Outreach program to Latino community

It takes several presentations to reach some

The staff at New Life Hospice in Elyria, OH, knew that reaching out to the Latino community would be beneficial to the hospice and the Latino population in the area, but the effort did not start out with a bang.

"If I had made the decision about the program's chance of success after my first presentation, it also would have been my last presentation," admits Joe Ocasio, RN, one of three Latino employees at the hospice. "The welcoming, smiling faces in the audience as his introduction began, quickly changed to somber faces when he identified himself as a hospice staff member, and there was little participation or questions during the talk," he says. Ocasio did not stop making presentations, and he has seen a slowly growing acceptance of hospice in the community over the past three years.

Although acceptance of the concept of hospice has not resulted in a significant increase in Latino admission to hospice, the program will continue, says Joan Hanson, RN, BSN, director of the agency. "We have a large Latino population in our community, and this program is an investment in the future," she reports. "As younger generations learn more about planning for end-of-life care, they will be more likely to choose hospice."

There is a difference in the way various generations of Latinos view end-of-life care, Ocasio says. "There is a great respect for older members of the family throughout all generations, and the belief is that you show your respect by caring for older, sick members of the family," he explains. "When we go into the home as outsiders, we have to be careful to involve family members in the care and emphasize a group approach to care." By making sure the family knows that hospice staff members are there to assist them in the care of their loved one, letting them make decisions, and respecting their role as primary caregiver, hospice is seen as a valuable service, Ocasio says.

When the caregiving family members are single parents or two-career couples, they are more apt to seek the services of hospice to help care for their older family members, Ocasio points out. "The baby-boomers' values and traditions are more modern and they are more likely to use home health, hospice, and nursing homes to make sure family members get the best care," he says.

Ocasio admits that the smiles on everyone's face when he steps up to do his presentation still disappear when he says, "My name is Joe Ocasio, and I'm from New Life Hospice." He continues his talk by focusing on how hospice care can make their family members' days more comfortable. "I talk about relieving pain, treating shortness of breath, and alleviating constipation," Ocasio says. Because Latinos are family-centered, he talks about how hospice can keep the family members at home and out of hospitals.

The types of questions Ocasio hears during his presentation range from, "How do you control pain?" to "Whom do we call in the middle of the night?" The most often-asked question is, "How do doctors or hospice staff know when a patient has six months or less to live?" says Ocasio. "Their concern is that only God knows when someone will die," he explains. Because Latinos are often religious and Roman Catholic, Ocasio doesn't want to offend their beliefs. He often says, "I agree. No one is God." Ocasio then says doctors and nurses will see trends in the health of the patient that make them come to this decision, but they are wrong sometimes.

"We also make sure that our social workers and nurses educate family members about the signs once we are caring for the patient," Ocasio adds.

Presentations are made at churches and community group meetings in the Latino community, says Ocasio. Some attend because they have been told that a family member might be ready for hospice, but others simply might want to learn more about hospice, he says. "I see some of the same faces at different presentations, but they may not be ready to hear what I'm saying until the third or fourth time," he says. It is for this reason that Ocasio says he'll "continue doing the presentations, even if he doesn't get a positive response from the audience at each one."