Palliative care needs with serious chronic health conditions 

Aboriginal and Torres Strait Islander peoples make up 3.3% of Australia's population. They are the original custodians of Australia, and today are defined by descent, self-identification, and community recognition. Indigenous Australians live in all parts of Australia, but two in three live in New South Wales or Queensland. Only one in three live in a capital city.

Why palliative care matters

Aboriginal and Torres Strait Islander peoples are more likely to have serious chronic health conditions including kidney disease and coronary heart disease than non-indigenous Australians. Many of these conditions are life-limiting illnesses. Among Aboriginal and Torres Strait Islanders:

  • two in three have at least one long-term health condition.
  • rates of smoking and high level alcohol intake are greater than for the non-Indigenous population, and these are risk factors for many serious chronic conditions.
  • they are more likely to be diagnosed with cancer at an advanced stage
  • lung, liver and cervical cancers are more common than among non-Indigenous Australians
  • they are twice as likely to be hospitalised for palliative care.

This contributes to their lower life-expectancy as a group compared to non-Indigenous Australians.

Common barriers and outcomes

The high rate of life-limiting conditions including advanced kidney and heart disease among Aboriginal and Torres Strait Islander Peoples increases the need for access to palliative care. Yet many are unaware of palliative care. Others are reluctant to talk about death and dying, and many face racism and discrimination that prevents access to care. Together with a fear or mistrust of ‘Western’ medicine, language barriers, and poorly serviced rural locations this has a major impact on their experience at the end of life.

Overcoming the barriers

Talk with Aboriginal and Torres Strait Islander peoples to find out how you can support them with their palliative care needs. Everyone is different, but this may include:

  • understanding that ‘Family comes first’, the extended family is likely to be extremely important, there may be a family spokesperson that isn’t the patient.
  • awareness that some men will prefer to be cared for by men, and women by women.
  • considering whether eye contact, holding a gaze or firm handshake is causing them to feel unsafe or uncomfortable.
  • identifying their specific cultural and spiritual needs, ceremonies, or practices in the lead up to death and post-death.
  • awareness that direct statements about death and dying are not spoken aloud in many Aboriginal and Torres Strait Islander communities. Terms that might be used instead include ‘sorry business’, ‘finishing up’, and ‘passing on’.
  • acknowledging that Aboriginal and Torres Strait Islander peoples may hold strong spiritual and cultural beliefs about the cause of serious illness. These beliefs may conflict with medical explanations. Respect any wishes for a traditional healer to visit.
  • awareness that some Aboriginal and Torres Strait Islander people may be reserved and unobtrusive when in pain and may not openly complain. They may feel embarrassed or feel that being awake and aware is more important than dulling the pain.
  • respecting that there may be a strong desire to die on country.

Learn more

To learn more visit the ELDAC website section about Aboriginal and Torres Strait Islander Peoples and palliative care and read the Australian Government Department report Health Exploratory Analysis of Barriers to Palliative Care Issues Report on Aboriginal and Torres Strait Islander Peoples (1.07MB pdf).

This information was drawn from the following resources:

Last updated 02 August 2021