Their Last Breath: Death and Dying in a Hmong American Community

Deborah Helsel, Kao Shoua Thao, Robin Whitney

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)68-74
Number of pages7
JournalJournal of Hospice and Palliative Nursing
Volume22
Issue number1
DOIs
StatePublished - Feb 1 2020
Externally publishedYes

Keywords

  • end-of-life issues
  • familism
  • migration
  • palliative care
  • qualitative

ASJC Scopus subject areas

  • Community and Home Care
  • Advanced and Specialized Nursing

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