Multiethnic Patients Report Language and Cultural Barriers in Accessing End-of-Life Care

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It is often the case in this country that the elderly face repeated hospitalizations and intensive treatments at the end of their lives. This phenomenon, however, is not due to the individual patient's desire for said treatment and intervention: the large majority of elderly patients express the desire to die "naturally" and "gently". The state of affairs is not only presents a massive cost to the nation but is also a social and humanitarian issue. This practice does not allow for respect and dignity. Given that the presence of health disparities affects individuals well into their old age, the quality of end-of-life care for minority patients is especially compromised. The authors of this paper examined whether end-of-life care (EOLC) was a priority for multiethnic families, and if those communities experienced barriers in obtaining EOLC.

The table below shows the six primary reported barriers to receiving EOLC.

It should not come as a shock that the top three barriers include "doctor behaviors" and "communication chasm between doctors and patients."  Given the current lack of support doctors and patients receive to communicate with each other across language and cultural barriers, the perception of "lack of empathy", "cultural insensitivity", or "lack of knowledge of EOLC options" and "doctors usually don't speak the same language and can't answer questions directly that patients have" are unsurprising reports of a multiethnic patient's current experience in the realm of the EOLC. Doctors would likely report "frustration" or "powerlessness" if asked how they feel in their interactions with patients of a different culture and language. Everyone is suffering.

This paper highlights the need for additional language assistance and creative technologies imbued with properties that can not only facilitate the exchange of information and clarity, but also help support connection and compassion; cultural sensitivity.

Canopy aspires to create technology with elements to aid in both information exchange and with the provider-patient relationship. How has our technology helped you to connect with your patients? What sorts of features would enhance this?


First author, Dr. VJ Periyakoil has written extensively on this subject. Check out a NY Times Opinionator article from this past April, here.

Dr. Periyakoil also directs the Stanford Ethno-geriatrics & the Successful Aging project. Check out her work here.