Pain Management and the African American Hospice Caregiver

Although African Americans’ use of hospice has increased (8.9% of all hospice patients were African American in 2010 as compared with 8.7% in 2009), their underutilization of hospice services continues,1–4 demonstrating there is still much to be learned about the African American hospice experience. A lack of knowledge and trust are considered primary barriers to hospice use among African Americans,2,5–8 and education has been recommended as a standard strategy for overcoming these and other barriers.9–12 Education about pain management and assessment is critical, as prior research has identified barriers to pain management are related to demographic characteristics such as culture2,13–16 and race.2,3,17–20 Family caregivers who are tasked with assessing pain and administering pain medications report fear of opioid side effects,21–23 fear of addiction,21–23 fear of legal euthanasia,24,25 and lack of knowledge regarding pain medication.23,26 The purpose of this case study is to explore one African American caregiver’s experience with hospice pain management.