Guidelines for a Palliative Approach in Residential Aged Care

include lack of information about these services, culturally inappropriate care provided, and the
lack of availability of the services in rural and remote areas where Indigenous Australians are
more likely to live than non-Indigenous Australians.
Indigenous Australians’ access to primary health care has gradually improved through the
establishment of Indigenous Australian community-controlled health organisations that are
able to offer culturally appropriate and accessible care. However, across Australia few services
are funded specifically to provide a palliative approach to Aboriginal or Torres Strait Islander
peoples [133] (Level QE). Nevertheless, there are Indigenous Australian residents and staff in
many RACFs.
10.2 PROVIDING APPROPRIATE SUPPORT
Members of the aged care team need to be proactive in their efforts to provide appropriate
support for Indigenous Australian residents and family members.
First, this requires being aware of the resident’s cultural identity, that is, whether the
resident and the resident’s family identify themselves as Aboriginal or Torres Strait Islanders.
Importantly, Indigenous Australian residents may have non-Indigenous Australian family
members. Additionally, family members of non-Indigenous Australian residents may be
Indigenous Australians.
Second, the use of Indigenous Australian aged care team members, Indigenous Australian
health workers and liaison officers are an important though often under-used resource
for consulting with the individual resident, their family and other significant cultural or
community members [133] (Level QE). Sullivan recommends initiating protocols to involve an
appropriate cultural broker (such as an Indigenous Australian health worker) in the care team,
with the resident’s and family members’ consent [133] (Level QE).
Third, RACFs will be better placed to meet the needs of Indigenous Australian residents and
family members if they establish dialogue and relationships with the local Indigenous Australian
community and particularly the relevant Aboriginal Community Controlled Health Organisation.
These groups can provide valuable referral services and advice about local cultural issues regarding
dying to ensure that Indigenous Australian residents’ and families’ total needs are met.
Finally, Eckerman and colleagues (1992) [351] (Level EO) warn about transporting simplistic
views of traditional values into rural and urban settings. Traditional Indigenous Australian
culture is far from simple. Adopting a standard view of Indigenous Australian culture and
expecting it to ‘fit’ every Indigenous Australian does not do justice to a complex culture.
Indigenous Australian populations are not, of course, homogenous. Indigenous Australians
live in a wide spectrum of ecological zones, speak several hundred languages and have varying
religious and healing practices, diets, family traditions, political structures and economic
strategies. Eckerman and colleagues take this even further with an exhortation “to be aware…
of differences within cultural groups [and] see Aboriginal people as individuals”. [351, p. 9] All
members of the aged care team should receive locally delivered cultural awareness training.
144 Guidelines for a Palliative Approach in Residential Aged Care