Barriers to and Facilitators of South Asian Indian-Americans' Engagement in Advanced Care Planning Behaviors.
Kavita Radhakrishnan, Shubhada Saxena, Regina Jillapalli and 2 others
PMID 28388828WHAT IT FOUND
South Asian Indian older adults often avoid advance care planning due to trust in family decisions and fear of burdening children.
Nurses can facilitate discussions by using community settings, providing materials in Hindi or Gujarati, and framing planning as relieving family burden rather than preparing for death.
Key findings
01Participants reported barriers to advance care planning including lack of prior awareness, trust in adult children or physicians to make decisions, and cultural hesitance to discuss death or private family issues.
02Facilitators for engagement included prior experience with difficult end-of-life decisions, distrust of healthcare providers, financial concerns about caregiving costs, and a preference for quality of life over longevity.
03Participants suggested that advance care planning discussions could be initiated in neutral community settings or during long-term care planning, and that materials should be available in Hindi and Gujarati.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used volunteers from specific community organizations in central Texas, so findings may not generalize to all South Asian Indian Americans or other populations. Physician demographic data was omitted to protect confidentiality due to the small number of participants. The sample size for physicians was very small (4 participants), limiting the weight of their perspectives.
The easy way to misread this
Do not assume that cultural barriers to advance care planning are uniform across all South Asian Indian Americans. The study participants varied in their acculturation and language preferences, and some engaged with planning when framed around family burden or financial control. Avoid stereotyping patients as unwilling to discuss end-of-life care; instead, explore their specific concerns about family roles and healthcare access.