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MONDAY, JULY 16, 2007

Minorities rarely use hospice care in Alabama

By Amanda Thomas
Associated Press Writer

MONTGOMERY — Unlike terminally-ill patients who die in hospitals, attached to tubes and monitors, Marie Madison wants the opportunity to die in the comfort of her home.

Madison, 97, who was diagnosed with acute respiratory failure in January, is the first in her family to receive hospice care, with nurses from New Beacon Hospice in Birmingham checking on her twice a week and on call 24 hours.

She also is a black person who chose an end-of-life service that minorities in Alabama and elsewhere have tended not to use as frequently as whites.

Denial of care

Blacks seek hospice care in disproportionately smaller numbers than whites partly because of cost, health insurance and cultural factors, including a sense of being denied medical care on the basis of race, according to health care specialists.

“Some people think that if a doctor wants them to stay home and not come into the hospital, that the medical system isn’t truly concerned about them,” said Jon Radulovic, vice president of communications for the National Hospice and Palliative Care Organization.

Many in the hospice industry are trying to be more culturally aware and reach out to blacks and the growing Hispanic population.

Madison said while she remembers reading about hospice care, no one had ever approached her about it until January.

“A social worker told me about it at the hospital and I thought it was nice,” Madison said in a recent phone interview from her home.

Nurses, chaplain

Along with help from nurses, the hospice care team includes a chaplain who comes to Madison’s home to sing her favorite hymns and read Scriptures with her.

“So far so good,” she said.

In 2005, 82.2 percent of the hospice population was white, while 7.5 percent were those who identified themselves as black or African-American and 8.3 percent were other or multicultural, according to the National Hospice and Palliative Care Organization.

The California HealthCare Foundation released a report in March that found fewer minorities and immigrants using hospice care, partly because they view it as a way for doctors to deny them the medical care they’ve been fighting to get.

According to David Stone, executive director of the Alabama Hospice Organization, it is this distrust of the medical system that keeps some minorities from seeking hospice care.

New Beacon director Debbie Cox said one of her goals is to reassure minorities that hospices provide a service they should consider.

“Once they see that I’m here to help you take care of your loved one, then they warm up to you a little bit,” Cox said.

Some hospices are trying to reach more blacks through their church programs.

“While I hate to generalize, African-Americans tend to rely a great deal on their spirituality and faith communities when dealing with serious illness,” Radulovic said.

“Further education to the faith leaders is an important part of outreach to that community.”

Spreading information

Stone said hospices are trying to get information to Hispanics through “nontraditional ways,” including Spanish language materials and making contact in “faith-based community settings and places were Latino laborers may gather.”

In addition to trying to gain more minority patients, hospices are making an effort to hire more minorities employees.

“Hospices are really trying to make sure they as hospice providers are actually more multicultural themselves,” Stone said.

He said people generally want to be cared for by those they can relate to.

“When you’re dealing with someone at such a vulnerable time, it’s understandable that you’d want someone you feel you have a connection with,” Stone said.

The NHPCO’s Caring Connections consumer engagement initiative has been focusing some of its recent efforts on helping providers be more inclusive.

Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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