The Experience of Punjabi Indians with Palliative Care at Residential Aged Care Facilities: A Regional Perspective

Abstract

<p>This research project deals with the important topic of palliative care services in regional New South Wales (NSW), Australia. There is an increasing emphasis on meeting the healthcare needs of culturally and linguistically diverse (CALD) communities in Australia. Negotiating the point of culturally appropriate care and the transition to palliative care requires effective communication and sensitivity to socio-cultural, religious, spiritual and linguistic needs. This can be a challenging process for clinicians, patients, and families.</p> <p>Employing Leininger’s Trans-Cultural Theory, Engel’s biopsychosocial model and Fricker’s concept of “epistemic injustice” in context with healthcare for marginalised migrant groups, this exploratory empirical case study was undertaken in three towns of the Riverina region of NSW (Wagga Wagga, Griffith, and Albury). A burgeoning population group of Punjabi Indians residing in the Riverina region was chosen for this study. Group interviews were conducted with six locally based Punjabi Indian families that had experienced care services at their local residential aged care services. To complement and provide a more comprehensive picture, group interviews were also conducted with care staff (nurses and personal care assistants) of residential aged care facilities (RACFs) in the same towns.</p> <p>In line with the exploratory nature of this research, a qualitative approach was adopted utilising an interpretive phenomenological methodology in the design, implementation and presentation of findings of the research. The informants in the research were selected through a non-random, purposeful selection process. Thematic analysis was used to determine the major findings of this study.</p> <p>The study identified barriers to appropriate and equitable palliative care and services for regionally based Punjabi Indians, with important implications for the wider CALD population. The study argues that the dominant medical knowledge base in context to palliative care services does not adequately account for experiences of the CALD population. To build a stronger foundation for the quality of culturally appropriate care, the palliative care sector must undertake fundamental change. Central to this reenvisioned approach is respect for cultural and religious practices that one is required to follow at end of life. The study proposes strategies to strengthen palliative care delivery models in regional areas of NSW by providing insight from consumers’ and care providers’ perspectives on processes that continue to be recommended in state and national policies as best-practice palliative care for people from diverse backgrounds. The study recommends a human rights framework where stronger ethics of care and cultural respect is demonstrated through the palliative care service delivery model. </p>