Sixth National Conference on Quality Health Care for Culturally Diverse Populations:

D-4 Integrating cultural sensitivity into palliative and end of life care

Integrating cultural sensitivity into palliative and end of life care


Culture and spirituality have the greatest significance at two important events in the life cycle: birth and death.  Attending to culture and spirituality in palliative and end-of-life care requires an understanding and awareness of the care providers’ culture and beliefs, as well as those of the patient and their family. While the experience of death is common to all human beings, it is also a uniquely individual process.  In addition, it has significant collective dimensions.   


Clear communications between providers, patients, families and surrogates are essential to decision-making, establishing goals of care and pain and symptom management.  These communications are always challenging.  Caring for patients across cultures requires additional capacity in the areas of cultural sensitivity, awareness, knowledge and competency.


Who needs to be included in decision-making?  Who is the family spokesperson?  How much information does the patient desire?  Is a direct or indirect style of communications preferred?  How is cultural mistrust addressed?  Knowledge regarding the specific practices/beliefs related to care at time of death and immediately following are crucial for care providers.  How does a provider acquire that information in a setting with limited time constraints and intra-cultural variation?


Respect for and attentiveness to others, careful listening (both verbal and non-verbal), awareness of issues of privilege and the power differential between providers, patients and their families along with use of language that recognizes health literacy concerns are all essential.  The culture of medicine primarily employs low context communications; end-of-life communications for patients and families are always high context communications.  How is this gap bridged with the additional overlay of variation in culture and beliefs?


What are the additional challenges when the patient is a child?  When the patient is deaf?


The members of this panel bring their expertise, stories, research and passion around these issues to share with their audience. Participants will have the opportunity to hear panel members speak to these issues as well as the chance to discuss applications of these principles to their own settings.
Wednesday, September 24, 2008: 8:30 AM - 10:30 AM
4th Floor - Pine/Cedar/Birch (Minneapolis Marriott City Center)
Child & Women's Health Diversity Program, Calgary Health Region
Linda Kongnetiman, MSW, RSW, Calgary Health Region
University of Minnesota
John Song, MD, MPH, University of Minnesota
The Deaf Hospice Education & Volunteer Project (DHEP)
Nancy J. Meyers, MS, Health Education & Access Initiative: Minnesota Deaf Community
Serving the World
Lauren Shaiova, MD, Metropolitan Hospital Center
Cross Cultural Care at the End of Life
Elaine J. Yuen, PhD, MBA, Thomas Jefferson University