Decision-making usually includes older or more respected family members. Women are expected to provide and be in charge of sick care within the family, including when the patient is hospitalized. The desire for family to be informed about a terminal illness or poor prognosis before the patient has at least the potential to lead to conflict. To avoid conflict it is best to clarify with the patient and family in early contacts that such information is given to the patient unless she or he expressly requests otherwise. It is difficult for patients and families to agree to DNR orders as such orders and acceptance of terminal status may represent giving up and abandonment of the patient.
Hospitalized patients are likely to be attended by family around the clock.
Hygiene is important and is best given by the patient her or himself, or by family members. Some will resist shampooing during an illness. Patients will struggle to use the toilet rather than a bedpan. Although Cubans are not excessively modest, modesty for persons who are ill may be an important issue. Health risks for Cubans in the U.S. and in Cuba include cardiac and cerebrovascular diseases, diabetes, malignant neoplasms.