La Buena Muerte: An ethnographic exploratory case study of rezadoras in Guatemala

Although early access to palliative care has been shown to improve quality of life and health outcomes at end of life (EOL), disparities persist in access to palliative care for Latinos. In one study, as few as 2% of Latinos with advanced cancer received a palliative care referral. One cultural practice that supports the collective care-taking of Latinos at the EOL is the service of the rezadora, a lay spiritual leader. Latinos now comprise the largest ethnic minority in the United States, yet clinicians know very little about the work of the rezadora. In 2018, an ethnographic case study was conducted to learn about the role and work of the rezadora in two villages near Antigua, Guatemala. This study builds on an 11-year collaborative community-academic partnership in Guatemala. Interviews from three rezadoras were transcribed and analyzed by a bilingual research team composed of two US academic and two Guatemalan partners. Rezadoras were adult women between 65 and 70 years of age. Field notes and contextual observations informed the interviews. Inductive content analysis was used to identify commonalities and differences within and between cases. A major finding was that the rezadora was instrumental in supporting families and the dying in the Buena Muerte or Good Death, which was expressed through prayer and song to relieve pain and suffering. All rezadoras described a “license� to work or a “calling� by God. Conversely, several differences were noted among the rezadoras. First, the practice of visiting the sick alone vs. in pairs or groups. Second, home visitation vs. hospitals and nursing homes. Third, visiting only families and the dying vs. visiting families during other major life events. Palliative care providers could identify practicing lay spiritual leaders in US Latino communities and incorporate their work in EOL care. Further research to discover how rezadoras impart their knowledge to the next generation is warranted