In traditional societies, the family members provide the senior care and the care for the sick. The seniors of these communities are often unfamiliar with the idea of having non-family members as caregivers. Seniors may feel abandoned by their family members when people outside the family serve as primary caregivers, and likewise, family members may struggle with feelings of shame and guilt.

The important question one needs to ask is, “How comfortable is the state of existence for the person I respect and love?” If the individual is terminally ill, the main responsibility one has is to make sure that one’s relative does not suffer. The sooner the family members deal with the reality, the better the life of their loved one will be: Minimum pain, less discomfort, best care possible provided collectively by a team of professionals, and not physically and emotionally exhausted relatives. Even the most trained and qualified doctors refer the ones they love to other doctors for major surgeries, although they could have performed the operation themselves.

Additionally, certain families may see hospice care as a last option and be resistant to it until all other life-saving medical interventions have been exhausted. In most societies, there is a great sense of respect and obligation towards one’s parents or older relatives. Feelings of guilt or fear of being judged may be associated with using hospice care. Guilt is especially powerful in immigrant communities where great sacrifices were made by older generations for the sake of younger generations. However, in challenging times, it is more beneficial to be guided by reasoning and intelligence rather than guilt or self- inflicted shame.

Effective Communication

Expectations may differ between the provider and the family about what will be communicated to the client. In ethnic speaking communities, it is common for the client not to be informed about a negative health status or prognosis because the family wants to protect them from this knowledge. Families prefer to be informed first, and may strongly object to bad news being given to the client, fearing this may cause extra suffering or loss of the will to live.

It may be helpful to engage a professional interpreter to facilitate communication. The practitioner will be assured that the information is clearly interpreted, all communication will be interpreted without the risk of it being misinterpreted or screened and the emotional stress on family members often makes it difficult for them to interpret effectively.

Words such as death, dying and cancer are taboo to some families. Cancer is sometimes referred to as “that terrible sickness.” Hospice care can gently be described as “caring for a loved one that is terminally ill.”

Understanding the culture for Health Professionals

Family members and their spiritual leaders are integral parts of the Hospice care team. Healthcare professionals should get to know them and know how to contact them.

Their involvement will make the client feel much more comfortable.

The preferred place of treatment is the home if possible; quality of life is connected to the home and family. However, because extended families are now more spread apart, seniors often live alone and seek out nursing homes.

Patients will prefer to have providers of the same gender, for privacy is important.

Distress and pain are generally expressed openly. Attitudes towards pain relievers such as morphine differ. Education on pain relief and DNR may be necessary.