Hospice/Palliative Care: Concepts of Disease and Dying

Abstract

Population across the globe is not only aging but also becoming ethnically diverse. This is critically important in providing patient–centered end of life (EOL) care. This recognized diversity in the lived experience of ethnic older adults requires that the patient be individually assessed for their language of preference, need for interpreter use, health beliefs, cultural values, knowledge of disease process and hospice care during clinical encounter. Literature about ethnic older adults EOL is limited because it is based on observational research of low quality, on data extrapolated from younger generation and each ethnic group is heterogeneous in itself. Healthcare disparities in EOL exist for various reasons (i.e. geography, supply, and EOL conversation) but race and ethnicity reporting differ among research studies and very seldom ethnicity solely explain EOL care disparity. The following chapter intends to describe the delivery of EOL care, cultural background influences in death and disease concepts, EOL preferences and hospice use among ethnically diverse elders. A list of suggestions is provided to enhance EOL care by improving research, education, policy and communication with ethnic older adults with advance illness and their family caregivers.