Ethnic and cultural dimensions of work with hospice families. Allowing latitude for religious differences.

Thereis ageneralassumption that the waysin which familiesrespondto illnessand deatharedeterminedprimarily by their psychologicalmakeup. However,onefactor is frequently ignoredwhenwe considerhow families carefor the terminally ill or families’ bereavementpatterns.That factor is cultural background.In anearlierpaper,’the author discussedwaysthatunderstandingthe dynamicsof family structurecancontribute enormouslyto effectivework by the hospiceteam.The teachingof ethnicandcultural differencesis oneimportant component of understanding familiesandthis articleexpandsupon theethnicdimension in working with families. Audiencesexperienceadegreeof discomfortwhenpresentedwith the ideaof ethnic differences;for many, talking abouthow wediffer maybeas toxic asdiscussingsex (or even death),andthereis oftena concernthatexaminationsof ethnicdifferencesmayborder on prejudiceor go beyondthe boundsof goodtaste.Indeed, manyfear thatemphasizing our differencessimply reinforceswhat dividesus;but what we mustacknowledgeis thatwe are differentandthat recognitionof thesedifferences canfacilitateour work with families.2 This paperwill addressfour generalareasof importancein work with hospicepatientsand their families andlook at the waysin which avariety of ethnic groupspresentthemselves in each.Theseareasare:Values regardinglife anddeath;attitudestowardpain; careof the ill andinterfacewith the extrafamilial environment;andexpressionsof griefandbereavementpatterns,including the useof ritesandrituals. It will presentexamplesof anumber of differentethnicgroups ratherthanfocusingon any one, in orderto providethe readeranoverviewof how groupnormsandbehaviorcan differ.