About

Susan Enguídanos, PhD, MPH, is an associate professor of gerontology at the Leonard Davis School of Gerontology at the University of Southern California (USC). Her research focuses on palliative care, including the development and implementation of a home-based model that is currently being adopted in various healthcare settings. Enguídanos has conducted extensive research investigating ethnic variation in access to and use of hospice care, which has led to the creation of theoretically-driven interventions aimed at improving hospice care access for diverse populations. Currently, she is engaged in evaluating community-based models of palliative care implemented within primary care settings. Dr. Enguídanos earned her bachelor's degree in psychology from UCLA, her master's degree in public health from California State University, Long Beach, and her doctoral degree in social work from USC.

Research topics

• Medicine
• Family medicine
• Nursing
• Physical therapy
• Psychology
• Developmental psychology
• Pediatrics
• Law
• Intensive care medicine
• Psychiatry
• Clinical psychology

Selected publications

• Health-Related Consequences of Financial Strain Among Family Caregivers in the U.S.

  Research on Aging · 2026-04-25

  article

  Family caregivers are essential to the healthcare system, yet many experience significant financial strain. Although financial strain is associated with worse caregiver mental health and well-being, the mechanisms underlying this association remain unclear. This study examines how financial strain relates to caregiver health outcomes within the caregiving stress process and assesses whether psychological resources—sense of purpose and perceived choice in caregiving—mediate these relationships. Using data from N = 1,223 family caregivers from the Caregiving in the U.S . 2020 dataset, hierarchical regression models examined the associations among care-related stressors, financial strain, and the outcomes of physical strain, emotional stress, and caregiving-related health impacts. Subjective financial strain significantly predicted greater physical strain, emotional stress, and negative health impacts. Perceived choice in caregiving was a partial mediator across all three outcomes. Findings underscore the importance of reducing subjective financial strain and strengthening coping resources to mitigate care-related stress.

  PublisherDOI

• Changes in Racial Differences in Palliative Care Awareness and Understanding From 2018 to 2024

  Journal of Pain and Symptom Management · 2026-02-12

  articleSenior author
  PublisherDOI

• Patient Needs and Palliative Care Psychosocial Interventions among a Primarily Hispanic Hepatology Clinic Population at a Large Public Hospital: A Qualitative Chart Review

  Journal of Palliative Medicine · 2025-09-19

  article1st authorCorresponding

  Findings illustrate the complex interplay between social determinants of health and disease management for Hispanic patients with advanced liver disease as well as the role of palliative care in providing tailored psychosocial and medical support.

  PublisherDOI

• An Explicit Live Discharge Protocol for Hospice-Initiated Live Discharges

  Journal of the American Medical Directors Association · 2025-11-16

  article
  PublisherDOI

• Enhancing Care Transitions with an Explicit Live Discharge Protocol (LDP) from Hospice

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Implementing a live discharge protocol (LDP) from hospice care is a critical component of ensuring safe and compassionate transitions for hospice patients (and their caregivers) who no longer meet eligibility criteria. A live discharge protocol (LDP) for hospice was recently developed with aims to (1) enhance patient and caregiver experience, (2) minimize disruptions of care, and (3) support hospice providers in navigating the complexities of care transitions. Key elements of the LDP include an inventory of clinical needs, assessment of psychosocial and financial concerns, needed community referrals, and post-discharge follow-up to prevent care gaps and assess caregiving well-being post-discharge. We tested the LDP in 4 US hospice agencies for live discharges experienced due to extended prognosis (n = 30). Following each discharge, in-depth, semi-structured interviews were conducted with hospice providers to elicit their perspectives on the usability of the LDP and suggestions for improving LDP implementation. A second set of interviews (n = 19) were conducted after the post-discharge phone call to explore the clinicians’ experiences with the LDP process. Thematic analysis was used. Providers noted the LDP was useful in ensuring a thorough collection of currently used equipment and supplies for improved discharge process. The need for the LDP referral section was specifically valuable for patients living at home. Finally, the follow-up phone call was found to be useful to support the hospice clinician in this care transition, and as a mechanism to remain connected to patients/caregivers for potential future re-enrollment onto hospice. Future research, policy and practice implications will be discussed.

  PublisherDOI

• Racial and Ethnic Differences in Advance Care Planning and End-of-Life Care in Older Adults With Stroke

  Neurology · 2025-03-20 · 1 citations

  article1st authorCorresponding

  BACKGROUND AND OBJECTIVES: Stroke is a leading cause of death and disability in the United States and may result in cognitive impairment and the inability to participate in treatment decisions, attesting to the importance of advance care planning (ACP). Although racial and ethnic differences have been shown for ACP in the general population, little is known about these differences specific to patients with stroke. The aim of this study was to examine the presence of ACP and receipt of life-prolonging care by race and ethnicity among decedents who had suffered a stroke. METHODS: We used the Health and Retirement Study, a nationally representative longitudinal survey. We conducted a cohort study of decedents who died between 2000 and 2018 using multivariable logistic regression models to explore the association between self-reported ethnicity and race and completion of ACP (including a living will [LW] and durable power of attorney for healthcare [DPOAH]) and receipt of life-prolonging care at end of life, controlling for covariates. Stratified models for each race and ethnicity also were conducted. RESULTS: < 0.001). The presence of ACP discussions, LW, and DPOAH was associated with lower odds of receiving life-prolonging care at end-of-life among non-Hispanic White decedents (OR = .64, CI = .447-0.904; OR = .30, CI = .206-0.445; OR = .61, CI = .386-0.948) but not among those who identified as Hispanic or non-Hispanic Black. CONCLUSIONS: Hispanic or non-Hispanic Black decedents with stroke had significantly lower rates of ACP discussions, LWs, and naming a DPOAH compared with those who identified as non-Hispanic White. In addition, ACP activities were inversely associated with receipt of life-prolonging care among non-Hispanic White decedents, but not among those who identified as non-Hispanic Black and Hispanic. Small ethnic/racial subgroup sizes limit the generalizability of this study.

