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End of Life Care for Older Russian Immigrants - Perspectives of Russian Immigrants and Hospice Staff

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Abstract

This pilot study examined immigrant Russian seniors and adult children’s views on end-of-life care, and hospice staff members’ experiences providing care to diverse immigrant clients, in areas of North Carolina with a high proportion of immigrants. Data were collected through individual in-depth interviews with informants, including Russian immigrant seniors, Russian adult children, and hospice staff, and analyzed by qualitative techniques. Findings indicate that there is little awareness of end-of-life care options among the Russian immigrant community in North Carolina. End-of-life care is rarely discussed within the family of first generation Russian immigrants but second-generation families are more open to doing so. First generation immigrant Russian seniors in our study do not seem to want any specialized end-of-life care often due to lack of awareness, and prefer family care. Second generation seniors’ attitudes are more accepting of this type of care. Hospice staff serve all those who seek care, receive training to serve diverse clients, and prioritize professional policies. There is sometimes potential for a gap between hospice policies regarding care and immigrant families’ expectations for care. Results suggest a great need for community outreach to immigrant groups to raise awareness of end-of-life care, including advance directives and hospice care and the role of interpreters in health care settings.

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References

  • Aldridge, M. D., & Bradley, E. H. (2017). Epidemiology and patterns of care at the end of life: Rising complexity, shifts in care patterns and sites of death. Health Affairs, 36(7), 1175–1183.

    Article  Google Scholar 

  • Ameredia (2012). Russian American demographics. Integrated multicultural marketing. Retrieved on May 13, 2014, from http://www.ameredia.com/resources/demographics/russian.html

  • Aroian, K. J., Khatutsky, G., Tran, T. V., & Balsam, A. L. (2001). Health and social service utilization among elderly immigrants from the former Soviet Union. Journal of Nursing Scholarship, 33(3), 265–271.

    Article  Google Scholar 

  • Barusch, A., Gringeri, C., & George, M. (2011). Rigor in qualitative social work research: A review of strategies used in published articles. Social Work Research, 35(1), 11–19.

    Article  Google Scholar 

  • Belusova M. (2011). The Russian diaspora in the US Russian Analytical Digest No. 107, 27 January 2011.

  • Bushfield, S. (2010). Use of spiritual life maps in a hospice setting. Journal of Religion, Spirituality And Aging, 22, 254–270.

    Article  Google Scholar 

  • Camarota, S. A. (2012). Immigrants in the United States: A profile of America's foreign-born population. Center for Immigration Studies. Retrieved from https://cis.org/Immigrants-United-States-2010. Accessed 2 Nov 2016.

  • Carr, D. (2012). Racial and ethnic differences in advance care planning: Identifying subgroup patterns and obstacles. Journal of Aging Health, 24, 923–947. https://doi.org/10.1177/0898264312449185.

    Article  Google Scholar 

  • Carrion, I. V., Park, N. S., & Lee, B. S. (2012). Hospice use among African Americans, Asians, Hispanics, and whites implications for practice. Hospice and Palliative Care, 29(2), 116–121. https://doi.org/10.1177/1049909111410559.

    Article  Google Scholar 

  • Casarett, D., Pickard, A., Bailey, F., Ritchie, C., Furman, C., Rosenfeld, K., & Shea, J. A. (2008). Do palliative consultations improve patient outcomes? Journal of the American Geriatrics Society, 56, 593–599. https://doi.org/10.1111/j.1532-5415.2007.01610.x.

    Article  Google Scholar 

  • Cho, J. Y., & Lee, E. (2014). Reducing confusion about grounded theory and qualitative content analysis: Similarities and differences. The Qualitative Report, 19(32), 1–20 Retrieved November 12, 2015 from http://nsuworks.nova.edu/tqr/vol19/iss32/2.

    Google Scholar 

  • Colón, M., & Lyke, J. (2015). Comparison of hospice use by European Americans, African Americans, and Latinos: A follow-up study. American Journal of Hospice and Palliative Medicine®, 32(2), 205–209.

    Article  Google Scholar 

  • Crawley, L., & Koffman, J. (2015). Ethnic and cultural aspects of palliative care. In N. Cherny, M. Fallon, S. Kaasa, R. Portenoy, & D. C. Currow (Eds.), Oxford textbook of palliative medicine (5th ed.). Oxford: Oxford University Press.

    Google Scholar 

  • Fernandes, R., Braun, K. L., Ozawa, J., Compton, M., Guzman, C., & Somogyi-Zalud, E. (2010). Home-based palliative care services for underserved populations. Journal of Palliative Medicine, 13, 413–419. https://doi.org/10.1089/jpm.2009.0216.

