Home > Review Articles > What are the priorities for developing culturally appropriate palliative and end-of-life care for older people? The views of healthcare staff working in New Zealand

What are the priorities for developing culturally appropriate palliative and end-of-life care for older people? The views of healthcare staff working in New Zealand

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Authors:
Summary:

Two joint interviews and 10 focus groups conducted with 80 healthcare staff across a range of primary, secondary and speciality care settings in 2010 explored their views regarding the provision of culturally appropriate palliative care for Māori, Pacific Island and Chinese elders living in Auckland, New Zealand. Participants regarded the involvement of family as fundamental to the provision of palliative care for older people. The healthcare staff indicated the importance of enabling family members to provide ‘hands-on’ care for Māori and Pacific Islanders, while the role of family in decision-making was fundamental to the delivery of and satisfaction with care for older Chinese family members. Chinese elders favoured collective decision-making. Care staff highlighted the importance of appreciating individual preferences both within and across cultures as a fundamental aspect of palliative care provision. They maintained that the role of family in ‘hands-on’ palliative care and decision-making requires care staff to relinquish their role as ‘expert provider’. Finally, they considered that it is important to provide families with the requisite knowledge and skills to give care to older family members.

Comment:
I was interested to read this paper providing an analysis of the views of healthcare staff, rather than people being cared for by their whānau. One area for concern was the statement that staff felt that family wanting “‘hands-on’ palliative care… requires staff to relinquish their role as ‘expert provider’”. I’d argue that people and whānau expect staff to continue to provide their expertise (in nursing care, treatment, nutrition, etc.) but work as a team to provide patient-centred care.
Reference: Health Soc Care Community 2013;21(1):26-34
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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