Living With Grief: African Americans and End-of-Life Care

Living With Grief®: African Americans and End-of-Life Care This special report in the Living With Grief® series examines African American attitudes about care at the end of life, offers explanations as to why hospice, historically, has not been a choice for many African Americans, looks at grief and the African American community, and suggests ways to reach out to African Americans who are making end-of-life decisions.

Panel:
Tawara D. Goode, MA
Wanda Henry-Jenkins, MHS
Karla FC Holloway, PhD
Richard Payne, MD
LaFrance Williams

One Continuing Education credit for social workers, nurses and counselors are available for an additional $12.50. (Evaluation and exam required; course is $30.99) View a list of board approvals here (PDF).

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Learning Objectives:

1. Understand the ways that cultural factors, spiritual factors, and discrimination – including
   disparities within health care -- have influenced African-American responses at the endof-
   life;
2. Explain factors that have inhibited hospice care for African-Americans and discuss ways
   to increase the utilization of the hospice option within African-American communities.
3. Define Dr. Karla Holloway's concept of Black Death, indicating the ways that the concept
   offers a unique perspective on African-American funerals and grief;
4. Offer examples of culturally competent practice in working with African-American
   families in end-of-life care, loss, and grief.

Program Highlights

1. Disparities in health care for African Americans exist throughout the health care
   continuum and are measurable at the end-of-life, with African Americans being less
   likely to use hospice care or be referred to hospice care by physicians. African
   Americans' history of mistreatment in the U.S. health care system, their religious and
   spiritual beliefs, and access to health care services all pay a part in their low usage of
   hospice care.
2. African Americans are more likely to want what they see as life prolonging, aggressive
   treatment at the end of life and are less likely to have advance directives.
3. African Americans made up 9 percent of the hospice patient population in 2007, while
   white Americans accounted for 66 percent of patients using hospice
4. African Americans tend to be less aware of hospice care unless they either experience it
   through a family member or are part of a concerted outreach effort.
5. Targeted education efforts show evidence of helping to increase use of hospice care by
   African Americans.
6. African-Americans, as Dr. Karla Holloway explained, have a different experience of
   death; they are more likely to die younger, more suddenly, and have higher rates of
   violent death.
7. Professionals assisting in bereavement care need to understand factors that complicate
   grief as well as the rituals and cultural strengths, including spirituality, that have
   sustained African-Americans as they have coped with loss.
8. Physicians and other health and social service professionals need training in cultural
   competency so that they are providing all options for patients and families at the end of
   life.

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