Differences in end-of-life care can be stark among nursing homes with different proportions of racial and ethnic minorities, according to a new study. The findings highlight a need for cultural competency training for facility staff, suggest researchers from the Columbia University School of Nursing, New York, NY. 

Investigators analyzed study data from four electronic databases from 2010 to May 2020. Quality of care was assessed using the Newcastle-Ottawa Scale. Among the findings:

  • Racial and ethnic minority residents were less likely to complete advance directives. 
  • Black residents were consistently less likely to use hospice before death. 
  • Hispanic and Black residents were more likely to experience an end-of-life hospitalization compared with non-Hispanic white residents. 
  • Racial/ethnic minority residents experienced worse pain and symptom management at the end of life.
  • No articles studied specifics of palliative care, such as spiritual care.

Few studies previously have delved into disparities in nursing home end-of-life care, including hospital transfers, place of death, hospice use, palliative care and advance care planning, reported Patricia W Stone, Ph.D., RN, FAAN, and colleagues.

To help reduce this imbalance in end-of-life experience, language services and cultural competency training for staff should be available in nursing homes with higher proportions of racial and/or ethnic minorities, Stone and colleagues concluded.

Full findings were published in the Journal of the American Medical Directors Association.