Preparing for death in a foreign land: Advance care directives and end-of-life care

In Australia's diverse ageing population there is growing recognition of the need for culturally sensitive end-of-life care. Currently, end-of-life planning is promoted in the form of advance care directives (ACD), which encourage preparedness for and conversations about death, and have a lower uptake in culturally and linguistically diverse populations. Drawing on preliminary findings of an ethnographic study that aims to identify and theorise points of uptake and resistance to ACD in Asian migrant groups in Adelaide, this paper explores how a western-framed neoliberal orientation  to ACD diverges from everyday and tacit end-of-life care practices in Asian contexts. Following Mol et al's (2010:14) suggestion that care involves tinkering in a world full of complex ambivalence and shifting tensions', the paper explores how conversations and silences around death and dying are negotiated, interpreted and enacted as a practice of care by individiuals, families and frontline stakeholders in cross-cultural contexts.