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Topics:
Health
Hospice
Austin Develops Community Model to Expand Minority Access
Confronted
with low minority participation in the hospice program, the HCFA
organized "Town Meetings" around the country to develop new strategies.
The Austin program decided to "raise their own nurses" with minority
scholarships that required 600 hours each year of hospice service
while in school, and a full-time commitment for two years upon
graduation. Nurses invest $100,000 of Hospice dollars in the local
NAACP credit union. Local ministers have collaborated to raise
minority volunteers in hospice from virtually none to 26 percent
of all volunteers. And programs have now become more responsive
to the cultural differences and strengths for care within distinct
minority communities. Story.
Story:
Hospice Austin Develops Community Model to Expand Minority Access
by
Bruce Jennings, Executive Director, the Hastings Center, and member
of the CPN Health Editorial Team.
Dr. Peg
O. McCuistion at Hospice Austin illustrates what can happen when
a program reaches out into its community, listens and responds.
Participation
by the minority community in the hospice program was very low.
More traditional patterns of outreach, including advertisements
in minority newspapers and requests of local institutions for
minority nurses yielded little. In fact, minority nurses were
not even in the schools. As a result of ideas generated at HCFA's
"Town Meetings" on hospice care, organized by Bernice Harper around
the country, the Austin program created a minority access committee
on their board and took the program "on the road."
Several
different strategies changed the picture. For example, hospice
decided to "raise their own nurses" and established minority scholarships,
obtaining dollars through local foundations and challenge grants.
Now they are supporting two students, an Hispanic nursing student
and an African-American young woman working toward an associate
degree and who is now going on for a four-year degree with their
support.
Students
give back to their community by working part time in the hospice
program while they are in school. Receiving a small stipend, they
each give almost 600 hours a year to hospice. At the end of their
educational preparation, they commit to work at full pay for two
years in the hospice program. Also, they invest in their community
by putting $100,000 of Hospice dollars into the NAACP credit union
and making it available for hospice members to draw upon. As the
director said, "if you take care of the living, you take care
of the dying."
Hospice
Austin has also reached out to local ministers, who challenged
them to answer the question "what do you have that we don't have?"
Hospice staff brought their message to the church laity during
Saturday and Sunday services. Powerful ideas emerged out of these
discussions. Over three years, minority community volunteers increased
from almost none to 26 percent of all volunteers. They attracted
the attention of an African-American chaplain working on a doctorate
who, in turn, did a program for African-American ministers, and
is now sharing the experience at the Texas Hospice Workshop and
developing partners in Amarillo and Texarkana. His message to
the community: "This is your responsibility. How are you going
to help? If you have a calling, use your calling to do this kind
of work."
Opening
up to the community and understanding its needs, in turn, changed
the way hospice works in and provides services to the minority
community. Sometimes the change is subtle. For example, in the
Hispanic community, talking to the man in the home first and making
sure he understands—even if he is not the caregiver—saves
a tremendous amount of time in the long run, since without his
cooperation, everything else can be extremely difficult. In this
minority community, folks are more likely to care for their own
families and their neighbors, so it's not necessary to waste their
time trying to "organize" them or search for caregivers. "They
already know that someone in the neighborhood needs to check in
at least three or four times a day." Understanding the patterns
of bereavement and grief services, the health care beliefs in
culturally different communities, such as the role of curanderos
and folk medicine, streamlines the work of hospice and helps hospice
workers be far more effective in serving the community and using
their resources well.
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