Focus Topics

topic 4 | Activity 7: Access to services and care

People from culturally and linguistically diverse backgrounds can be less likely to access and use end-of-life services compared to other groups. [1] Common barriers to accessing services include:

  • It’s family business / responsibility
  • Lack of knowledge and information about services available
  • Lower socioeconomic status
  • Lack of confidence to seek services and individual care needs
  • Social isolation
  • Complexity of the healthcare system
  • Communication barriers
  • Attitudes to seeking or receiving help
  • Beliefs that it is rude to respond or say no to a medical officer
  • Programs offered that are not culturally relevant
  • Past negative experience, particularly for migrants who previously experienced trauma or torture. [1-3]

People from a culturally diverse background are more likely to access services and comply with treatment when there is sensitivity shown by the healthcare staff and service. If necessary refer back to cultural competence in Activity 2 of this module. [1, 4]

Factors to be considered when caring for culturally and linguistically diverse people with a life-limiting illness and their family include:

  • The person’s understanding of life cycle / journey
  • The person / family understanding of symptoms
  • The person / family understanding of anatomy and bodily functions
  • The person / family understanding  of appropriate treatment
  • Optimal communication patterns
  • Autonomy and self-efficacy
  • Gender roles
  • Family involvement / inclusion or exclusion
  • Pain expression and management
  • Diets and dietary practices
  • Concepts of end of life, dying and death
  • Expectations of health professionals
  • Preferred location for care
  • Institutionalised racism in terms of policies and procedures that do not support cultural diversity
  • Personalised / individual racism. [5, 6]
  1. List strategies that could be used to increase the uptake of healthcare services by people from culturally and linguistically diverse backgrounds.
  2. Discuss education and support that would ensure everyone’s cultural safety is met.
  1. Evans, N., Menaca, A., Koffman, J., Harding, R., Higginson, I., Pool, R., & Gysels, M. (2012). Cultural Competence in End-of-Life Care: Terms, Definitions, and Conceptual Models from the British Literature. Journal of Palliative Medicine, 15(7), 812-820.
  2. Wiener, L., McConnell, D. G., Latella, L., & Ludi, E. (2013). Cultural and religious considerations in pediatric palliative care. Palliative & Supportive Care, 11(1), 47-67.
  3. Migrant Information Centre. (2009). Palliative Care for Culturally & Linguistically Diverse Communities. Retrieved from
  4. Broom, A., Good, P., Kirby, E., & Lwin, Z. (2013). Negotiating palliative care in the context of culturally and linguistically diverse patients. Internal Medicine Journal, 43(9), 1043-1046.
  5. Dreachslin, J., Gilbert, M., & Malone, B. (2012). Diversity and Cultural Competence in Health Care : A systems approach (1 ed.). Hoboken, NJ: Wiley.
  6. Huang, M., Yates, P., & Prior, D. (2009). Accommodating the Diverse Cultural Needs of Cancer Patients and Their Famlies in Palliative Care. Cancer Nursing, 32(1), 12-21.