The Aboriginal and Torres Strait Islander people are a diverse group of peoples, made up of many different nations and language groups. We acknowledge that past policies have had very negative impacts on these peoples. Despite this, the Australian Indigenous people are strong, richly diverse peoples. Aboriginal and Torres Strait Islander culture is a living culture, made up of both contemporary and traditional peoples.
When talking about how to provide palliative care for Indigenous Australians, it is important to look to the context in which many Aboriginal and Torres Strait Islander people are living today. Indigenous people are less like to live to an old age than other Australians, with higher disease rates for diabetes, cardiovascular disease and cancer. Australian Indigenous HealthInfoNet has a page providing a summary of Australian Indigenous health.
The circumstances of Aboriginal and Torres Strait Islander people impacts on how they view the world, and how they interact with others and with themselves. Learning more about Indigenous culture and history may help to understand the principles for practising in a culturally appropriate way, in conjunction with the other information and resources provided here.
Issues for Aboriginal and Torres Strait Islander people
There are substantial barriers for many Aboriginal and Torres Strait Islander people in accessing services, such as difficulty with communication and a lack of understanding by non-Indigenous service providers. This is often made more difficult with a lack of trust of government services including healthcare services.
Indigenous people living in more rural and remote areas may have to travel to major centres for appointments and treatments, which may be the first time away from country. There is also the issue of cultural sensitivity in terms of skin groups, of the community, and of 'going home to country'.
The extremely disadvantaged position of many Indigenous people, particularly those living in some rural and remote communities, poses special issues in the delivery of palliative care. These include issues related to the storage of medications and compliance, and the need for care-providers to be aware that multiple health problems are more common among Indigenous people.
Looking after people with a culture different from your own
In providing palliative care to Aboriginal and Torres Strait Islander people it is important to realise that there are cultural differences in attitudes to health and treatment, and these can also impact on health. These aspects have been addressed in a recent National Health and Medical Research Council (NHMRC) publication, Cultural competency in health: a guide for policy, partnerships and participation. The document reviews how values and beliefs can impact generally on healthcare delivery.
The document Providing culturally appropriate palliative care to Indigenous Australians (Commonwealth of Australia, 2004) covers many of the aspects to be addressed in relation to Aboriginal and Torres Strait Islander people.
As health professionals, there is no expectation to know everything or to be experts in every area. It is important though, to work alongside specialist organisations, and others such as Aboriginal Health Workers. Working with an Aboriginal Community Liaison Worker is important. They are the ‘gateway’ to Indigenous communities and can assist health professionals in cultural and traditional ways. Aboriginal and Torres Strait Islander people can be unsure of non-Indigenous people coming to give palliative care. Coming from different backgrounds and cultures, it can be frightening to have non-Indigenous people in the house.
The following two articles on Aboriginal Health Worker’s may be of interest:
Policies and Key reports
Brochures and stories
Related CareSearch Pages
Rural and Remote
Last updated 23 February 2012*