Understanding the Care Context
All health professionals providing palliative care for Aboriginal and Torres Strait Islander patients, clients and aged care residents need to consider a range of issues, such as providing the right care environment, and culturally safe and responsive holistic person-centred care. In order to provide the best quality palliative care as health professionals, it is essential to have a holistic view and an understanding of the lived experiences and the context in which people live.
Aboriginal and Torres Strait Islander peoples are the original inhabitants of Australia and the traditional custodians of this land. Aboriginal and Torres Strait Islander people are a strong diversity of people, nations and language groups, with a living culture made up of both contemporary and traditional practices. Aboriginal and Torres Strait Islander people live throughout Australia in urban, rural and remote areas.
Aboriginal and Torres Strait Islander people endure a far greater burden of disease and disability than non-Indigenous Australians, and are more likely to have multiple complex conditions. Evidence suggests that this is intensified in remote communities. Aboriginal and Torres Strait Islander people tend not to live as long as non-Indigenous Australians, with a life expectancy approximately 10 years less than non-Indigenous Australians. [1]
Closing this gap is currently a key priority within Australia. Strikingly, 65% of deaths among Aboriginal and Torres Strait Islander Australians occur before the age of 65, compared to only 19% of deaths among non-Indigenous Australians. The two most common causes of death are cardiovascular disease and cancer. [1] When considering Aboriginal and Torres Strait Islander Australians, this means that palliative care is often being provided to younger people. Knowledge of these demographic factors (such as the potentially younger age of the palliative care patient, with comorbid conditions, and with possible connections to a remote home) helps provide a context for care of Aboriginal and Torres Strait Islander people at the end of life. It is also important to recognise that past policies and practices have had negative impacts on Aboriginal and Torres Strait Islander people and how they seek and experience healthcare. [2]
