Barriers to Quality End of Life Care for Latinos: Hospice Healthcare Professionals' Perspective (S732)

Abstract

1.To identify healthcare providers' self-perceived barriers of hospice usage among Latino patients in a Hispanic-predominant community, as compared to a Caucasian-predominant community.2.To discuss hospice healthcare providers' perspectives of preferences of Latino patients, family members, and community when it comes to end-of-life care. Hospice is the gold standard of care for terminally-ill patients. However, promoting end-of-life (EOL) care in Hispanics is challenging. Hispanics are the fastest growing ethnic minority group in the US, but the most unlikely to use hospice services for EOL. Barriers and potential solutions (PS) remained to be explored To identify healthcare providers’ (HCP) self-perceived barriers/PS to improve use of hospice among Latino patients in both Hispanic-predominant and Caucasian-predominant communities. Focus groups were conducted at three hospice agencies to compare views on Hispanic EOL care. Two HCP groups from VITAS hospice in Texas (n = 9, 12) and one in Missouri (n = 24). Qualitative analysis was performed. Texas HCP were predominantly Hispanic/Spanish-speaking, whereas Missouri HCP were Caucasian, non-Spanish fluent (p = .001). Across groups, all HCP had similar distributions of professions (predominantly nursing). Despite the differences in ethnicity and few Hispanic patients in Missouri, common EOL barriers were identified. Language ("Hispanics expect HCP speak enough Spanish to communicate"), religion ("Hispanics are mostly Catholics, faith is important"), and family culture ("Hispanics expect you to accept hospitality," "families are huge”) were the main barriers voiced. Caring for dying Hispanics was mostly a rewarding experience (strong family values/bonding). PS identified included education in Spanish to families, community religious leaders (given the importance of faith), and the use of media ("novellas = soap operas") to bring the concept of Hospice to Hispanic homes. HCP identified barriers in Hispanic EOL across diverse communities. Those barriers remain to be addressed by the healthcare system in order to improve hospice care among growing Hispanic communities. HCP described PS like educational interventions targeting language, religion, cultural barriers, and media