Palliative Care for Aboriginal People - Essay Example

?Running head: PALLIATIVE CARE FOR ABORIGINAL PEOPLE Palliative Care for Aboriginal People Introduction: Palliative care involves providing medical care to patients in a bid to alleviate their pain and suffering and not so much to heal as is with medical treatment. In a standard setting, palliative care commences as soon as a condition is diagnosed, treated and only ends with the cure of the disease or the demise of the individual in question. The core purpose of palliative care is to alleviate physical, psychological and social distress so that improves the quality of life of individuals and their families facing the problems associated with life-limiting illness. In addition, it involves the family and in most cases extends to the involvement of the community. This aspect of palliative care raises the question of cultural influences to the effectiveness or defectiveness of the whole process in this multicultural country(Elliott, Aitken & Chaboyer, 2011). It is, therefore, imperative that nurses provide spiritual and cultural care for individuals and their family receiving palliative care through the application of spiritual and cultural competent nursing care principles (Elliott, Aitken & Chaboyer, 2011). The discussion will focus on Aboriginal and Torres Islander people spiritual and cultural care in relation to palliation. Importance of proving spiritually and culturally appropriate care for a person and their family receiving palliation: To grasp the sensitivity of palliative care to the Aboriginal people, one has to understand the underlying factors that precipitated their alienation from the rest of the Australian populations. Over 20% of the Aboriginal population lives in very remote areas (100 kilometres from a health centre). This Aboriginal population has the highest death rate in Australia especially for people between the ages of 25-45. What is worse if the fact that the current health system does not recognize most of the ailments this population faces as fatal. With the arrival of the Europeans came the arrival of chronic illnesses such as Hypertension, diabetes, stroke and a myriad of heart diseases (Austin Health, 2006). In addition, the past experience of Aboriginal people, especially the experience of the Stolen Generations result in the fact that most Aboriginal people do not trust government institutions and this creates a barrier between them and healthcare givers (Austin Health, 2006). The vulnerability of these populations makes it very imperative that they receive spiritually and culturally appropriate care. Cultural beliefs and traditions relating to death and dying in Aboriginal Communities: The Dreamtime is the ultimate spiritual and cultural guide to these people. It influences social systems, myths, punishment and reward, life, death and health. Specific to palliative care, Dreamtime makes the people view death as an ominous mythical secret. Furthermore, Dreamtime influences communication style, decision making and consenting, gender and kinship relations and role of elders in the community that are very crucial factors in palliative care for the Indigenous people. The Indigenous population favours a “homely demise” this is to say that they prefer to die in the confines of their community. Aside from the fact that the Indigenous population favours a “homely demise”, there is the issue of ceremonies that are very important to them, even those who predominantly practice Christianity. According to a study done by McGrath and Phillips (2008) the most popular and dominantly held practices include: The smoking ceremony; an elder smokes the house, room or car where the individual frequented to helps the spirit of the dead person pass on to the other side. The second one is marking the house of the deceased with red ochre that also releases the spirit of the dead person and releases it into the other world (spirit world). There is also dancing, singing and decorating of the house using flowers to ensure that the spirit of dead person gets a heartfelt send off in their last days on earth. Beside that, there are ceremonial rituals that may shock palliative caregivers especially those that are new in the Aboriginal territory. For instance, there is loud wailing accompanied by self-inflicted pain such as beating or cutting (McGrath & Phillips 2008). Application nursing principles to the culture of Aboriginal and Torres Strait Islander people: The implication of these ceremonies and spiritual believes is that the palliative caregiver has to take certain precautions. First, one has to appreciate their culture rather than misunderstand their intentions. This will help the caregiver to respect the Aboriginal’s and react in an appropriate manner towards the patient and the community (Poroch, Manion & Manion, 2011). Secondly, the caregiver should respect the peoples' right to grieve in the way they do. This means that in the event that the patient does not die in the confines of their home, caregivers should make timely plans to transport the body to the community so that it can go through the full ritual before burial. In other instances it will more appreciated by the community and the ailing individual that they die in their own home as mentioned above and the caregiver can also make plans to that effect (Poroch, Manion & Manion, 2011). After all palliative care giving is all about assisting patients and families during illness and subsequent bereavement (Matzo & Sherman, 2010). Compassionate care embraces dignity and comfort, listen to the clients patiently and to offer explanation and demonstrate their communication traits. The first importance of spiritually and culturally appropriate care is to the patient. The nurse’s aim is to ensure that the patient is comfortable first