Dorothy Siaw-Asamoah, PhD, and Kim Griswold, MD

Dorothy Siaw-Asamoah, PhD (right), shown here with her mentor Kim Griswold, MD, aims to understand how diverse families communicate when faced with difficult decisions.

Family Medicine Fellow Explores Diverse End-of-Life Care Dialogues

Published April 4, 2014

Inspired by personal experience, Dorothy Siaw-Asamoah, PhD, research fellow in family medicine, plans to further her study of cultural and communication barriers that affect planning ahead for end-of-life care.

“Different cultural attitudes toward end-of-life conversations require a certain type of sensitivity to the different ways of addressing this topic.”
Dorothy Siaw-Asamoah, PhD
Family medicine research fellow

Ultimately, the results could help family medicine practitioners better understand the unique advanced-care-planning concerns of patients and families with different cultural backgrounds.

How Do Diverse Families Talk About Death?

An immigrant who cared for her terminally ill mother, Siaw-Asamoah found that cultural complexities and nuances emerged as she and her family struggled to make difficult decisions before and after her mother’s death.

She wanted to learn more about how other immigrants make these important decisions, she says.

Especially given the increasing diversity of the U.S. population, “different cultural attitudes toward end-of-life conversations require a certain type of sensitivity to the different ways of addressing this topic,” says Siaw-Asamoah, who holds a doctorate in communication with a major in health communication from the University at Buffalo.

Difficult End-of-Life Care Conversations are ‘Essential’

People from any background are hesitant to discuss death, even though it is inevitable, notes Siaw-Asamoah. Yet, for several reasons, “this conversation is essential,” she says.

When family members must make decisions about an incapacitated loved one’s care, a lack of communication about the patient’s wishes often leads to futile, aggressive and expensive treatment.

These treatments also may be invasive, painful and may not significantly extend life, leading to emotional distress for both the patient and the family. Yet, in the absence of advance care planning, doctors must perform these procedures.

“Patients with proper education about the consequences of these procedures may opt out,” she says.

Fellowship Supports Family Medicine Research

With support from UB’s Department of Family Medicine, Siaw-Asamoah is participating in the Grant Generating Project based at Virginia Commonwealth University.

During her fellowship year, Siaw-Asamoah will focus on writing and fine-tuning grant proposals, mentored by Kim Griswold, MD, associate professor of family medicine.

Siaw-Asamoah plans to seek funding to explore some of the intricacies and questions that people of culturally diverse backgrounds have about advance care planning.

Her project, “Cultural Barriers to Communication About Advance Care Planning in the Patient-Centered Medical Home,” builds on her doctoral dissertation, “Communicating Advance Directives in the Physician-Patient Relationship: A Grounded Theory Approach of Experiences and Perceptions in the United States and Ghana.”

Project Involves Interdisciplinary Collaboration

In addition to Griswold, Siaw-Asamoah is collaborating with Bruce J. Naughton, MD, associate professor of family medicine and director of UB’s Geriatrics Center of Excellence, as well as Thomas Feeley, PhD, professor and chair of communication.

Siaw-Asamoah also is a faculty member in the UB School of Management and assistant faculty director for the LeaderCORE certification program.