Delivering palliative care to patients and caregivers in inner-city communities: Challenges and opportunities

Abstract

A CBPR approach enabled us to develop an interdisciplinary and culturally sensitive intervention to begin addressing the palliative and end-of-life needs of the patients and caregivers of the inner-city community.

Racial and Ethnic Disparities in Palliative Care: A Systematic Scoping Review

“…These findings are consistent with extant literature on barriers in access to and use of palliative care (Francoeur, Payne, Raveis, & Shim, 2007;Smith & Brawley, 2014). Provider-level barriers to palliative care, including communication barriers and perceptions of discrimination related to race or ethnicity, were also identified in the review, echoing the findings of other researchers (Francoeur et al, 2007;Kayser, DeMarco, Stokes, DeSanto-Madeya, & Higgins, 2014;Linton & Feudtner, 2008). Inconsistent findings across studies and ongoing gaps in the empirical literature, however, suggest the need for further empirical consideration, including the potential moderating effects of distinct diagnoses, care settings, and demographics such as gender and age.…”

Expanding palliative care’s reach in the community via the elder service agency network

“…Low-income ethnic and racial minorities may particularly benefit, as these populations have significantly greater rates of chronic illnesses than other groups (13, 14) and are less likely to receive inpatient palliative care (15–18). Experts in the field have called for the development of innovative models to deliver community-based palliative care to address these and other gaps in service delivery (15, 19–21). Working with agencies that serve older adults where palliative care needs are likely high should be particularly encouraged.…”

“…Older adult clients with chronic illnesses appear to support these efforts as well. Kayser and colleagues (15) identified strong interest in and need for community-based palliative care services in community-stakeholders, i.e., those living with chronic illnesses and family caregivers from five inner-city communities in the Boston area. Our group’s needs assessment revealed that almost 65% of clients interviewed were interested in receiving palliative care, and the majority (80%) wanted to receive palliative care at an elder service agency (33).…”

Initiating pain and palliative care outpatient services for the suburban underserved in Montgomery County, Maryland: Lessons learned at the NIH Clinical Center and MobileMed

“…In the United States, palliative care services for hospitalized and hospice patients have begun to expand their scope of service upstream to reach ambulatory patients in outpatient clinical settings as well as in home-based programs (Beresford & Meier, 2008). However, like with many areas of healthcare, tremendous socioeconomic disparities exist that limit patient access to palliative care specialty services (Kayser et al, 2014).…”