Friday, August 5, 2011

Hospice and Hispanics: Doctor-Patient Communication (Research, Video 2:52)

Cultural values play an important role in how racial-ethnic populations make decisions regarding terminal illness, caregiving, end-of-life experiences, and hospice participation. Communication is a critical factor in delivering information that can be understood in the context of these values. Doctors and their background training must reflect general cultural knowledge of racial-ethnic groups in order to communicate well with them, always keeping in mind that there are differences within populations.

With a focus on Hispanics, researchers at the University of South Florida School of Social Work studied factors that doctors use to communicate with patients. Communication involved revealing a terminally ill diagnosis and a hospice referral. Interviews conducted in Spanish and/or English with ten doctors in Central Florida reported these results relating to communication and related themes:

1)   Role of family members and end-of-life decisions
2)   Language barriers and limited knowledge of culture and beliefs relating to end-of-life decisions
3)   Gaps in training and education of doctors

Hispanics and other racial-ethnic populations that continue to be under-represented in hospice care must be included in the entitlement to death with dignity that the hospice philosophy supports. In order to improve representation, barriers such as language communication, knowledge of family roles, and cultural beliefs related to end-of-life decisions must be addressed. Better education and training of doctors and other healthcare workers can greatly improve their communication skills with various cultures.

This video from the Hospice Foundation of America Cares video series shares important information about Hispanic concerns that can help healthcare workers meet patients’ needs. Dorotea Gonzalez, nurse at Capital Hospice in Virginia, shares her perspectives on some of the philosophies at the foundation of Hispanic culture.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.


  1. The 4 areas (Familia, Respeto, Personalismo y confiansa) really resonated with me. Since being Latino had always been such an important part of my mother’s personality, I used the Latina Holy Trinity (food, family and music) to help stay connected to her while she went through each of the seven stages of the disease.

    For example, when I moved my mother into her first assisted living facility, I communicated to the staff in a blend of Spanish and English, and made special arrangements for them to bring her a thermos of café-con-leche every morning. As Alzheimer’s continued to chisel cognitive cracks in her brain, it never took away my mother’s joy and spirit which came out in full glory when she heard salsa music. She got lost in salsa music, not because Alzheimer’s predisposed her to being lost but because she poured her soul and her spirit into the sounds she heard. When she danced, she was connected to the air, the ground, the people around her, and the sounds she heard. I believe it brought her to all the happy moments in her life when she had danced as a child- with her mother, her grandmother, her uncle, her aunt, her niece, and then later in life with her own daughter and grand daughter. When she danced, she was in charge, not Alzheimer’s.
    Celia Pomerantz
    Author/Photographer of
    Alzheimer's: A Mother Daughter Journey, kindle book available through Amazon.

  2. Celia, thank you for sharing this wonderful testimony about your mother and the Latina Holy Trinity. Salsa music sounds like a great place to be "lost."