Effective palliative care for minority ethnic groups: the role of a liaison worker

Abstract

As the issue of equality of access to health-care services becomes more important, there is increasing concern that specialist palliative care services in the UK are under-used by minority ethnic groups (Haroon-Iqbal et al, 1995; Karim et al, 2000). Research into the provision of such services for black and minority ethnic communities identified a number of factors that contribute to a perceived low take-up of services (Hill and Penso, 1995). A strategy to promote ethnic and racial sensitivity in palliative care service delivery, and policies to improve access to, and take-up of, services was recommended. This article presents the important elements relating to equal access to specialist palliative care and the provision of culturally sensitive services, and examines the role of the Macmillan Ethnic Minorities Liaison Officer in the Bradford community palliative care team.

Talking about end-of-life care: the perspectives of older South Asians living in East London

“…While some participants expressed their preference to have discussions with their family and perceived that their family members are to be the final decision-makers, others reported that such end-of-life discussions with their family members remain culturally inappropriate. This is in contrast to previous studies, which reported that people tend to prefer to discuss any issues related to end-of-life with family members rather than with health professionals (Kahana et al., 2004; McDonald et al., 2003; Salmond and David, 2005).…”

“…Some argue that there is a lack of 'cultural transferability' in existing Western palliative service models which may make them unacceptable to some non-western people (Gunaratnam, 2001). In addition to this, language barriers Jack et al, 2001) may be a barrier to access to reliable information about end-of-life care services, such as hospice and cancer care facilities (Elkan et al, 2007;Randhawa and Owens, 2004). This may significantly impede awareness and uptake of palliative care services (Gaffin et al, 1995;Jones, 2005;NCHSPCS, 2003;PRIAE, 2006;Smaje and Field, 1997).…”

Community outreach to patients with AIDS at the end of life in the inner city: Reflections from the trenches

“…Reviewing the medical literature on the role of CHWs in disease prevention0health promotion~Warrick et al, 1992;Castro et al, 1995;Rodney et al, 1998;Felix-Aaron et al, 2002!, substance abusẽ Elwood et al, 1995Rahimian & Pach, 1999!, mental health~Morse et al, 1996Dixon et al, 1998;Anthony et al, 1988!, andend-of-life care~Robinson &Stacy, 1994;Maull, 1998;Jack et al, 2001!, and integrating these descriptions with our experiences in HIV palliative care, we identified seven critical stages in clinical care, with particular focus on the work of the CHW: Having witnessed so much death, I was excited by the idea of making a difference in the experience of people who were dying. I would have the chance to bring patients and their loved ones to appreciate one another after so many battles, to come to a place of acceptance and caring, and letting go.…”

“…Beginning with models developed in the third world, community health outreach workers~CHWs! have been successfully employed in the United States and elsewhere to bring health care to underserved and stigmatized populations~Warrick et al, 1992;Castro et al, 1995;Elwood et al, 1995;Morse et al, 1996;Rodney et al, 1998;Chen, 1999;Rahimian & Pach, 1999;Fried, 2000;Jack et al, 2001;Felix-Aaron et al, 2002!. Thus far, little attention has been given to the critical role that CHWs can play in bringing palliative care to patients dying of AIDS and other illnesses in our inner cities.…”

“…The roles of "a key worker"~Robinson & Stacy, 1994! and of the "ethnic liaison officer" Jack et al, 2001! have been described in the delivery of palliative care to urban, minority populations in the United Kingdom.…”