Undocumented Immigrants Unable to Get Adequate End-of-Life Care

Undocumented immigrants are unable to get adequate dialysis and end-of-life care.
Undocumented immigrants are unable to get adequate dialysis and end-of-life care.

HealthDay News — New research, published in JAMA Internal Medicine, offers insights into the medical plights facing undocumented immigrants in the United States.

Lilia Cervantes, MD, of Denver Health, and colleagues interviewed 20 undocumented immigrants who are only able to undergo dialysis once a week, via an emergency department, when they're critically ill.1

In some cases, the emergency department patients get dialysis on a Monday "when they're short of breath and feel like they're drowning," Dr Cervantes told HealthDay. They leave the next day and feel fairly well for a couple days, she said, but by Friday, "they're feeling really sick again, nauseous, short of breath." By Saturday, they're in bed, and by Sunday, "they're at death's door, but they don't go to the hospital because they feel like they're not sick enough and won't be treated after a five-hour wait. Instead, they come in on Monday when they can barely move."

In the second study,2 published as a research letter, Nathan Gray, MD, of the Duke University School of Medicine in Durham, North Carolina, sent surveys to 230 hospices in the United States and received answers from 179 about whether they treat undocumented immigrants. Nine percent (n=16) said they don't accept them, and nearly 24% percent (n=42) said their enrollment is restricted. The rest, 68% (n=121) said they don't restrict undocumented immigrants. According to the researchers, Medicare doesn't cover hospice care for undocumented immigrants.

References

  1. Cervantes L, Fischer S, Berlinger N, et al. The illness experience of undocumented immigrants with end-stage renal disease [published online February 6, 2017]. JAMA Intern Med. doi: 10.1001/jamainternmed.2016.8865
  2. Gray NA, Boucher NA, Kuchibhatla M, Johnson KS. Hospice access for undocumented immigrants [published online February 6, 2017]. JAMA Intern Med. doi: 10.1001/jamainternmed.2016.8870
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