‘Death is difficult in any language’: A qualitative study of palliative care professionals’ experiences when providing end-of-life care to patients from culturally and linguistically diverse backgrounds

Abstract

Underlying provider perceptions of caring for patients was that death is difficult in any language. Care was conceptualised as considering cultural and linguistic backgrounds within individualistic care. Understanding the migration experience and building trust were key elements of this individualised approach. Acknowledgement of the key role played by families in patient care and safety are strategies to minimise barriers and understand the concerns of this patient group.

Palliative care in its own discourse: a focused ethnography of professional messaging in palliative care

“…The message of "You matter: we see you as a person", is in line with previous studies that recognize the importance of knowing the person in an authentic way, which allows the team to assist the patient and family better and perform clinical tasks [31,32]. Observed professionals did so through active listening, acceptance and dedication towards the patient, adopting strategies to approach the patient and their family to create and maintain a personalized therapeutic relationship [19,33,34].…”

Perceived Barriers to Discussing End of Life Care Planning

“…A qualitative study by Green, Jerzmanowskam, Green, and Lobb (2018) structures, religious characteristics, and quality of life views. Green et al (2018) illustrated that respect for patient preferences and views is one of the major ethical principles supporting current palliative care in Western countries. Other important obstacles noted were communication, patient health literacy, and language which were identified as significant barriers to effective EOL care discussions and plans of care (Green et al, 2018).…”

“…Approaches to pain management were also reported as a significant challenge for providers where stoicism could play a role in treating a patient with strong opinions about use of opioids and taboo discussions about death (Green et al, 2018). Preferences for care in the home setting, place of death, and use of complementary medicine during the EOL process were other areas of conflict among providers and patient/family's (Green et al, 2018).…”

“…Approaches to pain management were also reported as a significant challenge for providers where stoicism could play a role in treating a patient with strong opinions about use of opioids and taboo discussions about death (Green et al, 2018). Preferences for care in the home setting, place of death, and use of complementary medicine during the EOL process were other areas of conflict among providers and patient/family's (Green et al, 2018). A predominant theme regarding provider experience caring for patients from CALD backgrounds was that death is difficult in any language, and concerns about approaching EOL was universal for all people (Green et al, 2018).…”

“…Preferences for care in the home setting, place of death, and use of complementary medicine during the EOL process were other areas of conflict among providers and patient/family's (Green et al, 2018). A predominant theme regarding provider experience caring for patients from CALD backgrounds was that death is difficult in any language, and concerns about approaching EOL was universal for all people (Green et al, 2018). Six key sub-themes emerged from the focus group results: determining the rules of engagement of diagnosis and prognosis; navigating the challenge of language to patient understanding;…”