Experiences of institutional care can impact palliative care

The term ‘care leavers’ refers to someone who has spent time in institutional care, including the foster care system.

This may include those that are considered as ‘forgotten Australians’, former child migrants and stolen generations. Forced adoption is the term used to describe the way in which parents were made to give their child up for adoption. These experiences can strongly influence access and responses to palliative care.

Why palliative care matters

Being part of these population groups may be associated with an increased risk of chronic, life-limiting health conditions as well as complex mental health issues such as depression, anxiety, and grief. Many care leavers were subject to abuse in their setting of care. This can lead to a reluctance to access health services, such as hospitals due to previous trauma associated with authoritative figures in institutions.

Common barriers and outcomes

Mental health issues and increased risk of drug and alcohol misuse and homelessness adds to the complexity of issues that might be faced by care leavers.

The complex issues of care leavers and those that were forced into adoption are often compounded by overlap with other population groups such as Aboriginal and Torres Strait Islander and migrants. This intersection of complex issues and experiences can lead to fear of institutionalised care such as residential aged care and a mistrust of health systems. This in turn can result in poor access to palliative care services.

Overcoming the barriers

Some approaches to care that may help care leavers to accept palliative care include:

  • accessing support services that specialise in the trauma associated with being a ‘care leaver’ or a ‘forgotten Australian’ may be helpful for individuals who choose to disclose this information.
  • having a trusted advocate that can help to navigate the health system.
  • sharing experiences through peer support can also be of benefit.

Learn more

To find out more about care leavers in the palliative care context visit the ELDAC website and the Australian Government Department of Health Exploratory Analysis of Barriers to Palliative Care - Issues Report on Care Leavers and People Affected by Forced Adoption.

This information was drawn from the following resources:

Last updated 02 August 2021