Assessing the palliative care needs and service use of diverse older adults in an urban medically-underserved community

Daniel S. Gardner, Nina S. Parikh, Carolina H. Villanueva, Angela Ghesquiere, Cara Kenien, Jean Callahan, M. Cary Reid

Research output: Contribution to journalArticlepeer-review


Although palliative care (PC) has become increasingly familiar, considerable gaps persist in access to and use of services. Community-based programs remain rare, and low-income, minority communities significantly under-utilize hospice and palliative services. We used community-based participatory research (CBPR) methods to conduct a mixed-methods community needs assessment of seriously-ill older adults (n=100) and providers from community-based programs and churches (n=41) in an urban medically-underserved community in the U.S. to explore: (I) the prevalence and severity of illness-related symptoms and psychosocial-spiritual concerns; (II) the scope and quality of community supports helping older adults manage their symptoms; and (III) the perceptions and utilization of palliative and supportive care services among older adults and community-based service providers. Participants reported high rates of chronic illness-related symptoms (i.e., pain, fatigue, sleeping difficulties, depression, and anxiety), and many described unmet needs around symptom management. Few had ever utilized PC or pain management services, and most relied primarily on family, friends, and faith communities to help them manage burdensome symptoms. Barriers included lack of familiarity with PC, limited access and financial concerns. Older adults were largely unfamiliar with PC, and many described unmet needs and desire for help with symptom burden. Findings support the need to further explore community-level and cultural barriers to PC among diverse, underserved older adults. Development of innovative community partnerships may help raise awareness of PC and address the physical and psychosocial-spiritual challenges facing chronically-ill minority older adults and their families.

Original languageEnglish (US)
Pages (from-to)769-774
Number of pages6
JournalAnnals of Palliative Medicine
Issue number5
StatePublished - Nov 2019


  • Chronic illness
  • Community-based participatory research (CBPR)
  • Disparities
  • Older adults
  • Palliative care (PC)
  • Symptom burden

ASJC Scopus subject areas

  • Advanced and Specialized Nursing
  • Anesthesiology and Pain Medicine


Dive into the research topics of 'Assessing the palliative care needs and service use of diverse older adults in an urban medically-underserved community'. Together they form a unique fingerprint.

Cite this