Beyond One Banner: End-of-Life Care Disparities and Effective Psychosocial Support for Patients of Diverse Asian and Asian American (AAA) Communities

Session Description:
This interactive and didactic presentation will focus on identifying the disparities in delivering effective end-of-life (EOL) care for patients in the Asian and Asian American (AAA) community including the areas of effective advance care planning, palliative care and hospice enrollment, explore clinical considerations for several AAA communities, and make recommendations to optimize psychosocial support for AAA patients and their families when facing EOL. This will be structured in two parts: 1) An introduction to define the AAA communities and provide historical and cultural contexts that result in disparities in EOL Care, and 2) Discussion of effective intervention strategies targeted to specific AAA communities, via small groups, vignette exercises, and panel discussion.

Part One will focus on AAA population and disparities in EOL care. As a patient population, AAA are not well studied and their needs are not well understood despite AAA being the only ethnic group in the United States whose leading cause of death is cancer and not heart disease (Lee et al., 2021). Asian patients made up only 1.5% of Medicare hospice patients in the United States and a study on multiple Asian American groups found that the rate of completed Advanced Directives designating a health agent was “about two to three times lower than that of the general older population, which ranged between 54.3% and 66%” (Chi et al., 2018; Rhee & Jang, 2020).We will identify the root of EOL disparities by examining common myths and misperceptions that providers may have when working with AAA families such as the model minority myth and the perceptions of the lack of health literacy in AAA people. Additionally, we will explore AAA patients’ misconception of the role of pain management in EOL care (Ragesh et al., 2017).

Part Two of this presentation will focus on advancing the knowledge of oncology social workers (OSWs) by engaging the group in interactive discussion of the unique EOL needs in specific ethnic communities. Despite the diversity of this population, AAA people are often treated as monolithic, and cultural differences are routinely disregarded. Understanding the cultural nuances within this community prepares OSWs to provide person-centered, culturally sensitive EOL care among AAA patients. Representing diverse practice settings, regions of the country, and ethnic backgrounds, the presenters will incorporate unique perspectives as Asian-identified OSWs supporting AAA families facing cancer. Specifically, we will focus our discussions around the Japanese, Korean, Chinese, Taiwanese, Vietnamese, Filipino and Indian/South Asian communities. We will primarily draw findings from literature review of evidence-based research, discuss common cultural themes, and explore clinical considerations specific to each community. The presenters will identify the significance of: the family system in EOL care, the role of spirituality, stigmatization of seeking psychosocial support, and mistrust for medical providers (Mori et al.,2017). By the end of this presentation, participants will have more awareness of the cultural barriers that perpetuate the gaps in EOL care and be equipped to conduct culturally tailored assessment and interventions to improve EOL care in AAA communities.

Speakers:
Ayaka Nakaji, MSW, LCSW, CCM, Cedars-Sinai Cancer
Sarah Low, MSN, RN, OCN, CMSRN
Helen Wu, LMSW
Kristine Naputo, LMSW
Leena Nehru, MSW, LCSW, OSW-C 

Learning Objectives:
After completing this activity, participants will be able to:

1. Recognize the historical and cultural context of diverse Asian and Asian American experience and understand at least three inter-cultural and inter-group differences in order to conduct more culturally attuned assessment when working with patients at End-of-Life.
2. Identify at least three End-of-Life disparities faced by Asian and Asian American patients and families, and three intervention strategies enabling improved access to appropriate EOL care among this population.
3. Develop better understanding of Asian and Asian American clinician experience during End-of-Life discussions and learn at least two ways to better support colleagues including social workers, nurses, physicians and other care team members.

CE credits: 1.5‎, which will be available for $25.
Click here to view Continuing Education information.
Category: Cultural Competency
Educational Level: Intermediate