Mercy Hospice’s Cultural Care Project is helping to address the common barriers preventing families from accessing timely, culturally appropriate palliative care.

Last year, when Yin Ling Tsang finally admitted she needed palliative care for her 97-year-old father, she regretted not saying ‘yes’ sooner.

Like many Chinese, Yin Ling felt ashamed to ask for help; traditionally it is expected that family members provide the support and care.

“I kept saying ‘no’ to the help and support I was offered and finally one day I was so exhausted, I knew I had no choice but to accept some help,” says Yin Ling, whose father is under the care of Mercy Hospice.

According to University of Auckland Research Fellow Dr Rosemary Frey, stories like this are not uncommon in New Zealand, and with its increasing diverse population
there is a real need to deliver culturally appropriate palliative care for Māori, Pacific and Asian patients.

Dr Frey has conducted a study that found that there were a number of barriers affecting families to access timely culturally appropriate palliative care.

The qualitative study published in 2013: ‘Where do I go from here’? A cultural perspective on challenges to the use of hospice services’, included 37 Māori, Pacific and Asian cancer patients, family and bereaved family and 15 health professionals who either utilised hospice services or required palliative care in some other setting.

The contributing barriers included a lack of awareness in different ethnic communities of available palliative care services, continuing misconceptions about the nature of hospice services, language barriers particularly for Asian patients and their families, and having no carers of one’s own ethnicity among hospice carers.

Dr Frey says the study has opened opportunities to identify gaps and a number of training programmes have been developed, but more can be done. She says one step would be to gather more accurate information about what people need and want.

Mercy Hospice Auckland is aware of the growing need to provide a culturally responsive  service to its increasing ethnic population – 238 patients (30 per cent of all patients) in 2015 compared with 211 in 2014 (26 per cent of
all patients).

Community social worker Maree Goh at Mercy Hospice Auckland says in 2011 the hospice began a Cultural Care Project in response to the challenges being faced as a result of the increasing culturally and linguistically diverse community served by the hospice.

The project has focused on “developing systems and resources so patients and their families can receive the care they require at the end of life and providing education and mentoring to support staff so they are equipped to deliver culturally appropriate care”.

“Our cultural liaison officers have promoted hospice services [for a number of years] within their respective communities and provided cultural support and advice to patients and their families, as well as guided staff within the organisation,” says Maree. “A significant challenge is to find more suitably qualified staff and volunteers from ethnic minorities to be engaged in hospice services nationally.”

Additionally, Mercy Hospice works alongside other Auckland hospices to help bridge the gap, such as providing an information stall at the annual Pasifika Festival; developing Pasifika resources and increasing awareness of hospice services through radio interviews and public events.

Yin Ling Tsang was able to speak Cantonese with Angel Chen, Mercy Hospice’s Chinese cultural liaison officer, and says, “Knowing that she understood our Chinese cultural background and what we really needed made all the difference.”

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