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Culturally appropriate palliative care on Country
Many Aboriginal and Torres Strait Islander people express the wish to be cared for, and to die, on Country if possible. When care at home is preferred, it can be provided by clinical services to help connect family, culture, community, Country and spiritual wellbeing, writes Prof. Liz Reymond MBBS (Hons), PhD, FRACGP, FAChPM, Director of the caring@home for Aboriginal and Torres Strait Islander Families project.
The Palliative Care Clinic Box, a free, culturally appropriate resource developed by the caring@ home project, is one tool to assist families and carers to support Aboriginal and Torres Strait Islander people who choose to remain at home or on Country for the final stage of their life.
When a person expresses a strong desire to return to Country and the family and community are supportive, clinical services can use the resources to teach families and carers how to care for their loved one at home. Clinicians can educate the family about common end-of-life symptoms and how to help manage these symptoms at home including how to give subcutaneous medicines if the need arises.
Using the resources enables clinical services to provide person-centred, high-quality palliative care and, as illustrated by the story highlighted right, can lead to beneficial outcomes for the person, their family and the community.
The resources in the Palliative Care Clinic Box are freely available to clinical services and applicable Australia-wide. They have been tailored from the standard caring@home resources, and include family tip sheets on symptom management, step-by-step guides about giving subcutaneous medicines, short training videos, a medicine book and wall chart. There are also specific resources for health professionals and clinical services to support teaching families and carers.
The caring@home team undertook an extensive consultation process over two years with Indigenous and non-Indigenous health professionals from primary health care and specialist palliative care clinical services and other key stakeholders in each state and territory, seeking advice and feedback on the development of the resources.
Since launching in August 2022, 500 Palliative Care Clinic Boxes have been distributed to clinical services around Australia with positive feedback received from clinicians and families about the usefulness and practicality of the resources.
Clinical services can order a free Clinic Box by visiting www.caringathomeproject.com.au. All resources can be downloaded from the website.
caring@home for Aboriginal and Torres Strait Islander Families is a National Palliative Care Project, funded by the Australia Government. This project is conducted by a consortium involving Australian Indigenous HealthInfoNet, Palliative Care Australia, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) and led by Brisbane South Palliative Care Collaborative.
“We gave that medicine; you know the one for sickness in the gut. Sis did real well using them easy instructions and tips in the [caring@home] resources.
And I’ll tell you what, after days of not eating, he smelt them roo tails being smoked on the barbie and a few hours after that sick medicine kicked in, he hoovered them tails right down.
He says that the roo tail, this is the cultural symbolism used for balance and strength… and the roo tail is used to defend off harm and threats. The roo tails give us direction, propulsion and speed. And I’m telling you what, we all know he can use these as her nears the Dreaming.
He sat by the fire with this family tonight. At three, his spirit danced in the flames, his body now at rest… because you guys ensured that his spirit got to rest in the definition of his own peace.
Aboriginal family from remote Western Queensland. This story was shared with the permission of the family involved. We thank them for their generosity in allowing us to publish it.