Faculty Spotlight: Dr. Carrion - School of Social Work
Although palliative and hospice care both focus on the quality of an individual’s life, there are differences. Palliative care supports an individual and their family during and after treatment; public health care system hospice care focuses on relieving symptoms and supporting patients and their families in the last months of a patient’s life. However, individuals in hospice care can receive palliative care, such as pain management, during hospice care. As the United States becomes increasingly more diverse, larger numbers of minority populations receive palliative care or enter hospice care.
Dr. Iraida V. Carrion’s research focuses on ensuring that the needs of vulnerable patients, particularly Hispanic populations, are met. There is no doubt that there is a significant need to improve care for patients with serious, complex, and potentially life-threatening or life-limiting medical conditions. Public health care systems hospice and palliative care play a critical role in the end of life care of nursing home residents. However, Hispanic families are less likely to utilize hospice care prior to death. In addition, Hispanics are more likely to experience severe levels of pain prior to death and less likely to visit health care practitioners for their pain. Also, given the limited the research on Latino men, Dr. Carrion has examined the treatment decisions of Latino men with cancer.
Dr. Carrion has determined that myths and misconceptions about hospice and pain management play a role in the underutilization of hospice services by Hispanics. As with other limited-English populations, there are structural and organizational barriers that preclude services use, such as the lack of Spanish-speaking healthcare providers, translation services, or awareness of cultural attitudes regarding illness, pain, and stigma. Further, there is a lack of general knowledge regarding eligibility criteria for hospice and the caregiver services, such as bereavement support.
Pain management is a major concern among nursing home and hospice residents. Dr. Carrion has also investigated the differences that race and ethnicity play in communication among nursing home residents and certified nursing assistants (CNAs). Since CNAs provide most of the direct care and surveillance of residents in the long-term care settings, they assess and report the level and intensity of pain residents have. However, the lack of a standardized protocol and intercultural communication styles may hinder accuracy in reporting and pain mitigation. Dr. Carrion and colleagues suggest formal education be made available to address the cultural attitudes, systemic and organizational barriers, and gaps in policy.
Dr. Carrion and colleagues also identified a knowledge gap regarding advance care planning (ACP) among three groups of Latina (Colombian, Mexican, and Puerto Rican) women with cancer diagnosis living in Central Florida. Differences between the three groups exist as a result of migration/immigration history, family support, education, English language proficiency, income, knowledge gaps, and information ascertained by medical and health professionals. Since Latina women have a preference for shared, family decision making and a desire to make arrangements before death occurs, there is a need for a formal ACP process to be implemented by medical professionals and healthcare settings that addresses level of literacy and non-English-speaking populations in the development of ACP forms and directions.
Dr. Carrion’s studies increase our understanding of cultural differences and the importance of effective communication surrounding treatment, palliative, and hospice care issues for all persons and their families who are involved in the healthcare system.
Read A Case Study of Hispanics and Hospice Care online for free.