Ohio nurses help hospice patients navigate end-of-life decisions

By Nadia Ramlagan

On the heels of National Nurses Week, hospice nurses are raising awareness about access to compassionate end-of-life care and medical decisions in the Black community.

Medicare, Medicaid and most insurance plans provide coverage for hospice care when health care providers predict a patient has six months or less to live.

Ottamissiah "Missy" Moore, a longtime hospice nurse and member of the African American Leadership Council for Compassion & Choices, said her personal experience relying on hospice care showed her how important it can be for families.

"My son was very young. He was 32 years old. He had advanced disease and before any doctors came in to talk to him, I went to him and said, "I want you to tell me what you think life is going to look like from now on," Moore recounted.

Research shows Black patients continue to utilize hospice at lower rates than their white counterparts. A recent study published by the Journal of the American Medical Association found around 34% of Black study participants died while using hospice services compared to more than 46% of their white counterparts.

Moore added the disparity echoes other racial inequities in health care, such as nonwhite people being less likely to receive pain medications and higher rates of maternal mortality.

Moore explained part of the issue is education around hospice and end of life, noting if patients do not explicitly understand and make decisions in advance, it is often left up to the practitioner to decide what is best if a person is no longer cognizant. She pointed out many people do not have experience with end-of-life hospital terminology, such as do-not-resuscitate orders.

"It may be as simple as the conversation," Moore contended. "An example is if you go into a hospital, the staff there will ask you, 'Would you like to be a DNR?'"

Cincinnati-based Mahogany Home Health and Hospice has garnered recent attention as the first Black-owned hospice and home health organization in Ohio, aimed at providing culturally competent end-of-life care to Black and underserved communities.