Hospice utilization and end-of-life care decision making of African Americans.
Multiple, complex factors influence end-of-life (EOL) decisions for all persons. In the African American population, these factors include history of disparities and discrimination in health care, which may affect the individual and the family, family system beliefs, values, and practices, and health care system issues. Family dynamics have an especially important role in treatment decisions for loved ones with advanced disease. A family systems framework can guide the clinicians in appreciating care needs and preferences at EOL. Understanding why so many African Americans choose aggressive and often burdensome care, even at the expense of suffering, is important for communication about options at the EOL and the delivery of quality care at the EOL.
Frances Payne Bolton School of Nursing, Case Western Reserve Universtiy, Cleveland, OH, USA. pmm@case.edu
Polly M
PM
Mazanec
Barbara J
BJ
Daly
Aloen
A
Townsend
D001741:Black or African American; D001294:Attitude to Health / Q000208:ethnology; D054521:Cultural Competency; D003657:Decision Making; D054625:Healthcare Disparities; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D008960:Models, Psychological; D011368:Professional-Family Relations; D013727:Terminal Care; D035502:Trust; D014481:United States