Racial and ethnic differences occur in accessing hospice care because black Americans are less satisfied with the kind of hospice care they receive from the caregivers. Results of communication and end-of-life debates between physicians and the patients differ by race. Black Americans are likely to receive less care reliability with patient's preferences. Black people fail to attend to hospice care compared to white and Latino people irrespective of their income and wish to be kept alive on life support machine even if there is a little opportunity to survive. Researchers say that eight per cent of blacks compared to forty-three of whites have a living will. The community never thought of putting their loved ones in hospice regardless of how ill the person was. They believed that it was their responsibility to take care of the sick person until they died (Salter, 2007). Because of heavy demands and many priorities connected to households responsibilities leading some women to sacrifice their health necessities to attend to other people's health.
The history of discrimination in the United States is another factor that limits the blacks from seeking hospice care. The healthcare provided to the blacks is inferior in quality thereby discouraging them from visiting the hospitals. In the 1960s, separated hospitals were common in the U.S. where black patients attended mixed race hospitals though they were housed in segregated floors. They lacked proper medication and health care leading to the death of many people pointing to toxic mistrust of health care systems (Jett, 2006). The distrust is still present today particularly at the end of life, as many blacks are still suspicious of the kind of health care they get worried that it is another method of hastening death. African Americans die from illnesses that can be treated and prevented with more occurrence than other racial groups.
Black Americans have sincere religious beliefs. Blacks are the strongest in religious beliefs compared to other races or the ethnic groups. Four out of five people usually pray on a daily basis and many attend church weekly. In most African-American churches, they believe that a doctor nor a patient do not decide the fate of death; instead, it is judged by God. Hospice reaches the white patients living in middle-class level successfully while black pastors along with their wives confronted the suspicion and fear of hospice care in black communities through prayers and personal stories.
Lack of black American staffs is a significant obstacle to enable hospice use among the black people. Many hospices have very less registered black nurses. Lack of knowledge of hospice is a considerable challenge to hospice use in black American communities. The church partnership with hospice providers helps in educating the community on the importance of hospice use hence improving the health of the community (Teno, et.al, n.d.). Recommendations to improve care for the black people include culture sensitization training to improve knowledge, attitude towards hospice care and health care provider skills to enhance patient satisfaction. Outreach to nursing homes is vital due to the growing population of black Americans who reside in nursing homes.
Africans-Americans are vulnerable to lacking health insurance or get care that is inferior in quality. They are more reluctant to plan for their lives hence ignore the doctor's suggestion to shop for treatment through securing insurance cover. Patients who lack to engage in planning their dying care receive aggressive, physical tax, expensive and treatments that are not necessary towards the dying period (Crawley, et.al., n.d). Black Americans appear for the hostile end of life than the white patients and show less concern in embracing hospice care.
Changing the African-American beliefs is challenging mainly when startling racial health differences remain. An example in the reported news showed a family in a black community where the father was a pastor lost their two sons from sickle cell disease who endured a lot of pain and prolonged death because they could not take them to a hospice. When their next son got sick, a caregiver urged them to choose hospice, but they hesitated because of their strong beliefs. They later agreed to try the hospice care, and the nurses addressed the pain their son was going through, and he died peacefully. The family appreciated the hospice system and urged other blacks to help reshape the community's opinions about hospice.
Older black people are most likely to live their last years with disabilities than older white people (Smedley, 2003.). Improving the care of older people who are severely sick needs not only to survey the disparities in utilization and the value that connects racial and ethnic groups but also to study the results in the groups. Methods of care that demonstrate favorable results without racial discrimination should be regarded as the best practices. Efforts to eliminate differences in caregiving should focus on patients, caregivers, communities, health facilities, and health policies. New methods of care that can accommodate the variety of requirements and favorites of a quickly growing population with racial and ethnics' disparities in aging people should be implemented.
Smedley BD, editor; Stith AY, editor; Nelson AR, editor. Institute of Medicine Committee on Understanding and Eliminating Ethnic and Racial Disparities in Healthcare, Board of Health Sciences Policy. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington, DC: National Academic Press; 2003.
Crawley L. Payne R. Bolden J. Payne T. Washington P, et al. Palliative and end-of-life care in the African-American community. JAMA. 2000;284:2518-2521.
Teno JM. Clarridge BR. Casey V. Welch LC. Wetle T, et al. Family perspectives on end-of-life care at the last place of care. JAMA. 2004;291:88-93.
Salter, P. S., & Multhaup, K. S. (2007). Ethnic self-identification in the African American community: The role of aging in label preferences. PsycEXTRA Dataset. doi:10.1037/e514412014-391
Jett, K. F. (2006). Mind-loss in the African American community: Dementia as a normal part of aging. Journal of Aging Studies,20(1), 1-10. doi:10.1016/j.jaging.2005.05.002
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