Abstract
Hispanic/Latinos are the fastest growing ethnic minority group in the US and the most unlikely of any racial/ethnic group to use hospice services for end-of-life (EOL) care. The construction of healthcare systems that are culturally compatible for an increasingly diverse population, particularly at the EOL when cultural perspectives are central to the decision making process, is an urgent yet complex task. This qualitative study, conducted in two locations in the southwest part of the US explored the attitudes and experiences of Mexican Americans that influence decisions about EOL care and participation in hospice programs. The key findings include the need for (a) effective incorporation of the family with its cultural and spiritual values, (b) careful negotiation of the fluctuating need for the patient and family to both maintain and release control in EOL care, and (c) culturally and linguistically consistent communication. Recommendations for hospice care staff and administrators are offered.