Topic 2 Toolkit: Caring for Australian Indigenous peoples affected by life-limiting illness

Statement from IPEPA National Indigenous Manager, Allyra Hulme

The PCC4U project team developed this toolkit resource in partnership with the Indigenous Program of Experience in the Palliative Approach (IPEPA).

This toolkit has been developed through First Nations-led community engagement and two-way consultation involving engagement with key First Nations stakeholders, organisational and project partners, educators and students. Learning aligns with key strategic frameworks for education and cultural responsiveness.

The toolkit supports holistic and culturally-responsive care. It has been designed to educate health professionals about the important role they play in breaking down the access barriers to mainstream healthcare, experienced by Aboriginal and Torres Strait Islander peoples. Students are provided with opportunities to reflect on a living and flexible model of service delivery and consider how their practice can support this.

This Focus Topic Toolkit was respectfully launched on National Close the Gap Day, 17 March 2022. Educators can now access an updated curriculum blueprint summary for this Focus Topic.

Focus Topic Acknowledgements

PCC4U thanks and acknowledges the many peer reviewers and contributors to this resource.

Organisations contributing to development:

• Indigenous Program of Experience in the Palliative Approach
• Indigenous Advisory Group for the Palliative Care Education and Training Collaborative
• National Advisory Group for the Palliative Care Education and Training Collaborative
• Palliative Care Australia Yarning Circle

Overview:

To provide quality, culturally-responsive care for people affected by life-limiting illness, health professionals need to be able to identify and respond effectively to individual needs.

This Focus Topic Toolkit: Caring for Australian Indigenous peoples affected by life-limiting illness will help students to develop the skills needed to provide quality care, across various settings, to Aboriginal and/or Torres Strait Islander people with life-limiting illness, and their families and communities.

Aims and Objectives:

This toolkit is based on the core principles of palliative care and is designed to supplement the learning activities in the four PCC4U Core Modules.

The toolkit provides a range of learning activities and resources in relation to the topic. Educators can select any or all of the activities to best support the development of their students’ palliative care capabilities.

The toolkit also provides information on the key aspects of cultural safety that students need to know before undertaking these toolkit activities. For details, refer to the section Pre-requisite knowledge.

Refer to the section below: Information for Educators  for information on learning outcome mapping and alignment with key strategic and education frameworks, and the toolkit development process.

Learning outcomes:

After completing the relevant sections of the focus topic, students will be able to:

1. Critically reflect on power, privilege and the institutional place of health services and professionals and how these impact on provision of palliative care for Australian Indigenous peoples. [Section 1]
2. Describe traditional kinship systems, and spiritual connections to Country and culture that influence the views that many Australian Indigenous peoples have of health and wellbeing. [Section 2]
3. Identify the key features of the United Nations Declaration of the Rights of Indigenous Peoples (UNDRIP) that relate to provision of palliative care for Australian Indigenous peoples. [Section 3]
4. Demonstrate an awareness of the historical and ongoing trauma that contributes to the current barriers that prevent Australian Indigenous peoples accessing palliative care services. [Section 4]
5. Demonstrate enhanced capability in communicating with and delivering family-centred care to Australian Indigenous peoples affected by life-limiting illness. [Section 5]
6. Recognise the cultural considerations associated with end-of-life care, grief and bereavement for Australian Indigenous peoples. [Section 6]

About the Toolkit

Promoting a safe and respectful learning experience

PCC4U recognises that many healthcare students and professionals find it difficult to have conversations with people about cultural needs and preferences and are concerned about making mistakes. This can lead to avoidance of these conversations and avoidance of engaging in learning to develop skills. Engaging with Australian Indigenous peoples in a way that is respectful and acknowledges the health professional’s willingness to learn is very important.

Content Warning The content in this toolkit challenges healthcare students to identify and reflect on entrenched beliefs and biases relating to racism and Australian Indigenous peoples. This process may be uncomfortable and overwhelming to some. It may also be triggering to students who identify as Aboriginal and/or Torres Strait Islander. Suggested responses for educators to support a safe learning space include: Brief students about the sensitive and potentially triggering nature of this content Allow students to determine the depth of engagement with these learning materials, as they feel ready Check in with students regularly to find out if additional support is required Advise students how to access additional support.

National Support Services: Lifeline 13 11 14 (24hrs) Beyond Blue 1300 22 4636 Link-Up Aboriginal Corporation 1800 624 332 Kids Helpline 1800 55 1800 Mensline Australia 1300 789 978

Healing Programs for Aboriginal and/or Torres Strait Islander people Healing Foundation Family Wellbeing Empowerment Program (Lowitja Institute) Marumali (to put back together) Journey of Healing Seasons for Healing Red Dust Healing We Al-Li

Information for Educators

Learning Outcomes Mapping Learning outcomes align with a number of key strategies and frameworks: The National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025 (AHPRA)1 Indigenous Allied Health Australia’s (IAHA) Cultural-responsiveness Framework to incorporate knowledge (knowing), self-knowledge and behaviour (being) and action (doing)2 Aboriginal and Torres Strait Islander Health Curriculum Framework3 PCC4U Graduate Capabilities in Palliative Care.4 Learning Outcomes alignment and mapping

Toolkit Development Process This resource has been developed through a rigorous and consultative process alongside our Australian Indigenous stakeholders. For further information on the development process, please refer to this document. Toolkit Development Process   Mapping to 2020 Focus Topic 2 Activities For educators who have used the previous Focus Topic 2 resource, this document provides a summary of how the previous activities align with the activities in the current Toolkit resource. Mapping Focus Topic 2: 2020 version to Toolkit version   Educator Support As with all PCC4U resources, educators can adapt the presentation of the focus topic content to suit the needs of their learners. The PCC4U project team is available to provide implementation support and have many resources available in our Educator Community Hub on our Learning Management System (registration is free). A recording of the webinar session launching this toolkit is available also. For example, this Padlet resource provides a way for students to interact with the content provided in Activity 15. We also have a summary of the videos embedded throughout the toolkit and their associated thinking points. This may be a helpful resource for educators when planning online or self-directed learning for students, using the toolkit resource. Toolkit Video Summary for Educators

Terminology

Language and naming terms are interwoven in a history of domination and colonisation that continues to perpetuate misunderstanding and misrepresentation of Aboriginal and Torres Strait Islander peoples today. Accordingly, this resource provides some background to the terminology it uses throughout. It is important to remember, that although the terms ‘Indigenous’, ‘Aboriginal’ and ‘Torres Strait Islander’ are commonly accepted, these are colonial labels that were imposed on peoples with diverse cultures and languages. In the development of this toolkit, it was indicated that use of the term ‘Aboriginal and Torres Strait Islander’ when referring to Aboriginal and Torres Strait Islander people collectively, may lead to the incorrect assumption that there are just two cultural groups – Aboriginal people and Torres Strait Islander people. Use of the word ‘peoples’ rather than ‘people’ can help address this but does not acknowledge that some people may identify as both Aboriginal and Torres Strait Islander. This resource, in seeking to acknowledge the diversity of Aboriginal peoples and Torres Strait Islander peoples, who have distinct cultures, languages, kinship systems, Lores and customs, respectfully uses the following terms: Australian Indigenous peoples when referring to Aboriginal and Torres Strait Islander peoples collectively Aboriginal and/or Torres Strait Islander person / family when referring to individuals and family groups.   PRACTICE POINT: Australian Indigenous peoples often identify with Country, Nation, Clan or Island groups. In healthcare practice, it is always important to ask how someone identifies and show respect and understanding by using preferred language and terms. These terms will vary from person to person and family to family, so it is essential to always ask.