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  • Writer's pictureHeidi L. Barham

Addressing Racial Disparities: Securing Grants for Equitable End-of-Life Support


nurse and patient holding hands

The disparity in hospice utilization within communities of color is persistent and has increased over the last twenty years. The result is that fewer Black, Hispanic, Asian and Indigenous Americans receive the benefits of hospice care, which focuses on quality of life as persons are approaching the end of their lives. This is unfortunate, because family feedback surveys have consistently shown that hospice patients and their caregivers greatly benefit from the customized and holistic plan of care that addresses physical, emotional, and spiritual suffering.  


Information learned from interviews, focus groups and surveys conducted by Hospice of the Western Reserve regarding the perception of hospice by Black families within Cuyahoga County highlighted how mistrust of the healthcare system, coupled with existing myths and misunderstandings, have contributed to the underutilization of hospice care services within some communities. For example, some respondents thought that hospice care was only available at residential hospice houses, and they would have to send their loved one away. This does not align, however, with certain cultural traditions that exist where family members are committed to “care for their own.” It was also noted that persons were less likely to complete their advance care directives to document their wishes as it relates to end-of-life care. 


In November, Hospice of the Western Reserve received a grant from Three Arches Foundation to expand its outreach efforts and help address racial disparities in the utilization of palliative care as well as hospice care services within Black and Hispanic communities that are in the Three Arches Foundation geography. The grant funding will also be used to support the palliative care services provided through our Western Reserve Navigator program. These services are appropriate for individuals who have been diagnosed with a serious or advanced illness that may not be ready yet for a hospice level of care. This intentional focus on establishing trusted relationships with patients and families, sooner rather than later, will help to ease the transition when it is time for hospice care. 


Hospice of the Western Reserve is grateful for the support we have received which will enable us to expand our educational programming and outreach efforts that are specifically focused on communities of color. It has been said that when we know better, we do better, and our goal is to help foster better outcomes for the patients and families we serve. By working with trusted community partners, faith-based organizations, and hosting Courageous Conversations with community members about their end-of-life wishes and options, we will be able to raise awareness, build trust and provide a greater understanding about the services we provide.   


Heidi L. Barham supports patients and their families as the Manager of Diversity, Equity, and Inclusion with Hospice of the Western Reserve. She can be reached at hbarham@hospicewr.org

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