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Posted: March 31, 2005


A doctoral student at the University of North Texas Health Science Center discovered that Mexican-Americans knew little about advance directives, including living wills.

Carmen Santiago, a doctoral candidate in the School of Public Health at the health science center, defended her dissertation, “Advance Directives Planning Among Mexican-Americans in Dallas-Fort Worth,” just moments after Terri Schiavo died. Schiavo, a brain-damaged Florida woman, received national attention this week when her parents and husband fought over the reinsertion of a feeding tube that has allowed Schiavo to live for the past 15 years.

Santiago’s dissertation reviewed research on advance directives in the United States and studied of Mexican-Americans in the Dallas-Fort Worth metroplex to determine the level of knowledge; attitudes; and cultural, religious and family influences on decisions regarding advance directives and living wills.

Her study included two focus groups of people who she interviewed for two and one-half hours. One group consisted of elderly Mexican-Americans who had been hospitalized or participated in home-healthcare programs within the past year. The other group included family members or caregivers of elderly people who had been hospitalized or participated in home-healthcare in the past year.

Santiago discovered lack of knowledge and confusion in both groups regarding advance directives. Some participants thought that the term living will meant the distribution of property. Religiosity and education did have some bearing on the respondents’ attitudes toward advance directives, according to the study, and the elderly participants were more likely to allow adult children to make decisions about extended life care.

“Terri Schiavo’s case is a sad example of the difficulties families must go through when a loved one does not have a living will,” Santiago said. “During my practice as a provider of home health and hospice services, primarily among Hispanics, the experience of encountering similar situation, that is family members’ disagreements regarding what is the will of the dying loved one, led me to do this study.”

Santiago is founder and CEO of Cuidado Casero Home Health & Hospice.


Contact: Kay Colley 817-735-2553, cell 817-980-5090, e-mail kacolley@hsc.unt.edu.

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