  PublisherDOI

• Subjective Financial Strain and Objective Financial Impact among Caregivers in the United States

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract Currently more than 41.8 million people in the U.S. provide care to an aging family member. These family caregivers provide critical unpaid care at significant personal expense to both financial and emotional well-being. However, limited research has examined the factors contributing to caregivers’ financial burden. This study aimed to investigate factors associated with both subjective financial strain and objective financial impact among caregivers of older adults in the U.S. Using cross-sectional data from the nationally representative “Caregiving in the U.S. 2020” survey, we analyzed data from 1,330 caregivers of older adults 50 years and older. We conducted hierarchical logistic regression models to explore key factors associated with subjective financial strain and objective financial impact. Younger care recipients (OR = 0.97, p &amp;lt; 0.001; OR = 0.98, p = 0.001) and the voluntary nature of the caregiving role (OR = 1.72, p &amp;lt; 0.001; OR = 1.32, p = 0.050) differentially influenced subjective and objective financial strain. In adjusted models, providing assistance with more instrumental activities of daily living (IADLs) was significantly associated with higher odds of experiencing subjective financial strain (OR = 1.19, p &amp;lt; 0.001) and objective financial impact (OR = 1.13, p = 0.007). Additionally, caregivers who reported time-consuming financial management tasks had higher odds of experiencing subjective financial strain (OR = 2.45, p &amp;lt; 0.001) and objective financial impact (OR = 1.46, p = 0.002). Our findings highlight the financial vulnerability of family caregivers heavily involved in IADLs, particularly those managing finances, and targeted financial support should be provided to those caregivers. Further, future research is needed to test the effectiveness of novel support programs in reducing caregiver’s financial strain.

  PublisherOA PDFDOI

• Racial Disparities in Advance Care Planning Documentation Among Older, Lesbian and Gay Adults

  Journal of Pain and Symptom Management · 2025-03-12

  letterOpen accessSenior author
  PublisherOA PDFDOI

• Palliative Care Interventions Among Hispanic Inner-city Patients with Advanced Liver Disease

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract Advanced liver disease is the 9th leading cause of death in the United States and the 7th leading cause of death among Hispanic individuals. Patients suffering from end-stage liver disease frequently encounter various physical and psychosocial stressors, yet routine access to palliative care is limited. This study aimed to identify the primary needs of a predominantly Hispanic patient population with advanced liver disease and the interventions provided by a palliative care team within a hepatology clinic at a large urban public hospital. We conducted a retrospective qualitative analysis of palliative care team medical record entries from a pilot palliative care program. Participants with advanced liver disease (MELD ≥20) were recruited between 2016 and 2017. Thematic analysis was performed to identify key patient stressors, sources of patient support, and interventions conducted by the palliative care team. Of the 65 participants, 94% identified as Hispanic, with over half undocumented. Common patient stressors included physical symptoms, financial hardship, and challenges related to immigration. Family involvement and religious faith were primary sources of support. Palliative care interventions included psychosocial counseling, end-of-life care planning, social service and public benefit referrals (e.g., food, in-home support, and disability insurance), substance use management, and help navigating the healthcare system. Findings illustrate the complex interplay between social determinants of health and disease management for Hispanic patients with advanced liver disease. Integrating palliative care into hepatology clinics addresses these multifaceted needs by providing tailored psychosocial and medical support. Further research is needed to optimize and expand these interventions.

  PublisherOA PDFDOI

• Subjective Financial Strain and Objective Financial Impacts Among Informal Caregivers in the United States

  Journal of Applied Gerontology · 2025-11-20

  articleSenior author

  Informal caregivers provide critical unpaid care while facing significant financial, emotional, and physical challenges. This study examined factors associated with subjective financial strain and objective financial impacts among informal caregivers of older adults in the United States. Using data from the "Caregiving in the U.S. 2020" with 1,333 informal caregivers who reported caring for an adult aged 50+. Findings indicate that providing assistance with a greater number of instrumental activities of daily living (IADLs) and seeking information about financial help are both significantly associated with increased odds of experiencing subjective financial strain and objective financial impacts. Findings underscore the need for targeted financial support for informal caregivers heavily involved in assisting with IADLs. Financial assistance programs should consider the additional costs associated with these tasks. Policies should ensure that informal caregivers receive adequate and timely support once they request assistance to mitigate both objective and subjective aspects of financial burden.

  PublisherDOI

Frequent coauthors

• Anna Rahman

  University of Southern California

  50 shared

• Alexis Coulourides Kogan

  University of Southern California

  28 shared

• Valeria Cardenas

  25 shared

• Yujun Zhu

  University of Southern California

  23 shared

• Deborah Hoe

  University of Southern California

  16 shared

• David A. Cherin

  14 shared

• Richard Brumley

  14 shared

• W. June Simmons

  11 shared

Labs

• The Enguídanos LabPI

Education

• Ph.D.

  USC

  2004

• Other

  CSU Long Beach

  1998

• B.A.

  UCLA

  1984

Awards & honors

• Kaiser Permanente Award for quality