Purpose Excellent perimortem care addresses survivors' experiences. Culture likely frames such experiences, but little research guides physicians in meeting survivors' needs.
Methods We used hypothesis-generating, open-response interviews to study, by ethnic group, survivors' experiences of a significant death. We asked 26 Mexican Americans (MAs), 18 Euroamericans (EAs), and 14 African Americans (AAs), aged 50 to 79, to describe the deaths of people closest to them. Content analysis identified themes in responses.
Results Many MAs, EAs, and AAs related negative experiences. Some detailed their grieving (38%, 50%, and 43%, respectively) or remembered the funerals negatively (31%, 45%, and 36%, respectively). Importantly, all subjects younger than 42 when the significant person died and 24 of 25 who cited their mothers as that person remembered the funerals negatively. More MAs and AAs than EAs said family presence at a death is important (31% and 43% vs 17%). Yet equal percentages of MAs recalled family unsupportiveness and supportiveness at the significant death (31%), and more AAs recalled family unsupportiveness than supportiveness (21% versus 14%). Some subjects, especially MAs, related positive experiences. More MAs than EAs or AAs remembered the funerals positively (23% vs 6% and 14%) or expressed hope that the dead reached heaven (36% vs 11% and 19%). MAs alone, especially women (25%), said that one should say only good things about the dead. EA men's memories were especially bleak: 71% remembered the funerals negatively, none remembered the funerals positively, and none recalled family supportiveness at the death.
Conclusion Physicians should encourage family presence and support at a death. Certain survivors_the young, children of any age whose mothers die, and EA men_may need special attention through the grieving process.
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