End-of-Life Essentials: Care for Diverse Communities

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A blog post written by Deb Rawlings, Co-Investigator, End-of-Life Essentials project

Most people will visit hospital in their last year of life, and many will die there. In fact, people in high/middle income countries including Australia, are more often likely to die in hospital. [1,2] End-of-Life Essentials (EOLE) [3] provides education modules and resources (based on the work of the Australian Commission on Safety and quality in Health Care), [4] designed to help health care professionals working in acute hospitals to deliver good quality end-of-life care.

EOLE have released a new education module called ‘End-of-Life Care for Diverse Communities’. This module celebrates diversity while recognising that inequity and adversity face many people when accessing health care, including end-of-life care. The module addresses many of the common issues that health care professionals must consider to enable quality care for all patients and those who are important to them.

There are many people who face discrimination, whether racial, religious, cultural or because of their sexuality/gender identity, or their mental health. They may have received suboptimal care in the past requiring trust to be built and barriers to be reduced for care delivery now and in the future.

Within the module the following concepts are covered:

• Intersectionality – someone may be LGBTIQ+ as well as Culturally and Linguistically Diverse.
• Power and privilege – many people have been questioned or felt marginalised due to their race, gender, or mental health while others never have.
• Barriers to inclusive care – recognising and reflecting on what these are.
• Building trust / addressing assumptions / stereotyping.
• Building inclusive environments and practice – thinking about your organisation.
• Empowering yourself as a care provider – thinking about your practice and your attitude and increasing confidence in helping to meet the needs of those who are part of diverse communities.

This module includes three case study exemplars which have been included to help health care professionals consider how to strengthen their practice around inclusive care.

In summary, this EOLE module recognises the inequity in access to care for some individuals who may not have formed trusting relationships within health care in the past. The messages to health care professional learners are to put aside your assumptions, to acknowledge that not all people are the same (even those who are assumed to be because of a shared culture or sexuality), that there is work to be done within your organisation to foster good quality care and within yourselves to be inclusive, open-minded, and respectful.

This new module will join the suite of EOLE modules currently available, many of which have been evaluated and published, [5-7] and which we know can improve learners’ knowledge, skills, attitude, and confidence in providing end-of-life care in hospitals.

References

1. Sallnow L, Smith R, Ahmedzai SH, Bhadelia A, Chamberlain C, Cong Y, et al. Report of the Lancet Commission on the Value of Death: Bringing death back into life. Lancet. 2022;Jan 31:S0140-6736(0121)02314-X. doi: 10.1016/S0140-6736(21)02314.
2. Swerissen H, Duckett S. Dying Well; Grattan Institute: Melbourne, Australia, 2014.
3. End of Life Essentials https://www.endoflifeessentials.com.au/tabid/5126/Default.aspx
4. Australian Commission on Safety and Quality in Health Care. National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care; ACSQHC: Sydney, Australia, 2015. https://www.safetyandquality.gov.au/publications-and-resources/resource-library/national-consensus-statement-essential-elements-safe-and-high-quality-end-life-care
5. Rawlings D, Winsall M, Yin H, Devery K. How hospital staff say goodbye to dying patients – Evaluation of an online education module: Imminent Death. Australian Nursing and Midwifery Journal. Online 4^th March, 2022 https://anmj.org.au/in-practice/
6. Rawlings D, Winsall M, Yin H, Devery K. What is a compassionate response in the emergency department? Learner evaluation of an End‐of‐Life Essentials online education module. Emergency Medicine Australasia, 2021. http://dx.doi.org/10.1111/1742-6723.13776
7. Rawlings D, Winsall M, Yin H, Devery K, Morgan DD. Evaluation of an End-of-Life Essentials Online Education Module on Chronic Complex Illness End-of-Life Care. Healthcare (Basel), 2020. 8(3): p. 297. https://www.mdpi.com/2227-9032/8/3/297.

 

 

Deb Rawlings, Co-Investigator, End-of-Life Essentials project