Abstract
Although hospice care has been described as the gold standard for the terminally ill, racial and ethnic minorities underutilize the service. This is concerning, given that racial/ethnic diversity is a key feature of the growing aging U.S. population; Latinos represent the fastest growing subgroup. This study explored factors influencing terminally-ill older Latinos’ care decisions, including electing or declining hospice. Providers from four hospice agencies, one nursing home, and two hospital departments identified and referred participants to the study. Eleven semi-structured, qualitative interviews have been conducted with terminally-ill, hospice-eligible Latinos 65+, or their caregivers. Interviews include hospice users and non-users and have been conducted in English and Spanish. Information was obtained regarding demographics; values, needs, and preferences related to health and end-of-life (EOL) care; and services/supports needed and available to them. Thematic analysis was used to analyze the interview data. Preliminary findings show that caregivers, lacking guidance regarding their loved ones’ preferences (e.g., no prior discussions or advanced care plans [ACP]), feel at peace accepting hospice only after exhausting all other options. Both caregivers and patients cited accepting hospice as a way to access services, such as medical supplies, and not having other options available. Despite accepting hospice, many describe ongoing needs as well as curative goals, particularly those with low levels of formal education. Results suggest hospice represents a way to access services, and not necessarily a philosophy of care that Latinos understand or seek at EOL. Enhancing ACP discussions and hospice education remains a need in the Latino community.