Perspectives of Advance Care Planning for Latinos During COVID-19.

Latinos face challenges in accessing care for serious illness and lack preparedness for healthcare crises which were exacerbated by the COVID-19 pandemic. Following a social ecological model, this study explored perceptions of advanced care planning (ACP) for Latinos from key informants including community members and health care providers. A total of 12 focus groups including 25 community members and 24 providers were completed in both English and Spanish from April to July of 2020. Using a grounded theory approach and constant comparison, we identified 4 primary themes: underlying vulnerabilities and barriers to ACP, the pandemic context, unique Latino pandemic experience, and urgency to do ACP because of COVID. The Latino experience reflects a complex interplay between 2 macro systems, a unique Latino experience and the pandemic, which included significant communication gaps, isolation, mistrust, and anxiety. The pandemic was an eye-opening experience for many Latinos which has made ACP more relevant as awareness and knowledge of death and dying shifted.