Barriers to hospice use and palliative care services use by African American adults.
This study explored the reasons for low levels of hospice participation by African Americans.


METHODS
Data about attitudes toward dying and death, advanced directives, and barriers to using hospice services were collected from 314 adults attending 11 diversely populated churches in North Carolina.


RESULTS
Almost all participants indicated (91%) willingness to use hospice, particularly if the hospice team were diverse (77%). Most are without a living will (72%) or health care power of attorney (81%); approximately half (54%) have shared final care wishes.


CONCLUSIONS
Despite evidence of a willingness to use hospice, African Americans were unlikely to complete advanced directives or share final care wishes. However, many were more likely to use hospice if the care team were diverse suggesting the importance of culture.
Department of Behavioral Sciences and Social Work, Winston-Salem State University, Winston-Salem, North Carolina 27110, USA. yancuc@wssu.edu
Cecile N
CN
Yancu
Deborah F
DF
Farmer
Dee
D
Leahman
D000293:Adolescent; D000328:Adult; D016223:Advance Directives / Q000208:ethnology; D001741:Black or African American; D000368:Aged; D001293:Attitude to Death / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010166:Palliative Care / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*