Abstract
Forty years after the creation of the Medicare hospice benefit, low use of hospice and palliative care services in persons of color increases suffering and aggressive care at the end of life related to social determinants of death. A lack of culturally appropriate programs, diversity in hospice personnel, and education for health care personnel, and marginalized populations remain problematic. This article provides tools for nurse practitioners and other health care personnel in spiritual, cultural, and goals-of-care assessments, quality improvement, and an explanation of the benefits of faith-based programs and partnerships
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