Boston Hospices Target Minorities To Address Use Disparities

Boston-based Beacon Hospice and at least two other area hospices are marketing services to minority communities in an effort to reduce racial disparities in hospice use, the Boston Globe reports (Rowland, Boston Globe, 3/26). According to a preliminary analysis of an ongoing Harvard University study funded by the National Cancer Institute that will involve 800 terminally ill cancer patients in Massachusetts, Texas, Connecticut, New Hampshire and New York, black participants were two to three times as likely as white participants to seek all possible measures to prolong their lives. The analysis also found that about half of black participants would seek measures to prolong their lives, regardless of whether they had only a few days to live -- about three times the rate among white participants. A second study that involved 800 elderly patients in a Los Angeles hospital found black participants were twice as likely as white participants to want their lives prolonged in end-of-life situations, such as an irreversible coma (Kaiser Daily Health Policy Report, 3/12). Beacon Hospice, which is staffed primarily with black nurses and home health aides, has targeted minority patients since 2005, but it launched a more aggressive effort in January, the Globe reports. Eric Hardt, clinical director of the geriatric section at Boston Medical Center and medical director of Beacon Hospice's location in Roxbury, said, "The African-American community is just as ready and willing to have them die at home as members of any other community. But if the hospice staff you offer them is white, and their understanding of death and dying is different, if you have a staff that is afraid of entering the neighborhoods, and they have a different feeling about prescribing opiates in the inner city than in the suburbs, people pick up on this instantly." He added, "If you are not culturally competent, people feel this." Hospice Care in Stoneham, Mass., and Hospice of the North Shore, have launched similar efforts (Boston Globe, 3/26).