Barriers to quality end-of-life care for Latinos: Hospice health care professionals' perspective

Hospice is an option that serves the care needs of terminally ill patients. However, promoting awareness of pursuing end-of-life (EOL) care among Hispanics is challenging. Hispanics are the fastest growing ethnic minority group in the United States but themost unlikely to use hospice services for EOL. This project was intended to identify health care providers' (HCPs') self-perceived barriers/solutions to improve use of hospice among Latino patients in both Hispanic-predominant and white-predominant communities. Focus groups were conducted at 2 hospice agencies to compare views on Hispanic EOL care. Two HCP groups from VITAS hospice in Texas (n = 9, 12) and 1 in Missouri (n = 24) participated. Qualitative analysis was performed. Across groups, all HCPs had similar distributions of professions (predominantly nursing). Despite the differences in ethnicity and few Hispanic patients in Missouri, common EOL barriers were identified, including language, religion, and family culture. Potential solutions identified included education in Spanish to families, the use of community religious leaders, and use of media ("telenovelas = soap operas") to bring the concept of Hospice to Hispanic homes. From the perspective of HCPs, this study identifies barriers and solutions with potential health care implications to improve hospice care among growing Hispanic communities in a culturally appropriate manner.