Cultural and linguistic diversity considerations in palliative care

In Australia, many of the population live with the influence of a different culture. They may also come from a non-English speaking background. This is officially termed CALD – Cultural and Linguistic Diversity.

The 2016 Census of Population and Housing reported that of Australia's 23.4 million people, about one third were born overseas, with a further 18% of residents having at least one parent born overseas. [1]

Although almost 300 different languages are spoken in homes across Australia, almost 73% of Australia's population speak only English at home and 2% don’t speak English at all. The most common languages spoken at home (other than English) were Mandarin (2.5%), Arabic (1.4%), Italian (1.2%), Cantonese (1.2%) and Vietnamese (1.2). [1]

Multicultural policies have been adopted by local, state and commonwealth governments since the 1970s to ensure that all Australians are treated justly and equally regardless of their race and ethnicity.

Common issues

There are a range of issues to be considered when looking after patients from culturally diverse backgrounds. This has included in the health care system, where acknowledging the needs of those who come from a different background and / or speak another language is considered paramount.

Understanding what palliative care is can be difficult. The concept of palliative care may be unfamiliar or foreign. Therefore the views of patients from some cultural backgrounds may be conflicted with palliative care principles, such as the transition from care with a curative intent. [2] Many of those from a CALD background will shy away from services believing a cost is involved.

Family and community support

Many patients from culturally diverse groups will have strong family support which often also extends to extensive community support. Families can sometimes be protective towards patients, reluctant to let them know what is happening for fear of them ‘giving up’. This can be especially true when interpreting, with family members filtering the information to the patient to protect them.

It is always recommended to get official interpreters to interpret information. The patient may wish to talk confidentially with the healthcare team, or the family member may have difficulty talking about sensitive or private information or potentially breaking bad news.

Finding information in different languages

  1. Australian Bureau of Statistics. Census of Population and Housing: Reflecting Australia - Stories from the Census, 2016 [Internet]. 2017 [cited 2021 Sep 3]; ABS cat. no. 2071.0.
  2. Broom A, Good P, Kirby E, Lwin Z. Negotiating palliative care in the context of culturally and linguistically diverse patients. Intern Med J. 2013 Sep;43(9):1043-6.

Last updated 20 August 2021