with their situation. This requires that the nurse employ appropriate communication skills and show enough empathy. Secondly, the nurse should ensure that the patient is comfortable with the type of care they are receiving spiritually, culturally and professionally. What one needs to keep in mind is that the aim of palliative care is not to hasten or postpone death but to ensure that whatever the outcome the patient is ready (Matzo, & Sherman, 2010). Integrating both spiritual and psychological aspects will help ease the patient’s pain because they are at peace with what is going on around them. It is imperative to remember that palliative care giving focuses on the comfort of the patient and for most of these Indigenous populations, the comfort of the community is the comfort of the patient (Poroch, Manion & Manion, 2011). End-of-life planning is not an Indigenous favourite topic given their beliefs and high burden of grief. Death to them is as a community affair and, therefore, the family of the sick person plus the community are very involved. Spiritually and culturally appropriate palliative care also helps the community better because it helps the community accept and cope with the situation. The family and the community appreciate when the caregiver considers their feelings and believes. Spiritual and psychological consideration is, therefore, good for the family and the community because it will ease the road to acceptance. Nurses should be aware of their own culture so that they can be more aware of the cultural differences they have with their clients to ensure holistic care. According to the School of Nursing and Midwifery Learning Guide (2013), there are principles that guide nursing and healthcare giver. There are several objectives but there are those that are specific to palliative care giving. The first one is valuing intellectual inquiry. Before going to the field, the nurses should have abundant knowledge of their course and the people they intend to care for (Matzo, & Sherman, 2010), in this case the Aboriginals. Another objective is awareness towards cultural sensitivity while maintaining a professional approach. It is not enough to know that a certain community behaves in a certain manner. The nurse has to go the extra mile, respect their culture, and have objective approaches to deal with cultural issues that may be a hindrance to proper care giving. For instance, a son may refuse to take care of the sick mother because some communities see this as wrong in which case the nurse can seek out a female friend of the sick individual. While most institutions in the country are keen on cultural awareness, there is only so much formal training can do (Payne, Seymou & Ingleton 2008). It is for this reason that one of the objectives in the lesson guide is critical thinking and critical self-awareness. This will help the nurse or caregiver to make decisions that are of the best interest to the patient and their families. Secondly, this will help the nurse respond appropriately to change and unexpected circumstances. Finally, nurses have to ensure that the decisions they make are lawful but at the same time maintain the dignity of the patient in view of their spiritual believes and culture (Payne, Seymou & Ingleton 2008). For instance, if an aboriginal dies in hospital, it is in most cases necessary that the doctors carry out an autopsy. While the community may resent this, there are legal grounds and the autopsy should proceed. On the other hand, the nurse can act as the clients as an advocate in view of their express wishes. For instance, the nurse can safe guard the family from coercion to donate organs by informing them of their legal rights on the same seeing as this is a terrible wrong in most Aboriginal communities (Austin Health, 2006). Conclusion: The most important traits for a nurse dealing with the Aboriginal population are patience tolerance and firm decision-making skills (O'Toole, 2012). The nurse should be able and always be ready to take personal responsibility by taking charge of issues (School of Nursing and Midwifery Learning Guide, 2013) this affirms their accountability to both the patient and their family. Proper application of professional nursing principles will give both the patient and their family an easy time in dealing with a disease or impending death. Nonetheless, the nurse can empower the patients to make decisions on their own by giving them reliable and adequate information regarding an issue (O'Toole, 2012). It is crucial for nurses to take into account the cultural and spiritual dispositions of individuals and their families while giving palliative care through integrating nursing principles with spiritual and cultural competence (Matzo, & Sherman, 2010). References: Austin Health. (2006). Especting People's Choices. Sydney: Rural Health and Palliative Care. Elliott, D., Aitken, L., & Chaboyer, W. (2011). Acccn's Critical Care Nursing. Sidney: Elsevier Australia. School of Nursing and Midwifery Learning Guide. (2013). Family Health Care: Chronicity and Palliative Care Nursing. Sydney: University of Western Sydney. Matzo, M. L., & Sherman, D. W. (2010). Palliative Care Nursing: Quality Care to the End of Life. New York: Springer Publishing Company. McGrath, P., & Phillips, E. (2008). Insights on end-of-life ceremonial practices of Australian Aboriginal peoples. Collegian, 15, 125 – 13. O'Toole, G. (2012). Communication: Core Interpersonal Skills for Health Professionals. Sidney: Elsevier Health Sciences. Payne, S., Seymou, J., & Ingleton, C. (2008). Palliative Care Nursing: Principles and Evidence for Practice. New York: McGraw-Hill International. Poroch, N. C., Manion, H.-A., & Manion, G. (2011). Kurunpa: Keeping Spirit on Country. The International Journal of Health Sociology, 383 - 395. Read More