Elderly Indo-Caribbean Hindus and end-of-life care: a community-based exploratory study

America's increasingly diverse older population needs clinicians to be familiar with ethnic and cultural issues pertaining to end-of-life care (EOLC). Although there has been some work addressing these issues among African-American, Hispanic-American, and some Asian-American populations, data on the Asian-Indian and Hindu populations remain sparse. This community-based exploratory study surveyed older Indo-Caribbean Hindu people (a subset of the Hindu population living in America) attending a senior center in Queens, New York. This study describes the demographic and health characteristics of this population and examines their attitudes, knowledge, and beliefs regarding some EOLC issues. Data on participants' demographic, medical, psychosocial, and cognitive status were obtained. Previously validated scales were used to collect data on subjects' acculturation, religiosity, and EOLC beliefs. Participants had a mean age+/-standard deviation of 71.1+/-5.1 years; 43% were married. Prevalent illnesses included diabetes mellitus (48%), hypertension (66%), and arthritis (57%). Subjects were socially connected, moderately acculturated, and religious. Scores on the Ethnicity and Attitudes Towards EOLC Survey indicated negative beliefs about life-sustaining or prolonging technology and positive attitudes about advance care directives (ACDs), truth-telling, and family involvement. The number of ACDs that had been completed and knowledge about ACDs was low. The Indo-Caribbean elder population in this study expressed attitudes and beliefs regarding EOLC similar to those of other ethnic elders. Many of these beliefs are in conflict with current EOLC practice patterns. This highlights the importance of being aware of differing attitudes to provide sensitive EOLC.