How will we ensure Aboriginal and Torres Strait Islander peoples have access to culturally safe palliative care and end-of-life services?
This question is fundamental to the health, welfare and quality of life of Aboriginal and Torres Strait Islander peoples nationwide.
Currently, Aboriginal and Torres Strait Islander people are significantly less likely to access palliative care services, in comparison to the Australian population. This under representation is particularly apparent within the general practice setting. [1, 2] And when Aboriginal and Torres Strait Islanders access these services, they are not necessarily treated in a culturally safe way.
The provision of quality palliative care services to Aboriginal and Torres Strait Islander people is an important part of efforts to achieve health equality in Australia.
Quality palliative care and end-of-life services are:
- person and family centred
- available for people with life limiting illness
- responsive to the holistic needs, preferences and values of people, their families and carers
- life affirming, while recognising dying as an inevitable part of life.
The ultimate goal here is to ensure the comfort, dignity, cultural respect and wishes of those on their end-of-life journey.
A National Priority
The palliative care health gap is not a new public health issue. In 2011, Palliative Care Australia identified Aboriginal Health Workers urgently needed palliative and end-of-life education and training. Aboriginal and Torres Strait Islander people have also identified the need for more culturally appropriate trained health professionals.
More recently, the Federal Government's National Palliative Care Strategy 2018 highlighted a growing need for palliative care. This Strategy also emphasized the need for a sustainable investment in the workforce to support palliative care delivery in any setting. This includes at home, in a hospital, hospice, aged care facility or an institutional setting (such as a correctional facility or accommodation for people with a disability). Aboriginal and Torres Strait Islander health professionals and front-line staff obviously play essential roles in bridging this gap.
The Department of Health’s publication Exploratory Analysis of Barriers to Palliative Care clearly outlines the barriers to Aboriginal and Torres Strait Islander people receiving palliative care. Most importantly though it identifies a number of recommendations including addressing the following enablers:
- Networks, partnerships and collaborations
- Workforce development
- Research, evaluation and monitoring.
Following these recommendations, the Federal Department of Health has engaged Australian General Practice Accreditation Limited (AGPAL) to support workforce upskilling in this area.
How will AGPAL address this issue?
In partnership with Palliative Care South Australia, AGPAL will develop a comprehensive suite of education and training materials to support the provision of culturally safe palliative care services.
This project aims to support relationships between service providers, front-line staff and Australian Aboriginal and Torres Strait Islander people.
The key objectives of this project include improved:
- Quality of culturally safe palliative care services for Aboriginal and Torres Strait Islander people by developing skilled frontline staff
- Access to and uptake of palliative care service delivery through enhanced community awareness of palliative care
- Understanding and increased uptake of advanced care planning
- Delivery of coordinated culturally relevant and safe palliative care across community and acute care settings
An Advisory Committee will guide the development of the educational material. This Committee consists of 60% Aboriginal and Torres Strait Islander representation and will include Aboriginal and Torres Strait Islander health, palliative care, communication and engagement subject matter experts.
Online modules, recorded workshop, interactive webinars, workbooks and tool kits will be available to health care professionals on an eLearning Platform. This will enable all health care professionals to gain access to this information at anytime from anywhere within Australia.
AGPAL will also deliver ‘train the trainer workshops’ nationally to Aboriginal Health Workers, community care teams and other frontline staff to support them to further train and coach other health professional to provide culturally safe palliative care.
If you'd like to find out more about this project or to receive access to the eLearning Platform once its live please contact me at tjanamian@agpal.com.au
I would also be interested to hear of your own Aboriginal and Torres Strait Islander palliative care experiences.
References
- Australian Institute of Health and Welfare (AIHW). Palliative care in general practice [Internet]. Canberra: AIHW; 2020 [updated 2020 Sept 15; cited 2020 Oct 9].
- Sullivan K, Johnston L, Colyer C, Beale J, Willis J, Harrison J, et al. National Indigenous Palliative Care Needs Study: Final Report (1.20MB pdf). Canberra: Australian Government Department of Health and Ageing; 2003 Apr.
Dr Tina Janamian, General Manager Education and Innovation, AGPAL Group of Companies