Hospice by the Sea delivers culturally sensitive and competent care through model programs for Hispanics and African-Americans
No one wants to face the emotional turmoil of a terminal illness alone, yet many people in South Florida, who have emigrated from other countries, may find themselves in just such a situation. Without family nearby or caregivers who speak their language, these individuals find themselves in a less than desirable situation, isolated and unsupported, in their final phase of life.
Wall of Remembrance which was part of a candlelight memorial service offered at Opening Doors, Hospice by the Seas African American outreach program in Deerfield Beach. Residents of the community posted photos, cards, and the names of their loved ones from November 20-25, 2006.
Enter Abriendo Puertas (which means “Opening Doors” in Spanish), a unique program designed by the professional staff at Hospice by the Sea in Boca Raton to bring culturally sensitive end-of-life care and education to the underserved Hispanic populations of Palm Beach and Broward counties.
The program, established in 2002 with a $494,000 start-up grant from The Robert Wood Johnson Foundation and matching funds from several other local foundations, including Quantum Foundation, Palm Healthcare Foundation, and Allegany Franciscan Foundation, specializes in educating Hispanics about hospice and improving their access to quality end-of-life care. Bilingual professionals, including physicians, registered nurses, certified nurses assistants, social workers, and spiritual counselors, serve patients facing life-limiting illnesses in a way that is respectful of Hispanic customs and traditions.
Mari Chumaceiro, director of the Abriendo Puertas program, says “Facing a terminal illness is hard enough, but many Hispanics also have to deal with language barriers, cultural misunderstandings, and a lack of support. Our program makes it possible for Hispanics to receive the medical care they need, and the emotional support they deserve, in their own language. They can tell us what hurts, what scares them, and we can help.”
Over the programs first three years, Hospice by the Seas average daily census of Hispanic patients nearly tripled, while its percentage of Hispanic patients more than quadrupled. Awareness and understanding of hospice within the Hispanic population also increased significantly as demonstrated using post presentation testing.
The success of Abriendo Puertas encouraged Hospice by the Sea directors to apply the program model to the African-American community, another underserved population by hospice. This led to the extension of the Opening Doors Outreach Program to the African American community, with an office in Deerfield Beach off of Dixie Highway and Hillsboro Boulevard.
Janice Fulmore-Tigner, outreach coordinator for Opening Doors, is a fervent devotee of getting out the message that hospice is not a place to go to die, but a non-profit service that helps make a patients final months more comfortable and provides assistance and support to the patients caregivers and family members. She regularly speaks at community gatherings, schools, funerals, and churches, engaging with the community at all levels and helping marginalized African Americans obtain needed services.
“The African-American community generally has a distrust of institutional medicine, and they also have concerns about the cost of care. Its my mission to explain to everyone I meet that most hospice services, such as bath visits and pain relief, are delivered in the home, and that these services are available regardless of a persons ability to pay.”
A local resident receives food and a Christmas tree for the holidays from the joint efforts of Janice Fulmore-Tigner of Hospice by the Seas Opening Doors African American Outreach Program (first row, second from the left), City of Deerfield Beach Commissioner Sylvia Poitier (not pictured), and Public Works employees.
There are many misconceptions about hospice care, found not only among minority groups but within the community at large. One of the most important facts to know about hospice is that it emphasizes comfort and quality of life over aggressive treatments. It involves a strategy of care that focuses on alleviating pain and providing emotional, spiritual, and social support to patients and their families.
Since Opening Doors was initiated in the African-American community, Hospice by the Sea has admitted 276 African-American patients, most through the Opening Doors program. In the past 6 months, 83 of these patients were admitted, as the program has focused more exclusively in identifying and connecting with African American caregivers.
Florida Hospices and Palliative Care (FHPC) recently awarded Hospice by the Sea the 2006 Community Education and Awareness Award for Abriendo Puertas. FHPC, a not-for-profit organization, represents Florida hospices, assures quality of care, and advocates for the needs of those at the end of life. The Hispanic Chamber of Commerce of Palm Beach County also honored the Abriendo Puertas program by naming it Non-Profit of the Year (2006).
Hospice by the Seas Abriendo Puertas and Opening Doors programs now serve as models for other healthcare organizations interested in reaching out to diverse communities. Abriendo Puertas, in particular, has garnered national recognition.
Abriendo Puertas and Opening Doors are now expanding to address the educational and cultural needs of patient caregivers through monthly caregiver workshops. The focus of the workshops is on four key areas: wellness, stress management, caregiver responsibilities and caregiving techniques, and access to community resources. Workshops, presented by psychosocial staff, feature a different topic each month. Those who attend will receive hand-outs in their native tongue, as well as “A Lifeline for Home Caregivers,” a 40-minute video-DVD with detailed caregiving information.
The workshops are free of charge, and open to any one who takes care of a family member or friend who is seriously ill (they do not have to be terminally ill). The workshops are held in three Hospice by the Sea locations: the Boca Raton Care Center, 1531 Palmetto Park Road, Boca Raton (third Saturday of the month, 11:00 a.m.noon); the African American outreach office, 49 S. Dixie Highway, Deerfield Beach (third Thursday of the month, 6:30 7:30 p.m.); and the Hollywood Care Center at the Hollywood Medical Center, 3600 Washington Street, Hollywood (third Wednesday of the month, 1:00 2:00 p.m.).
Mari Chumaceiro, director of the Abriendo Puertas program, says “Facing a terminal illness is hard enough, but many Hispanics also have to deal with language barriers, cultural misunderstandings, and a lack of support. Our program makes it possible for Hispanics to receive the medical care they need, and the emotional support they deserve, in their own language. They can tell us what hurts, what scares them, and we can help.”
Over the programs first three years, Hospice by the Seas average daily census of Hispanic patients nearly tripled, while its percentage of Hispanic patients more than quadrupled. Awareness and understanding of hospice within the Hispanic population also increased significantly as demonstrated using post presentation testing.
The success of Abriendo Puertas encouraged Hospice by the Sea directors to apply the program model to the African-American community, another underserved population by hospice. This led to the extension of the Opening Doors Outreach Program to the African American community, with an office in Deerfield Beach off of Dixie Highway and Hillsboro Boulevard.
Janice Fulmore-Tigner, outreach coordinator for Opening Doors, is a fervent devotee of getting out the message that hospice is not a place to go to die, but a non-profit service that helps make a patients final months more comfortable and provides assistance and support to the patients caregivers and family members. She regularly speaks at community gatherings, schools, funerals, and churches, engaging with the community at all levels and helping marginalized African Americans obtain needed services.
“The African-American community generally has a distrust of institutional medicine, and they also have concerns about the cost of care. Its my mission to explain to everyone I meet that most hospice services, such as bath visits and pain relief, are delivered in the home, and that these services are available regardless of a persons ability to pay.”
