A scoping review of end-of-life discussions and palliative care: implications for neurological intensive care among Latinos in the U.S.

Diaz, Monica M; Guareña, Lesley A; Garcia, Bettsie; Alarcon-Ruiz, Christoper A; Seal, Stella M; Rubinos, Clio; Cruz-Oliver, Dulce M; Carhuapoma, J Ricardo · Lancet Reg Health Am · 2024

review · Level V

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Abstract

Goals of care (Goals-of-care) discussions and palliative care (PC) are crucial to providing comprehensive healthcare, particularly for acute neurological conditions requiring admission to a neurological intensive care unit. We identified gaps in the literature and describe insight for future research on end-of-life discussions and PC for U.S. Latinos with acute neurological conditions. We searched 10 databases including peer-reviewed abstracts and manuscripts of hospitalized U.S. Latinos with acute neurological and non-neurological conditions. We included 44 of 3231 publications and identified various themes: PC utilization, pre-established advanced directives in Goals-of-care discussions, Goals-of-care discussion outcomes, tracheostomy or percutaneous gastrostomy tube placement rates among hospitalized Latinos. Our review highlights that Latinos appear to have lower palliative care utilization compared with non-Latino Whites and may be less likely to have pre-established advanced directives, more likely to have gastrostomy or tracheostomy placement and less likely to have do-not-resuscitate status.