Negotiating palliative care in the context of culturally and linguistically diverse patients

Abstract

There is an increasing emphasis on meeting the healthcare needs of culturally and linguistically diverse (CALD) communities in Australia. Negotiating the point of futility and the transition to specialist palliative care requires not only effective communication but also sensitivity to cultural and linguistic specificities. This can be a challenging process for clinicians, patients and families. Here, we outline some of the key challenges currently facing many clinicians in the context of CALD patients, with particular reference to the transitioning of patients to specialist palliative care. We suggest a focus on further research that can systematically document and model existing CALD-specific clinical processes and pathways, which can then support the development of targeted educational interventions. This includes developing a multi-stakeholder understanding of the CALD experience that moves beyond cultural stereotyping and predicting need.

Cultural considerations at end of life in a geriatric inpatient rehabilitation setting

“…Education opportunities should be designed to assist clinicians in understanding and being sensitive, respectful and responsive to the complexities of the patient's and family's preferences and needs (ACSQHC, 2015;Broom et al, 2013). With this in mind, educational interventions should not be aimed at producing a prescriptive list of information for each ethnicity or religion (Bellamy & Gott, 2013) as this 'cookbook' approach is short-sighted and limiting (Jones, 2005).…”

Assuaging death anxiety in older overseas-born Australians of culturally and linguistically diverse backgrounds hospitalised for end-of-life care

“…Despite a growing recognition of the importance of providing EOL care that is "culturally appropriate" for patients of diverse cultural and language backgrounds, there is a lack of Australian research systematically investigating cross-cultural considerations in EOL care for older immigrants of CALD backgrounds and the influence that culture might have on the provision of appropriate care (Broom, Good, Kirby & Lwin, 2013;Hiruy & Mwanri 2013;Johnstone, Hutchinson, Rawson & Redley, 2015;McNamara, Martin, Waddell & Yuen, 1997). This is so despite calls by some international researchers for "culture" to be made a priority in EOL care research (Gysels et al, 2012).…”

Solid and liquid modernity: A comparison of the social geography of places to die in the UK and Australia

“…The standard response to this challenge has been to espouse equality, liberal doctrine, where it is claimed everyone receives equal treatment and consideration. However, we know that people from ethnic minorities have very different experiences of PEoLC (Broom, Good, Kirby & Lwin, 2013) Dying at home might be seen as offering a much more individualised and personal experience. The liquid setting of community care offers a much more individually tailored care.…”

“…It is perhaps not a surprise that in highly individualised societies such as Australia and the UK that people would choose an obviously more individualised care delivery setting. The stereotypical cultural traps of home care are perhaps well known (Gott et al, 2014), although assumptions about cultural cohesion and adherence may still result in poor, or no care provision (Broom et al, 2013). In addition, there are challenges of over medicalising the home setting, the dangers of an over romantic view of home, which may be the site of abuse or failed relationships (Gott et al, 2014;Fisher, 2003).…”