Planning for End-of-Life is not a Death Sentence. The Influence of Culture on End-of-Life Decision.
THE POWER OF QUESTIONS
QUESTION: How do we introduce the End-of Life Conversation to Minority Communities?
QUESTION: How do we Negotiate Cross-Cultural Issues at the End-of Life?”
ANSWER: B.E.T. = BUILD COMMUNITIES. EDUCATE. TEACH.
My Fellowship Leave in the Fall of 2015 was in search of answers to the following questions: “How do we introduce the End-of Life Conversation to Minority Communities?” and “How do we Negotiate Cross-Cultural Issues at the End-of Life?”
After attending a New York State Conference on Aging workshop on End-of –Life Planning, I observed that there was little or emphasis on how culture impacts how End-of-Life decisions are made. This particular workshop was filled to capacity. Experts from the field shared their knowledge, social workers spoke about the challenges of talking to family members who had no idea that they were terminal. Physicians defended themselves saying, patients were told but were in denial. Nurses said, they were not the ones responsible to break the devastating news to the patients, or their families. Debates ensued, the legal ramifications of the process; startling data was shared, research studies were quoted, yet somehow in the maze of information there was a void when it came to the inclusion of cultural sensitivity, cultural awareness, even cultural humility in this dialogue.
Is it possible that culture does play a key role in End-of –Life planning? Are we asking the right questions? What about religion? What about family structure and dynamics?, Have we considered traditions, beliefs, language?
In fact, the conversation surrounding End-of-Life care in the minority community is a discussion that should consider diverse ethnic and religious groups instead of a “one size fits all” document for End-of-Life planning. Historically, the discussion of End-of-Life care has been shown to occur less often in minority communities.
Hence the questions, How do we introduce the End-of Life Conversation to Minority Communities? How do we Negotiate Cross-Cultural Issues at the End-of Life?” The answers to these questions were a catalyst to investigate this topic.
The funds from the Title V Grant, under the direction of Office of Academic Affairs afforded me the opportunity to dedicate time to research this pheonomena in order to determine of what was factual and what was assumed.
The Student Research Assistants (SRA) who were assigned to assist me were from minority communities. It was evident form their responses to the project that they themselves knew little or no knowledge about End-of Life Care.
Using Hostos’ databases to identify articles on End-of-Life Care in the minority community, under the guidance and expertise of the Head of Library Access Services, the students identified possible literature for further study as well as were taught how to summarize the articles they retrieved.
The following semester I was approved for a Fellowship Leave. Fordham University invited me to participate in the Health Care Management Certificate Program and the Collaborative for Palliative Care which offered me an opportunity to examine some of the important healthcare management questions, including, Introduction to Public Health and Healthcare Management Law, Ethics, and Humanism in Care Management of Seriously Ill Patients and Special Populations,Foundations in Palliative Care, Challenges in Management of End-of-Life Care Interdisciplinary Collaborative Practice and Leadership Models, Death, Dying, and Bereavement, Gerontological Issues in Healthcare Management, Health Systems Management and Innovation: Changing Business Models, Delivery and Payment System Reforms, and Technology.
Aging and Health Studies Program Coordinator
Eunice Flemister is a full-time tenured-Lecturer at Hostos Community College and the Program Coordinator for the Gerontology Unit. Prior to this she was the Associate Director and Marketing Director for the Amsterdam Adult Day Care Program where she developed and was responsible for the unique delivery of care to seniors in the inner city. She has a M.P.H. from Hunter College, an undergraduate degree from City College of New York and has taken Post Graduate courses from the Brookdale School on Aging. Her experience and knowledge in Palliative and Long Term Care of the elderly culminated in academia, with the combination of community and academic experience provide her students with a robust and engaging learning atmosphere. She teaches various courses in Gerontolgy including Health and Aging. She is a champion and cheerleader for Service Learning and is active on the College’s Service Learning Committee. In her recent sabbatical (Fall 2015) she completed a Health Care Management Certificate Program in Public Health, Palliative and Long Term Care at Fordham University. On a local level she serves as a Board Member for both the State Society of Aging of NY, and B.R.I.C.A – Bronx Regional Interagency Council on Aging. Nationally, she serves on the Community College Task Force and Global Aging Committee for the Association for Gerontology in Higher Education. She feel s privileged to help shape the lives of future care-givers for an ever increasing aging population.