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Willingness to use hospice care among caregivers of Latino patients in the United States–Mexico border region

Published online by Cambridge University Press:  09 September 2016

Eunjeong Ko ,
Jaehoon Lee ,
Carlos Ramirez ,
Stephanie Martinez  and
Denicka Lopez
Eunjeong Ko*
Affiliation:
School of Social Work, San Diego State University, San Diego, California
Jaehoon Lee
Affiliation:
College of Education, Texas Tech University, Lubbock, Texas
Carlos Ramirez
Affiliation:
AccentCare Home Health, El Centro, California
Stephanie Martinez
Affiliation:
Imperial Child Protective Services, El Centro, California
Denicka Lopez
Affiliation:
Department of Psychology, San Diego State University, San Diego, California
*
Address correspondence and reprint requests to: Eunjeong Ko, School of Social Work, San Diego State University, 5500 Campanile Drive, San Diego, California 92182-4119. E-mail: eko@mail.sdsu.edu.
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Abstract

Objective:

Hospice is an important method of promoting quality end-of-life (EoL) care, yet its utilization is relatively low in underserved populations. The unique characteristics of a border community—such as a lack of healthcare resources and cultural integration—impact EoL decision making. The aim of our study was to assess the willingness to use hospice care services and its predictors among family caregivers of Latino patients in the United States (U.S.)–Mexico border region of Southern California.

Method:

This study analyzes secondary data from a home health agency in the U.S.–Mexico border region. Quantitative data were collected via a face-to-face interview with 189 caregivers of patients enrolled in the agency. Bivariate tests and logistic regression were employed to address our study objectives.

Results:

The majority (83%) of family caregivers were willing to use hospice services for their loved ones. The factors impacting willingness to use hospice services included the primary language of the caregiver (OR = 6.30, CI95% = 1.68, 23.58); trust in doctors to make the right decisions (OR = 3.77, CI95% = 1.05, 13.57); and the belief that using hospice care means giving up on life (OR = 0.52, CI95% = 0.30; 0.88). Caregivers who trusted doctors to make the best decisions for their loved ones and English-speaking caregivers were more willing to utilize hospice services, while caregivers who held a strong belief that hospice care means giving up on life were less likely to consider using hospice care for their loved ones.

Significance of results:

The willingness of family caregivers to use hospice services for their loved ones is influenced by cultural perspectives about hospice care. As the importance of family involvement in EoL care planning has been highlighted, family caregivers' beliefs about hospice care services need to be addressed within their particular cultural context.

Keywords

Hospice careCaregiversLatinoUnited States–Mexico borderRural
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 3 , June 2017 , pp. 279 - 287
Copyright
Copyright © Cambridge University Press 2016 

