Culture Differences in Advance Care Planning and Implications for Social Work Practice

Abstract Advance care planning (ACP) is the process of making plans and decisions regarding end-of-life care (EOLC) in advance while one has the physical and cognitive capacity to do so. However, even if health practitioners recognize the importance of ACP, they may be constrained by social and cultural factors in engaging their clients in ACP. This study examined cultural differences in ACP and various strategies that social workers use to initiate conversations on ACP in a range of settings. Using the case study method, we conducted in-depth interviews with 7 social workers who work in South Korea, 2 Korean-American social workers working in the Korean-American communities in the US, and 3 American social workers serving diverse populations in the US. Their practice sites include: university hospitals, day care centers, a community senior center, a nursing home, and a hospice agency. Social workers in both countries emphasized the need to build rapport with their clients early on and to empower them to take the lead in their ACP while they were still healthy. In Korean and Korean-American communities, social workers recognized their clients’ reluctance to speak about EOLC and highlighted the importance of communicating with their family due to their clients’ preference for family-centered decision-making. When doing this, a step-by-step approach in giving relevant information was recommended. We identified relationship-building, empowerment, and culturally sensitive approaches as common strategies in initiating discussions on ACP in both countries.


CULTURE DIFFERENCES IN ADVANCE CARE PLANNING AND IMPLICATIONS FOR SOCIAL WORK PRACTICE
Jung-Hwa Ha, 1 Changsook Lee, 1 and Jennifer Yoo, 2 1. Seoul National University,Seoul,Republic of Korea,2. University of Georgia,Atlanta,Georgia,United States Advance care planning (ACP) is the process of making plans and decisions regarding end-of-life care (EOLC) in advance while one has the physical and cognitive capacity to do so.However, even if health practitioners recognize the importance of ACP, they may be constrained by social and cultural factors in engaging their clients in ACP.This study examined cultural differences in ACP and various strategies that social workers use to initiate conversations on ACP in a range of settings.Using the case study method, we conducted in-depth interviews with 7 social workers who work in South Korea, 2 Korean-American social workers working in the Korean-American communities in the US, and 3 American social workers serving diverse populations in the US.Their practice sites include: university hospitals, day care centers, a community senior center, a nursing home, and a hospice agency.Social workers in both countries emphasized the need to build rapport with their clients early on and to empower them to take the lead in their ACP while they were still healthy.In Korean and Korean-American communities, social workers recognized their clients' reluctance to speak about EOLC and highlighted the importance of communicating with their family due to their clients' preference for family-centered decision-making.When doing this, a stepby-step approach in giving relevant information was recommended.We identified relationship-building, empowerment, and culturally sensitive approaches as common strategies in initiating discussions on ACP in both countries.

DEVELOPMENT AND FORMATIVE EVALUATION OF A DEATH EDUCATION PROGRAM FOR COMMUNITY-DWELLING CHINESE OLDER ADULTS
Mandong Liu, 1 and Iris Chi, 2 1.University of Southern California, Hangzhou, China (People's Republic),

University of Southern California, University of Southern California, California, United States
Planning for end-of-life (EOL) care in advance can enhance one's quality of life at EOL. Culturally sensitive educational programs are needed in Chinese populations to enlighten the public and encourage advance planning due to a culture of death-denying and avoidance.This study describes the team's efforts to develop and formatively evaluate a death education program designed for community-dwelling Chinese older adults.The program was designed based on the Knowledge-Attitude-Behavior Model, as a 2-session 3-hour program spreading over two days with 1.5 hours for each day.The content paid attention to discussing the importance of making plans for EOL in Chinese culture and discussing how to have death-related conversations with the family and health care professionals.In 2020, semi-structured interviews were conducted by phone with 12 health care professionals and researchers, and four Chinese older adults in China to obtain their feedback on program content and delivery.The directed content analysis method was used to analyze the data.Although they confirmed multiple challenges in conducting death education in China, such as family avoidance even if an older adult initiates the death-related conversation, health care professionals not feeling comfortable with such discussions, etc., they also felt the urgency and importance of delivering death education among older adults and in society as a whole.Detailed suggestions were categorized into relationship building, program preparation (e.g., setting, materials), multiple ways of recruitment, target population, length, various formats of content delivery, content (e.g., pay attention to spiritual care), and general support from the public.

ay.The content paid attention to discussing the importance of making plans for EOL in C
inese culture and discussing how to have death-related conversations with the family and health care professionals.In 2020, semi-structured interviews were conducted by phone with 12 health care professionals and researchers, and four Chinese older adults in China to obtain their feedback on program content and delivery.The directed content analysis method was used to analyze the data.Although they confirmed multiple challenges in conducting death education in China, such as family avoidance even if an older adult initiates the death-related conversation, health care professionals not feeling comfortable with such discussions, etc., they also felt the urgency and importance of delivering death education among older adults and in society as a whole.Detailed suggestions were categorized into relationship building, program preparation (e.g., setting, materials), multiple ways of recruitment, target population, length, various formats of content delivery, content (e.g., pay attention to spiritual care), and general support from the public.


Session 1075 (Paper)

Health and Long-Term Care

Session 1075 (Paper)
Health and Long-Term Care