Caregivers of African American hospice patients report unsatisfactory spiritual support in hospice. Hospice professionals, chaplains, clergy, and policymakers need to understand factors influencing spiritual care of African American hospice patients to advance equitable end-of-life and hospice care. We partnered with large community hospice in Georgia, USA, and interviewed caregivers of African American hospice decedents, their clergy, and chaplains. We heard caregivers of African American hospice patients desired chaplains to pray, visit frequently and be present. Caregivers' lack of knowledge about hospice, general medical mistrust, and clergy's minimal understanding of the breadth of spiritual care were barriers to adequate spiritual care.
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