Gender Differences in End-of-Life Care in Older Mexican American Adults

Abstract

Mexican Americans (MAs), 1 of 10 subgroups of Latinos, are the largest and fastest growing Latino subgroup in the United States; yet, their access to end-of-life (EOL) care using hospice services is low. An investigation was needed into extant research-based knowledge about factors influencing EOL care decisions among MAs to guide health-care professionals in assisting MAs to make timely, acceptable, and satisfactory EOL care decisions. To determine whether gender was an influence on EOL decision-making among older MAs, CINAHL and PubMed were searched for articles published between 1994 and 2018. Relevant sources were also identified through the reference lists of review articles. Reports were included if they were written in English, involved participants aged 50 years and older who identified themselves as MA, and data derived directly from participants. Reports in which MAs were not equally represented in the sample, large databases, and instrumentation development and testing articles were excluded. Of the 345 unduplicated articles identified in our electronic search and the 47 identified through review articles, 22 met the inclusion criteria. Content analysis was conducted using a priori codes from the Ethno-Cultural Gerontological Nursing Model (ECGNM). Only 8 (36%) of the 22 articles reported on MA older adults’ gendered experiences related to EOL decision-making. Results indicate an association between gender and EOL decision-making. As the older MA population grows, tackling disparities in EOL services use requires attention to how culture and gender influence EOL decision-making and care.

Factors Influencing Older Adults' End-of-Life Care Preferences

“…Previous studies on older adults have shown that sex affects their perceptions of EOL care. 3,[21][22][23][24][25] One study indicated that women were more likely to refuse special life-sustaining treatment, such as CPR and ventilator, than men. 24 Another study in Switzerland showed that women had higher AD awareness and completion levels than men.…”

“…Compared with men, women had low overall LSPQ scores and tended to avoid antibiotics, CPR, surgery, and nasogastric tube feeding. Previous studies on older adults have shown that sex affects their perceptions of EOL care 3,21-25 . One study indicated that women were more likely to refuse special life-sustaining treatment, such as CPR and ventilator, than men 24 .…”

Call the Rezadora: Aiding Latino Families at the End of Life

“…Unfortunately, this can impede the use of palliative care services due to the difficulty families may have in transferring care responsibilities to health professionals (Ko et al, 2017). In addition, gender differences were noted among Latinos regarding EOL decision making (Crist et al, 2019; Ortiz-Dowling et al, 2020). Mexican American men more often refrained from expressing EOL desires, whereas women were more likely to delineate their EOL plans.…”

“…Mexican American men more often refrained from expressing EOL desires, whereas women were more likely to delineate their EOL plans. Still, Latino family members maintain a crucial role in a peaceful death (Ortiz-Dowling et al, 2020).…”