A growing amount of research has documented disparities between African-American and white populations with respect to access to end-of-life care. Decisions regarding end-of-life care are complex, and require substantial and effective patient-provider communication. Unfortunately, there is considerable evidence that white health providers' communication with African-American patients is often seriously flawed. Language patterns and social mores often differ between the two groups. In addition, many African-Americans (who are disproportionately likely to be medically uninsured and to reside in medically underserved areas) are often suspicious of end-of-life care options that are offered to them by the largely white medical establishment, feeling that they are often simply a covert effort to save money by reducing medical services. This leads to unsatisfactory decisionmaking on care options for terminally ill African-American patients, particularly for those patients who are low income and from medically underserved areas. To overcome these racial disparities, providers must better understand the reasons for patient-provider communication problems, and develop innovative community programs that can overcome them. The developing research of the authors analyzes the reasons for provider communication problems with terminally ill African-American cancer and congestive heart failure (CHF) patients. Using specific examples obtained from existing end-of-life care programs, the authors also show how these problems can be overcome through the development of community-based structures that entail innovative provider training programs (including the use of on-line curricula for physician training), more effectively targeted resources, more community-friendly caregiving structures, and greater family and community involvement with medical providers.
Learning Objectives: At the conclusion of this presentation, the participant should be able to: 1. Understand the racial disparities that currently exist in access to end-of-life care. 2. Recognize the problems that often exist in provider - patient communication with respect to African-American patients. 3. List the reasons for such communication problems, as shown by research findings. 4. Assess alternative methods for overcoming communication problems with end-of-life African-American patients, as illustrated by specific community-based programs
Keywords: End-of-Life Care, Patient Perspective
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.