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References

REFERENCES

Born, W.K., Greiner, A., Sylvia, E., et al. (2004). Knowledge, attitudes, and beliefs about end-of-life care among inner-city African Americans and Latinos. Journal of Palliative Medicine, 7(2), 247–256.Google Scholar
Campbell, C.L., Merwin, E. & Yan, G. (2009). Factors that influence the presence of a hospice in a rural community. Journal of Nursing Scholarship, 41(4), 420–428. Available from http://onlinelibrary.wiley.com/doi/10.1111/jnu.2009.41.issue-4/issuetoc.CrossRefGoogle Scholar
Carrion, I.V. (2010). When do Latinos use hospice services? Studying the utilization of hospice services by Hispanics/Latinos. Social Work in Health Care, 49(3), 197–210.Google Scholar
Carrion, I.V., Cagle, J.G., Van Dussen, D.J., et al. (2015). Knowledge about hospice care and beliefs about pain management: Exploring differences between Hispanics and non-Hispanics. The American Journal of Hospice & Palliative Care, 32(6), 647–653. Epub ahead of print Jun 5, 2014.CrossRefGoogle ScholarPubMed
Casarett, D.J., Hirschman, K.B., Crowley, R., et al. (2003). Caregivers' satisfaction with hospice care in the last 24 hours of life. The American Journal of Hospice & Palliative Care, 20(3), 205–210. Available from http://ajh.sagepub.com/content/20/3/205.abstract.CrossRefGoogle ScholarPubMed
Chastek, B., Harley, C., Kallich, J., et al. (2012). Health care costs for patients with cancer at the end of life. Journal of Oncology Practice, 8(Suppl. 6), 75s–80s. Available from http://jop.ascopubs.org/content/8/6S/75s.abstract.Google Scholar
Colón, M. (2005). Hospice and Latinos. Journal of Social Work in End-of-Life & Palliative Care, 1(2), 27–43. Available from http://www.tandfonline.com/doi/abs/10.1300/J457v01n02_04.Google Scholar
Colón, M. (2012). Acculturation and attitudes of Latinos toward hospice. Journal of Social Work in End-of-Life & Palliative Care, 8(3), 229–248. Available from http://www.tandfonline.com/doi/abs/10.1080/15524256.2012.708110.Google Scholar
Colón, M. & Lyke, J. (2013). Comparison of hospice use by European Americans, African Americans, and Latinos: A follow-up study. The American Journal of Hospice & Palliative Care, 32(2), 205–209. Epub ahead of print Nov 11. Available from http://ajh.sagepub.com/content/32/2/205.Google Scholar
Cruz-Oliver, D.M., Talamantes, M. & Sanchez-Reilly, S. (2014). What evidence is available on end-of-life (EoL) care and Latino elders? A literature review. The American Journal of Hospice & Palliative Care, 31(1), 87–97. Epub ahead of print Mar 15. Available from https://www.researchgate.net/publication/236056101_What_Evidence_is_Available_on_End-of-life_EOL_Care_and_Latino_Elders_A_Literature_Review.Google Scholar
Gelfand, D.E., Balcazar, H., Parzuchowski, J., et al. (2004). Issues in hospice utilization by Mexicans. The Journal of Applied Gerontology, 23(1), 3–19. Available from http://jag.sagepub.com/content/23/1/3.CrossRefGoogle Scholar
Holley, A.P.H., Gorawara-Bhat, R., Dale, W., et al. (2009). Palliative access through care at home: Experiences with an urban, geriatric home palliative care program. Journal of the American Geriatrics Society, 57(10), 1925–1931. Epub ahead of print Aug 21. Available from http://onlinelibrary.wiley.com/doi/10.1111/jgs.2009.57.issue-10/issuetoc.Google Scholar
Johnson, K.S., Kuchibhatla, M. & Tulsky, J.A. (2008). What explains racial differences in the use of advance directives and attitudes toward hospice care? Journal of the American Geriatrics Society, 56(10), 1953–1958. Epub ahead of print Sep 2. Available from http://onlinelibrary.wiley.com/doi/10.1111/jgs.2008.56.issue-10/issuetoc.Google Scholar
Karikari-Martin, P., McCann, J.J., Hebert, L.E., et al. (2012). Do community and caregiver factors influence hospice use at the end of life among older adults with Alzheimer disease? Journal of Palliative Nursing, 14(3), 1–19.Google Scholar
Kreling, B., Selsky, C., Perret-Gentil, M., et al. (2010). “The worst thing about hospice is that they talk about death”: Contrasting hospice decisions and experience among immigrant Central and South American Latinos with U.S.-born white, non-Latino cancer caregivers. Palliative Medicine, 24(4), 427–434. Available from https://www.researchgate.net/publication/44635479_%27The_worst_thing_about_hospice_is_that_they_talk_about_deathg%27_Contrasting_hospice_decisions_and_experience_among_immigrant_Central_and_South_American_Latinos_with_US-born_White_non-Latino_cancer_care.CrossRefGoogle Scholar
