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The following article presents findings from a study conducted in the Northern Territory of Australia that explores Indigenous peoples' understanding of the Western notion of palliative care and hospice. The findings provide practical insights into the problems occurring at the interface of Western palliative care and traditional Indigenous care of the dying. In so doing, the findings can inform the development of service provision for all involved in end-of-life care for Aboriginal people. If palliative care is to be introduced to Aboriginal people, it is imperative that it be done in a culturally appropriate way. [ABSTRACT FROM AUTHOR]

The following discussion presents findings from a National Health and Medical Research Council (NHMRC) study that documents the importance to Indigenous people of including the network of extended family and community in health care communication. In particular the discussion explores the data relating to the importance of communicating through family meetings with Aboriginal people during end-of-life care. The data was collected through a series of open-ended, qualitative interviews (n=72) conducted with a cross-section of members of the Aboriginal community and health professionals within the Northern Territory, Australia. Acknowledging Aboriginal peoples' relationship rules and communicating through family meetings are practices that demonstrate respect for Indigenous cultural processes of information sharing. Anger on the part of Aboriginal people about lack of information can be the outcome when such processes are ignored or not understood. Respecting the need to ‘share the story’ broadly with appropriate people in the extended family and community network through family meetings is noted as vitally important in health care, especially during the dying trajectory. The discussion explores the practical issues associated with, the different reasons for, and the positive outcomes from, incorporating family meetings for Indigenous people along the illness trajectory. [ABSTRACT FROM AUTHOR]

Whilst access to respite care has been found to represent an important source of support for terminally ill patients and their families, the availability of these services to Indigenous Australians has to date remained undocumented. This potential need for respite in Indigenous communities was explored as part of a National Health and Medical Research Council (NH&MRC) funded study designed to develop an innovative model for Indigenous palliative care. The data needed for model development were collected through a series of open-ended, qualitative interviews conducted with a cross-section of consumers and health professionals within the Northern Territory, Australia. The findings reflected a serious need for Indigenous respite services, coupled with a severe deficiency in the present availability of these services, especially within rural and regional areas. This lack of local respite services was documented to be negatively impacting upon the ability of carers to fulfil their caring duties and was found placing undue physical, emotional and economic stress upon carers, patients and their families. Furthermore, the lack of access to local respite services documented was found to be forcing rural and regional patients to relocate to metropolitan areas away from the family, community and land to which strong ties are held. The lack of Indigenous respite services was also found to obstruct patients’ and carers’ wishes for death to occur in the local community, rather than in far away cities. Significant obstacles were found to be hindering the provision of respite care to Indigenous Australians, namely beliefs about families looking after their own, resource restrictions, limited staff availability in local areas, as well as problems associated with hostel use in metropolitan areas. The conclusions drawn from this study suggest the importance of tackling the obstacles preventing local respite services being established in areas close to where patients and carers live. [ABSTRACT FROM AUTHOR]