life (EOL) care among Hispanics is challenging. Hispanics are the fastest growing ethnic minority group in the United States but the most unlikely to use hospice services for EOL. This project was intended to identify health care providers' (HCPs') self-perceived barriers/solutions to improve use of hospice among Latino patients in both Hispanic-predominant and white-predominant communities. Focus groups were conducted at 2 hospice agencies to compare views on Hispanic EOL care. Two HCP groups from VITAS hospice in Texas (n = 9, 12) and 1 in Missouri (n = 24) participated. Qualitative analysis was performed. Across groups, all HCPs had similar distributions of professions (predominantly nursing). Despite the differences in ethnicity and few Hispanic patients in Missouri, common EOL barriers were identified, including language, religion, and family culture. Potential solutions identified included education in Spanish to families, the use of community religious leaders, and use of media (“telenovelas = soap operas”) to bring the concept of Hospice to Hispanic homes. From the perspective of HCPs, this study identifies barriers and solutions with potential health care implications to improve hospice care among growing Hispanic communities in a culturally appropriate manner.

Dulce M. Cruz-Oliver, MD, CMD, is associate professor of internal medicine, Division of Geriatrics Medicine, Saint Louis University, Missouri.

Sandra Sanchez-Reilly, MD, FAAHPM, is associate professor, The University of Texas Health Science Center at San Antonio, GEC and GRECC, South Texas Veterans Health Care System.

Address correspondence to Dulce M. Cruz-Oliver, MD, CMD, Division of Geriatrics, Department of Internal Medicine, Saint Louis University, 1402 South Grand Blvd M238, St Louis, MO 63104 (

This work was supported by the Health Resources and Services Administration (HRSA) Geriatric Academic Career Award K01HP20479-03-00.

The authors have no conflicts of interest to disclose.

Copyright © 2016 by The Hospice and Palliative Nurses Association. All rights reserved.

© 2016 by The Hospice and Palliative Nurses Association.