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.

Hospice and Nursing Homes Blog

Hospice Volunteer Training: End-of-Life Communication Issues

Sooner or later, hospice volunteers experience or observe communication concerns relating to patients or their families. In a research study by the Communications Department at the University of Utah, hospice volunteers reported that denial was the most common communication issue for patients, family members, and caregivers. The second most reported communication problems related to negative feelings and family conflicts. At personal levels, volunteers reported that their most common communication problems centered on interacting with patients who had diseases such as Alzheimer's or Parkinson's disease that impaired conversations. These results suggest that volunteer training programs should include more information to support volunteers in their communication efforts.

Personally, I enjoy coming up with ways to bridge gaps in communication. I never assume patients cannot hear me, unless they have been officially diagnosed as hearing impaired. I talk to them the way I would talk to hearing patients. I tell them what's going on at the nursing home and other news. Even when their eyes are closed, but I know they are awake, I tell them who else is in the room and say something positive about them to those present, so patients can feel included in the conversations.

I check their assignment forms and talk to their caregivers to find out what their backgrounds and interests are. This gives me more sources for topic ideas. If patients are able to leave the room, I take them on walks or wheelchair rides. I read to them, play music I think they will enjoy, touch them to reinforce my presence; I feed them, play games, sing, play the radio, and watch television with them, regularly making comments and always analyzing their body language to see if I'm making connections.

When I do a good job of this, I see signs that we are making progress. There may be smiles, alertness, something in their eyes that tells me our communication gaps are getting smaller, that we are forging relationships enhancing our lives. That's when the beauty of hospice volunteering sweeps me up like a great piece of music.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog