Let him not be alone: perspectives of older British South Asian minority ethnic patients on dying in acute hospitals

Abstract

Allowing older relatives to die in hospital seems to evoke feelings of missed filial responsibilities and guilt among family carers among older ethnic minorities. The presence of cultural paranoia and mistrust often led minorities to experience sub-standard end-of-life care in acute hospitals.

Palliative care for older South Asian migrants: A systematic review

“…The literature search revealed studies discussing both the formal (professional) and informal (family) practice of PC in the migrant families. Fourteen studies raised the concern about preferred place of death and receiving care (Chattoo and Ahmad, 2008; Coupland et al, 2011; Cowan, 2014; Khosla et al, 2016; Owens and Randhawa, 2004; Radhakrishnan et al, 2017; Randhawa and Owens, 2004; Shanmugasundaram and O'Connor, 2009; Sharma et al, 2012; Venkatasalu, 2017; Venkatasalu et al, 2014; Weerasinghe and Maddalena, 2016; Wilkinson, Waqar, et al, 2017; Worth et al, 2009). According to these studies, preference was dependent on the interplay of various factors, for example, finance (Venkatasalu et al, 2014), availability of caregivers at home (Cowan, 2014), mistrust in institutional care (Venkatasalu, 2017; Weerasinghe and Maddalena, 2016), and the opportunity to perform religious practices (Venkatasalu, 2017; Venkatasalu et al, 2014).…”

“…Home was considered the preferred place of care and death in several studies (Cowan, 2014; Doorenbos, 2003; Venkatasalu, 2017; Venkatasalu et al, 2014; Weerasinghe and Maddalena, 2016), as patients felt happier at home (Cowan, 2014). Some older migrants expressed their wish to go back to their homeland (country of birth) to die a peaceful death (Cowan, 2014).…”

“…According to relatives, family care was named as the best option to retain dignity and comfort of the patients near death (Venkatasalu, 2017). Within families, most caregivers were female (children/ daughters-in-law, and spouses of the ill patient) (Chattoo and Ahmad, 2008; Cowan, 2014; Somerville, 2001).…”

“…The need for building trusting relationships among healthcare providers (HPs) and migrant families was mentioned in ten studies (Ackroyd, 2003; Cowan, 2014; Doorenbos, 2003; Khosla et al, 2016; Khosla et al, 2017; Radhakrishnan et al, 2017; Venkatasalu, 2017; Venkatasalu et al, 2013; Wilkinson, Waqar, et al, 2017; Worth et al, 2009). Despite this, a lack of trusting relationships with migrant families and the HP were often reported (Cowan, 2014; Doorenbos, 2003; Venkatasalu, 2017).…”

“…Although, studies did show that HPs with cultural and religious sensitivity were really appreciated by migrant families (Ackroyd, 2003; Owens and Randhawa, 2004). Some studies discussed the importance of partnership among HPs, patients, families, and community (Venkatasalu, 2017; Weerasinghe and Maddalena, 2016; Worth et al, 2009), while others described the importance of an individual approach (Randhawa and Owens, 2004) to building trustworthy relationships.…”