How is palliative care delivered for older Chinese people in Australia?

Palliative care has developed as a specialised health care field in Australia since the 1980s and has been part of a worldwide movement to address the needs of people who are dying and their families. While in recent years a number of research projects have contributed to the body of knowledge about palliative care provision in Australia, there is little application of these studies to the particular needs of Chinese immigrants. Despite Chinese people having become one of the largest ethnics groups in Australia, with many having lived here for generations, they still value their culture and traditions. These Chinese migrants have adopted Australia as their home; however, particularly in times of crisis, culture and tradition remain an important framework for their lives. Taoism, Confucianism, and Buddhism are the main three philosophies or religions in Chinese culture and Chinese beliefs about death and dying are heavily influenced by a mixture of beliefs related to these three philosophies and religions. To understand Chinese clients’ needs from palliative care services in Australia, the researcher, with her Chinese cultural background, undertook the investigation in Melbourne, within a Chinese cancer support group. The study pioneered a view of Chinese people’s experiences of the end-of-life. This research has demonstrated that Chinese traditional rituals have been heavily relied upon by Chinese-Australians facing the end of their life, or their family member. The research has also highlighted however, that western healthcare systems and health professionals often lack the cultural sensitivity to understand the significance of these traditional practices and so fail to provide appropriate care. In addition, linguistic barriers have been highlighted as a major inhibiting factor in the lack of understanding of the palliative care services available and in connecting to them. Three main themes emerged from the case study approach culture and traditions; perception of care; and communication issues. The results showed that Chinese people have unique requirements at the end of life and from palliative care services. The findings suggested that Chinese participants required concomitant care with integrating Western medicine and their traditional beliefs; to continue their traditional relationships with the dying relative, even in institutional care; and adequate communication with western health professionals. There were limitations in undertaking the research, most particularly the difficulties of recruiting Chinese participants as well as the lack of a health professional voice in the study; the latter being an area of possible further research. The recommendations were the cultural sensitisation of western health professionals about the needs of Chinese people; more ready availability of interpreters; and encouraging continuing Chinese efforts in representing their traditional needs within western health care systems.