Palliative care is an important part of the health care continuum. Up to 90 per cent of people at the end of life prefer to be cared for and to die comfortably at home, yet Australia has one of the lowest rates in the world of people dying outside of hospital or in residential aged care. We need to get better at supporting end-of-life choices around comfort and dignity and improve access to palliative care at home.
A person-centred approach to palliative care must account for cultural and individual needs. Yet we know that these same cultural factors sometimes in fact pose barriers to community members accessing the benefits of palliative care and the support available to die well.
There is low awareness and use of palliative care services among some cultural, linguistic and spiritually diverse communities. Among others, there are beliefs and values which impact on perspectives of death and dying, and therefore accessing end-of-life services. For example, religion, attitudes to family and filial piety, to illness and pain management, to mental health, and to receiving care or care in the home can all impact on individuals and families’ willingness to engage.¹
Culturally responsive palliative care must be sensitive to these beliefs and must also continue to improve whole-of-community’s understanding of the quality of life benefits to accessing palliative support earlier in the illness journey, by changing the conversation to a focus on symptom management and comfort. As we move towards inclusive community approaches to dying in Australia, such as Compassionate Communities, which enhance the informal care networks around people at the end of life, we need to be even more sensitive to family-centred and community-centred approaches to care.
More inclusive and responsive services to palliative care: Engaging multicultural communities
Palliative Care South East delivers home-based care to people living with a life-threatening illness in the south east of Melbourne, which includes the multicultural hub of Dandenong and surrounds. The service is cognisant of the changing demographics in its catchment and continues to review its engagement approach to be responsive to local community needs.
Larter worked with Palliative Care South East to develop a range of resources to promote palliative care to ensure more people receive the end of life care they want, when and where they want it. This includes a range of posters in ten local community languages (Arabic, Chinese, Dari, Farsi, Italian, Greek, Khmer, Sinhala, Vietnamese) to engage local communities to improve their choices for end of life care. Part of the engagement is to ensure formal and informal networks understand how to support people wanting to end their lives at home.
Family caregivers and carers have a unique role in supporting someone at the end of life. Their roles and wellbeing are critical to ensuring a person’s end-of-life choices can be maintained. A Carer Support Kit translated into 10 community languages is also available from Palliative Care South East.
Contact us if you’d like to discuss optimising service access for vulnerable communities.