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Journal of Aging and Health, Vol. 18, No. 6, 791-813 (2006)
DOI: 10.1177/0898264306293614
© 2006 SAGE Publications

Care at the End of Life

Focus on Communication and Race

Jane G. Zapka

Medical University of South Carolina

Rickey Carter

Medical University of South Carolina

Cindy L. Carter

Medical University of South Carolina

Winnie Hennessy

Medical University of South Carolina

Jerome E. Kurent

Medical University of South Carolina

Susan DesHarnais

Northwestern University

Objective: To profile communication and recommendations reported by adults with terminal illness and explore differences by patient and physician characteristics.

Method: This pilot was a cross-sectional study sample of 90 patients (39 Caucasian, 51 African American) with advanced heart failure or cancer. Participants completed an in-person, race-matched interview.

Results: Participation was high (94%). Discussion about end-of-life topics was low. For example, only 30% reported discussion of advance directives, and 22% reported their physician inquired about spiritual support. Participants with cancer were significantly more likely to be receiving pain and/or symptom management at home, aware of prognosis, and participating in hospice. African American participants who were under the care of African American physicians were less likely to report pain and/or symptom management than other racial matches.

Discussion: Although additional research on factors related to communication is important, initiation of patient-centered counseling by all physicians with seriously ill patients is essential.

Key Words: end of life • minorities • communication • race • processes of care


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