Culturally Sensitive Palliative Care Part I: Self-Reflection Amy Wilson, RN, BSN, CHPN Marquette General Home Health and Hospice Escanaba, MI
Geriatric Education Center of Michigan activities are supported by a grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Public Health Service Act, Title VII, Section 753(a).
Learning Objectives 1. Define culturally sensitive palliative care. 2. Describe how health care provider s personal knowledge and attitudes impact the approach to culturally sensitive care. 3. List the critical elements important in palliative care. 4. Identify strategies for collaboration and consultation in promoting improved end-of-life care. 5. Recognize the importance of assessing and supporting caregivers.
Culturally Sensitive Palliative Care is The care of a person who is living with a progressive, far-advanced disease for whom the focus of care is comfort and sustained quality of life
Palliative Care Person-oriented not disease oriented Not primarily concerned with life prolongation (nor with life shortening) Not primarily concerned with producing long-term disease remission Holistic in approach and aims to address all the client s problems, both physical and psychosocial
Palliative Care Multidisciplinary/interprofessional in its approach to cover all aspects of care Dedicated to the quality of whatever life remains for a person Not limited to just people living with cancer
Culturally Sensitive Palliative Care includes an awareness of a person s culture The customary beliefs, social forms, and material traits of a racial, religious or social group The characteristics of everyday existence (a way of life) shared by people in a place or time
Culturally Sensitive Palliative Care realizes that culture is Influenced by technology & resources Generally unexpressed and rarely discussed at a conscious level Influenced by the role changes of women Handed down from one generation to another within their value/beliefs systems
Culturally Sensitive Palliative Care realizes that culture is Learned from birth through language and socialization Dynamic and always in a state of change Adopts in an ongoing way to the environment, social and historical context
Culturally Sensitive Palliative Care is also mindful that, for a person s well-being, Culture, spirituality and health are inextricably intertwined Culture, spirituality and health are not separate components
Culturally Sensitive Palliative Care is also mindful that, for a person s well-being, (cont.) ***Special Note: All people of particular culture do not agree to a common cultural pattern of responses. Cultures do change over time.
Critical elements of Cultural Sensitivity in Palliative Care Listen and watch for: A person s personal preference: cultural, spiritual, religious Body language and other non-verbal communication Avoid assumptions about those I serve and ask them about their culture/traditions
Critical elements of Cultural Sensitivity in Palliative Care Listen for and: Provide culturally appropriate health promotion materials Understand the kinship web including family members and extended members in the circle of care Avoid cultural ignorance and hurtful actions
Elements of Collaboration and Consultation in Promoting End-of-Life Care Be mindful that end-of-life care needs to be Respectful Culturally sensitive Holistic to the whole unit of care Physical Emotional Mental Spiritual Social
Assessment and Support for the Caregivers needs to be ongoing needs to be holistic to the whole UNIT OF CARE [physical, emotional, mental, spiritual, social]
Appraise Individual/Personal Knowledge As Health Care Professionals: Be aware of and accepting of cultural differences Have self-awareness of my own culture/traditions Seek to learn and to understand another s culture
My knowledge and attitude will impact my approach to culturally sensitive care Spirituality vs. Religion
References & Resources Alzheimer s Association (2007). Alzheimer s Association Campaign for Quality Residential Care: Dementia care practice recommendations for assisted living residence and nursing homes. Phase 3 end-of-life care. Retrieved from https://insite.alz.org/downloads/programs/professionaltraining/dementia/care/practice/recommendations-phase-3.pdf Barnato, A.E., Anthony, D.L. Skinner, J., P.M., Fisher, E.S. (2009) Racial and ethnic differences in preferences for end-of-life treatment, Journal of General Internal Medicine, 24, 695-701. Betancourt, J.R. (2006). Cultural competence and medical education: Many names, many perspectives, one goal. Academic Medicine, 81, 499-501.
References & Resources Ming-Chen, M.L. (2010) Cultural brokerage: Creating linkages between voices of life, world and medicine in cross-cultural clinical settings. Health, 14, 484-504. Perloff, R.M. Bonder, B., Ray, E.B., Siminoff, L.A., (2006), Doctor-patient communication, cultural competence, and minority health: Theoretical and empirical perspectives. American Behavioral Scientist, 49, 855-852.