Lackan, N.A., Ostir, G.V., Freeman, J.L., et al. (2004). Hospice use by Hispanic and non-Hispanic white cancer decedents. Health Services Research, 39(4, Pt. 1), 969–984. Available from http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2004.00267.x/abstract.Google Scholar
Levinson, W., Kao, A., Kuby, A., et al. (2005). Not all patients want to participate in decision making: A national study of public preferences. Journal of General Internal Medicine, 20(6), 531–535. Available from http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1497.2005.04101.x/abstract.CrossRefGoogle ScholarPubMed
Ludke, R.L. & Smucker, D.R. (2007). Racial differences in the willingness to use hospice services. Journal of Palliative Medicine, 10(6), 1329–1336.Google Scholar
Lynch, S. (2013). Hospice and palliative care access issues in rural areas. The American Journal of Hospice & Palliative Care, 30(2), 172–177. Epub ahead of print Apr 24, 2012. Available from https://www.researchgate.net/publication/224834882_Hospice_and_Palliative_Care_Access_Issues_in_Rural_Areas.Google Scholar
Manu, E., Mack-Biggs, T.L., Vitale, C.A., et al. (2013). Perceptions and attitudes about hospice and palliative care among community-dwelling older adults. The American Journal of Hospice & Palliative Care, 30(2), 153–161. Epub ahead of print May 2, 2012. Available from https://www.researchgate.net/publication/224897552_Perceptions_and_Attitudes_About_Hospice_and_Palliative_Care_Among_Community-Dwelling_Older_Adults.CrossRefGoogle ScholarPubMed
National Hospice and Palliative Care Organization (2015). NHPCO's facts and figures: Hospice care in America. Available from http://www.nhpco.org/sites/default/files/public/Statistics_Research/2015_Facts_Figures.pdf.Google Scholar
Park, N.S., Jang, Y., Ko, J.E., et al. (2015). Factors affecting willingness to use hospice in racially/ethnically diverse older men and women. The American Journal of Hospice & Palliative Care, 33(8), 770–776. Epub ahead of print Jun 11. Available from http://ajh.sagepub.com/content/33/8/770.CrossRefGoogle ScholarPubMed
Rabow, M.W., Hauser, J.M. & Adams, J. (2004). Supporting family caregivers at the end of life: “They don't know what they don't know.” The Journal of the American Medical Association, 291(4), 483–491.Google Scholar
Schockett, E.R., Teno, J.M., Miller, S.C., et al. (2005). Late referral to hospice and bereaved family member perception of quality of end-of-life care. Journal of Pain and Symptom Management, 30(5), 400–407. Available from https://www.researchgate.net/publication/7457596_Late_Referral_to_Hospice_and_Bereaved_Family_Member_Perception_of_Quality_of_End-of-Life_Care.Google Scholar
Selsky, C., Kreling, B., Luta, G., et al. (2012). Hospice knowledge and intentions among Latinos using safety-net clinics. Journal of Palliative Medicine, 15(9), 984–990. Epub ahead of print Jun 25. Available from https://www.researchgate.net/publication/228064894_Hospice_Knowledge_and_Intentions_among_Latinos_Using_Safety-Net_Clinics.Google Scholar
Smith, A.K., Sudore, R.L. & Pérez-Stable, E.J. (2009). Palliative care for Latino patients and their families: “Whenever we prayed, she wept.” The Journal of the American Medical Association, 301(10), 1047–1057, E1. Available from http://jama.jamanetwork.com/collection.aspx?categoryID=6014&page=5.CrossRefGoogle Scholar
Virnig, B.A., Moscovice, I.S., Durham, S.B., et al. (2004). Do rural elders have limited access to Medicare hospice services? Journal of the American Geriatrics Society, 52(5), 731–735. Available from http://onlinelibrary.wiley.com/doi/10.1111/jgs.2004.52.issue-5/issuetoc.Google Scholar
Virnig, B.A., Ma, H., Hartman, L.K., et al. (2006). Access to home-based hospice care for rural populations: Identification of areas lacking service. Journal of Palliative Medicine, 9(6), 1292–1299. Available from http://online.liebertpub.com/doi/abs/10.1089/jpm.2006.9.1292.Google Scholar
Waldrop, D.P. & Meeker, M.A. (2014). Final decisions: How hospice enrollment prompts meaningful choices about life closure. Palliative & Supportive Care, 12(03), 211–221. Epub ahead of print Aug 13, 2013. Available from http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9263690&fileId=S1478951512001113.CrossRefGoogle ScholarPubMed