Australian Aboriginality is a broad category within which are embedded many language groups and subcultures. Aboriginal peoples are the Indigenous Australians and should be respected as the traditional custodians of the land. Indigenous Australians make up approximately 2.5% of the total population. [1]
Factors which may impact on healthcare provision to Aboriginal people include:
- Historical factors such as interactions with European settlers, and detrimental government and healthcare policies & practices. [1, 4]
- Social factors including welfare issues, education and employment. [2]
- Physical and environmental factors including housing, access to safe water and sanitation and necessary services (electricity, phone etc). [2]
- Mortality and morbidity data. The life expectancy gap between Indigenous and non-Indigenous. Australians is currently estimated to be 11.5 years for men and 9.7 years for women. [2] 80% of the mortality gap can be attributed to chronic diseases. [2] From ages 35-54, the ratio of Indigenous to non-Indigenous death rates is highest for diabetes, diseases of the liver, chronic respiratory disease and ischaemic heart disease. [3] This may make experiences of grief and loss especially profound.
Fundamental to providing culturally safe palliative care to Aboriginal people are three key practice principles. The first of these principles is to engage with Aboriginal organisations and personnel in the planning, provision and monitoring of palliative care to ensure culturally relevant requirements are addressed and preferences of the patient and/or their family are considered. [4]
Some ways in which you can engage with Aboriginal communities include:
- Refer to and establish links with Aboriginal liaison officers and/or Aboriginal health workers – they can be invaluable resource in hospital and community settings [1, 4, 5]
- Liaise with the appropriate Aboriginal organisations as part of discharge planning.
- Refer to Aboriginal Medical Services (AMS), Regional Councils, Aboriginal community health organisations for information as required
- Acknowledge the importance of kinship, traditional healers and bush medicines for some individuals. [4, 5]
Thinking Points
- Consider how each of these factors – historical, social, physical and environmental, mortality and morbidity – can impact on the provision of palliative care for Aboriginal people.
References
- Taylor, K., Guerin, P. (2010). Health Care and Indigenous Australians: Cultural safety in practice. Melbourne, VIC: Palgrave Macmillan.
- AIHW. (2011). The health and welfare of Australia’s Aboriginal and Torres Strait Islander people: an overview 2011. Cat. no. IHW 42. Canberra: AIHW. Retrieved 9 December 2011, from www.aihw.gov.au/publication-detail/?id=10737418989
- AIHW Indigenous observatory. (2011). Life expectancy. Retrieved 9 December 2011, from www.aihw.gov.au/getmedia/b0a6bd57-0ecb-45c6-9830-cf0c0c9ef059/16953.pdf.aspx?inline=true
- Commonwealth of Australia. (2004). Providing culturally appropriate palliative care to Aboriginal and Torres Strait Islander Peoples: Resource Kit. Retrieved 9 December 2011, from www.health.gov.au/internet/main/publishing.nsf/Content/palliativecare-pubs-indig-resource.htm
- McGrath, P. (2010). The Living Model: An Australian model for Aboriginal palliative care service delivery with international implications. Journal of Palliative Care, 26(1), 59-64.