    Article  Google Scholar 

  • Fortuny K. & Chaudry A. (2012). Overview of immigrants’ eligibility for SNAP, TANF, MEDICAID, and CHIP ASPE Issue Brief March 2012, Office of the Assistant Secretary for planning and evaluation, US Dept. of Health and Human Services. Retrieved May 26, 2015 from http://aspe.hhs.gov/hsp/11/ImmigrantAccess/#Publications

  • Goss, P. E., Strasser-Weippl, K., Lee-Bichkovsky, B., Fan, L., Li, J., Chavarri-Guerra, J., et al. (2014). Challenges to effective cancer control in China, India, and Russia. The Lancet Oncology, 15(5), 489–538, April 2014. https://doi.org/10.1016/S1470-2045(14)70029-4.

    Article  Google Scholar 

  • Hofmann, E. T. (2012). The burden of culture? Health outcomes among immigrants from the former Soviet Union in the United States. Journal of Immigrant & Minority Health, 14(2), 315–322. https://doi.org/10.1007/s10903-010-9436-3.

    Article  Google Scholar 

  • Iowa Center on Health Disparities. (2010). Russians and Other Immigrants from the Former Soviet Union retrieved on 8/5/15 from http://www.iowahealthdisparities.org/documents/russian.pdf

  • Ivanov, L. L., Hu, J., & Leak, A. (2010). Immigrant women’s cancer screening behaviors. Journal of Community Health Nursing, 27, 32–45.

    Article  Google Scholar 

  • Jackson, J., Nguyen, D., Hu, N., Harris, R., & Terasaki, G. S. (2011). Alterations in medical interpretation during routine primary care. Journal of General Internal Medicine, 26(3), 259–264. https://doi.org/10.1007/s11606-010-1519.

    Article  Google Scholar 

  • Knapik, G. P., Martsolf, D. S., Draucker, C. B., & Strickland, K. D. (2010). Attributes of spirituality described by survivors of sexual violence. Qualitative Report, 15(3), 644–657.

    Google Scholar 

  • Kreling, B., Selsky, C., Perret-Gentil, M., Huerta, E. E., & Mandelblatt, J. S. (2010). ‘The worst thing about hospice is that they talk about death’: Contrasting hospice decisions and experience among immigrant central and south American Latinos with US-born white, non-Latino cancer caregivers. Palliative Medicine, 24(4), 427–434. https://doi.org/10.1177/0269216310366605.

    Article  Google Scholar 

  • Kwak, J., & Haley, W. E. (2005). Current research findings on end-of-life decision making among racially or ethnically diverse groups. The Gerontologist, 45(5), 634–641.

    Article  Google Scholar 

  • Kwak, J., Ko, E., & Kramer, B. J. (2014). Facilitating advance care planning with ethnically diverse groups of frail, low-income elders in the USA: Perspectives of care managers on challenges and recommendations. Health and Social Care in the Community, 22(2), 169–177. https://doi.org/10.1111/hsc.12073.

    Article  Google Scholar 

  • Lynch, T., Connor, S., & Clark, D. (2013). Mapping levels of palliative care development: A global update. Journal of Pain and Symptom Management, 45(6), 1094–1106. https://doi.org/10.1016/j.jpainsymman.2012.05.011.

    Article  Google Scholar 

  • MedicareResources.org (2015). Retrieved May 26, 2015 from http://www.medicareresources.org/faqs/can-recent-immigrants-to-the-united-states-get-health-coverage-if-theyre-over-65/

  • Mehta, N. K., & Elo, I. T. (2012). Migrant selection and the health of U.S. immigrants from the former Soviet Union. Demography, 49, 425–447. https://doi.org/10.1007/s13524-012-0099-7.

    Article  Google Scholar 

  • Meier, D. E. (2011). Increased access to palliative care and hospice services: Opportunities to improve value in health care. Milbank Quarterly, 89, 343–380. https://doi.org/10.1111/j.1468-0009.2011.00632.x.

    Article  Google Scholar 

  • Michael, N., O’Callaghan, C., Baird, A., Hiscock, N., & Clayton, J. (2014). Cancer caregivers advocate a patient- and family-centered approach to advance care planning. Journal of Pain and Symptom Management, 47(6), 1064–1077.

    Article  Google Scholar 

  • National Hospice and Palliative Care Organization. (2018). NHPCO facts and figures: Hospice Care in America Rev Ed April 2018. Alexandria: National Hospice and Palliative Care Organization.

    Google Scholar 

  • Newhouse, L. (2013). Working with Russian-Jewish immigrants in end-of-life care settings. Journal of Social Work in End-of-Life & Palliative Care, 9(4), 331–342. https://doi.org/10.1080/15524256.2013.846884.

    Article  Google Scholar 

  • O’Neil, K., & Tienda, M. (2014). Age at immigration and the incomes of older immigrants, 1994–2010. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(2), 291–302.

    Article  Google Scholar 

  • Ortman J. M., Velkoff V. A., & Hogan H. (2014). An aging nation: The older population in the United States. Population Estimates and Projections Current Population Reports Issued May 2014 P25-1140 U.S. Dept. of Commerce Economics and Statistics Administration U.S. Census Bureau.

