Their Last Breath: Death and Dying in a Hmong American Community. Issue 1 (February 2020)

• Record Type: Journal Article
• Authors: Helsel, Deborah; Thao, Kao Shoua; Whitney, Robin
• Is Part Of: Journal of hospice and palliative nursing. Volume 22:Issue 1(2020)
• Publication Date: 2020-02
• Subjects: end-of-life issues -- familism -- migration -- palliative care -- qualitative; Hospice care -- Periodicals; Palliative treatment -- Periodicals; Terminal care -- Periodicals; Nursing -- Philosophy -- Periodicals; Nursing -- Research -- United States -- Periodicals; Hospice nurses -- Training of -- United States -- Periodicals; 616.029
• DOI: 10.1097/NJH.0000000000000616
• Languages: English
• ISSNs: 1522-2179

Abstract

Abstract : Hmong Americans have typically been unwilling to use biomedical palliative care for end-of-life needs. This has resulted in confusion and frustration for Hmong patients, families, and nurses. Hmongs' end-of-life care choices for family members usually involve in-home caregiving provided by the family using a combination of biomedicine and traditional healing methods. Health care decisions are made for the patient by the family and community in this familistic culture. A qualitative approach was used to explore the beliefs that ultimately determine end-of-life care goals and strategies for Hmong patients. Semistructured interviews were conducted with 15 family caregivers of terminally ill patients and 5 shamans and Hmong funeral officiants. Several themes affecting care choices were identified, including cultural legacies of the responsibility of end-of-life caregiving by the family, the desire for family privacy in caregiving, and the role of community in the care for the dying, as well as completion of the rituals that ensure the soul of the deceased reaches the afterlife. Suggestions for improving communication between Hmongs and biomedical providers include providing information about end-of-life care beliefs and strategies to biomedical care providers and providing information to Hmong patients and families about hospice and palliative care options and services to support family care.