Palliative care aims to provide holistic, person-centred care. Culturally safe and responsive care is an essential part of this care and an extension of this practice.
Culturally safe and responsive health care requires that the health professional recognises and responds to the health beliefs, health practices and culture and linguistic needs of the individual and of communities. Health professionals need to understand and attend to these cultural and social factors in therapeutic encounters. Culture is central to health and wellbeing, and therefore is essential to palliative care practice.
There is a growing awareness that health outcomes are linked to the social and cultural determinants. We need to acknowledge the impact of these historic and contemporary cultural and social factors on the individual as well as considering how our own belief systems influence our care.
Culturally safe and responsive health care aims to ensure Aboriginal and Torres Strait Islander people feel culturally safe when receiving health care. Aboriginal and Torres Strait Islander Australians are more likely to seek health care, and achieve better outcomes by accessing services that are culturally safe and respectful places. Evidence indicates that health service provision that has respect for a person’s cultural and spiritual heritage can positively impact on overall health and wellbeing.  Therefore, ensuring cultural safety is a key strategy for reducing inequalities in healthcare access and improving the effectiveness of care for Australia’s first people.  It is important to remember that only the person receiving health care can determine whether they feel culturally safe. The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) notes that the essential features to cultural safety include: understanding one’s own culture; acknowledgement of difference, and a requirement that caregivers are actively mindful and respectful of difference(s); it is informed by the theory of power relations; an appreciation of the historical context of colonisation, the practices of racism at individual and institutional levels, and their impact on First Nations people’s lives and wellbeing (both past and present); and the presence or absence of cultural safety is determined by the experience of the recipient of care, it is not defined by the caregiver. 
Ensuring that Aboriginal and Torres Strait Islander people receive culturally safe and responsive health care is the responsibility of health professionals, their educators, and health service providers. Indigenous Allied Health Australia (IAHA) notes that to deliver culturally responsive health care, health professionals need to appropriately respond to the unique attributes of the person, family or community they are working with. Central to this is being able to comfortably interact with people from different cultures, and avoidance of generalisations or stereotypes about a person’s cultural group.  Further, to ensure cultural capability within organisations, health service providers need to build governance structures that ensure health professionals are encouraged and capable of responding to the needs of Aboriginal and Torres Strait Islander people effectively. [4-5]
There are a number of ways that you as a health professional, health worker or community worker can become more knowledgeable and provide more culturally responsive care as an individual, as a team member, and within your organisation. Learning occurs throughout your life and builds on your experiences. You can read more about cultural safety and cultural responsiveness. You can learn more about the history and diverse cultures of Aboriginal and Torres Strait Islander peoples. You can attend training opportunities made available within your health service or through your professional associations. You can attend a free Culture-Centred Care Workshop run by the Program of Experience in the Palliative Approach (PEPA). You can apply for a free PEPA placement.
More information about PEPA training and other education options can be found in Developing your Knowledge and Skills.
Page authored by Colleen Gibbs (CATSINaM), Donna Murray and Anna Leditschke (IAHA), in conjuction with the CareSearch Team.Last updated 19 August 2021