Improving the quality of palliative care

Author(s): Yasmin Gunaratnam;  

Briefing series: Better Health Briefing Paper 1

Publisher: Race Equality Foundation

Publication date: January 2007

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Improving the quality of palliative care
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There has been growing concern in recent years about the accessibility and the responsiveness of palliative care to the needs of minority ethnic groups. Perceived cultural barriers both from patients and health professionals may prevent provision of and access to appropriate services, whilst the differing patterns of disease in minority ethnic groups has meant that palliative care needs may not be met by existing 'cancer-focused' services.

Key messages:

  • Palliative care is mainly used by people with cancer. Cancer rates are relatively lower for most minority ethnic groups. The differing patterns of disease in minority ethnic groups has meant that the palliative care needs of those with non-cancer diseases have not been met
  • Access to palliative care can be restricted by a lack of understanding amongst professionals about appropriate referral criteria
  • Although palliative care can be given throughout an illness, use of palliative care services can be adversely affected by misunderstanding or fears about death and dying
  • People with life-limiting illnesses who do not speak the dominant language (English/Welsh) face significant difficulties in communicating with professionals
  • End-of-life decision making is assuming greater relevance with technological and legal developments. The focus in palliative care upon individual autonomy in end-of-life decision making can be problematic for patients and carers from different ethnic and cultural groups
  • Palliative care- related policy and research has emphasised the need for professionals to have training in cultural awareness/competency to enhance equity. However, there are no national standards for the training of palliative care professionals in transcultural care.

Sections:

  • Differing disease patterns can lead to unmet needs and inequity in access
  • There is need for appropriate referral criteria
  • Fears about death and dying can restrict access to palliative care
  • Not speaking the dominant language can put people at a disadvantage
  • A focus on individual autonomy in end-of-life decision making can be problematic
  • National transcultural care training and standards are needed