A new study identifies six main patient-reported barriers to receiving quality end-of-life (EOL) care among ethnic minority populations. The biggest barrier is lack of sufficient financial resources and insurance, according to the article published in Journal of Palliative Medicine, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available to download free on the Journal of Palliative Medicine website until Dec. 18, 2015.
VJ Periyakoil, MD, Eric Neri, and Helena Kraemer, PhD, Stanford University School of Medicine and VA Palo Alto Health Care System, Palo Alto, CA, describe five additional barriers: doctor behaviors, a communication chasm between doctors and patients, family behaviors and beliefs, healthcare system barriers, and cultural and religious barriers. Older women from all ethnic groups were most likely to report challenges in receiving quality EOL care for persons within their communities.
In the article 'Patient-Reported Barriers to Quality End-of-Life Care: A Multiethnic, Multilingual, Mixed-Methods Study', the researchers emphasize the urgent need for education, training, and support to improve end-of-life care among diverse patient populations. It is also very important for patients to identify their proxy decision makers and work with them to ensure that the proxies understand their values and are willing to be guided by them when making future decisions for the patient.
"These results challenge the conventional wisdom that ethnic minority populations don't want good EOL care," says Charles F. von Gunten, MD, PhD, Editor-in-Chief of Journal of Palliative Medicine and Clinical Professor of Medicine, Ohio University.