  • Pan, C. X., Abraham, O., Giron, F., LeMarie, P., & Pollack, S. (2015). Just ask: Hospice familiarity in Asian and Hispanic adults. Journal of Pain and Symptom Management, 49(5), 928–933. https://doi.org/10.1016/j.jpainsymman.2014.09.016.

    Article  Google Scholar 

  • Polit, D. F., & Beck, C. T. (2006). Essentials of nursing research: Methods, appraisal, and utilization (6th ed.). Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  • Richter, J., Eisemann, M., & Zgonnikova, E. (2001). Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany. Journal of Medical Ethics, 27(3), 186–191.

    Article  Google Scholar 

  • Rising, M. L., Hassouneh, D. S., Lutz, K. F., Lee, C. S., & Berry, P. (2017). Integrative review of the literature on Hispanics and hospice. American Journal of Hospice and Palliative Medicine, 35(3), 542–554. https://doi.org/10.1177/1049909117730555.

    Article  Google Scholar 

  • Robinson, O. C. (2014). Sampling in interview-based qualitative research: A theoretical and practical guide. Qualitative Research in Psychology, 11, 25–41. https://doi.org/10.1080/14780887.2013.801543.

    Article  Google Scholar 

  • Schoua-Glusberg A., Kenward K., & Morales G. (2016). Qualitative research with demographically diverse Russian speakers. - U.S. Census Bureau research support services −2016 AAPOR Annual Conference–Austin, Texas–May 14, 2016. Retrieved November 12, 2016 from https://www.census.gov/content/dam/Census/newsroom/press-kits/2016/Qualitative%20Research%20with%20Demographically%20Diverse%20Russian%20Speakers.pdf.

  • Scommegna, P. (2013). "Elderly immigrants in the United States," Today's Research on Aging, no. 29, Population Reference Bureau, October 2013.

  • Selsky, C., Kreling, B., Lhuta, G., Makgoeng, S. B., Gomez-Duarte, J., Barbo, A. G. A., Mandelblatt, J. S., & Latin American Cancer Research Coalition. (2012). Hospice knowledge and intentions among Latinos using safety-net clinics. Journal of Palliative Medicine, September 15(9), 984–990. https://doi.org/10.1089/jpm.2011.0517.

    Article  Google Scholar 

  • Strauss, A. C., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks: Sage.

    Google Scholar 

  • Tran, T. V., Khatutsky, G. G., Aroian, K. K., Balsam, A. A., & Conway, K. K. (2000). Living arrangements, depression, and health status among elderly Russian-speaking immigrants. Journal of Gerontological Social Work, 33, 63–77.

    Article  Google Scholar 

  • Tran, T. V., Sung, T., & Huynh-Hohnbaum, A. T. (2008). Measure of English acculturation stress and its relationships with psychological and physical health status in a sample of elderly Russian immigrants. Journal of Gerontological Social Work, 50, 37–50.

    Article  Google Scholar 

  • Tsytsarev, S., & Krichmar, L. (2000). Relationship of perceived culture shock, length of stay in the U.S., depression, and self-esteem in elderly Russian-speaking immigrants. Journal of Social Distress and the Homeless, 9, 35–49.

    Article  Google Scholar 

  • Van Son, C. R., & Gileff, T. Y. (2013). Relying on what they know: Older Slavic Émigrés managing chronic health conditions. Qualitative Health Research, 23(12), 1660–1671. https://doi.org/10.1177/1049732313508842.

    Article  Google Scholar 

  • Yarova, L. A., Covan, E. K., & Fugate-Whitlock, E. (2013). Effect of acculturation and health beliefs on utilization of health care services by elderly women who immigrated to the USA from the former Soviet Union. Health Care for Women International, 34, 1097–1115. https://doi.org/10.1080/07399332.2013.807259.

    Article  Google Scholar 

  • Zong, J., & Batalova, J. (2015). European immigrants in the United States. Migration Policy Institute Migration Information Source, Dec 1 2015. Retrieved from: https://www.migrationpolicy.org/article/european-immigrants-united-states-2. Accessed 3 Oct 2016.

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Acknowledgements

The authors are grateful to the Gerontology Program of UNC Greensboro for research support to the first author.

Funding

This study received funding from the Gerontology Graduate Program, UNC Greensboro.

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Authors and Affiliations

  1. School of Occupational Therapy, Brenau University, 500 Washington St SE, Gainesville, GA, 30501, USA

    Emily H. Eckemoff

  2. Department of Human Development and Family Studies, UNC Greensboro, 248 Stone Bldg, Greensboro, NC, 27402-6170, USA

    S. Sudha & Dan Wang

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  1. Emily H. Eckemoff
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  2. S. Sudha
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Correspondence to S. Sudha.

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Eckemoff, E.H., Sudha, S. & Wang, D. End of Life Care for Older Russian Immigrants - Perspectives of Russian Immigrants and Hospice Staff. J Cross Cult Gerontol 33, 229–245 (2018). https://doi.org/10.1007/s10823-018-9353-9

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