Question: Mrs. W is a 78-year-old Indigenous woman from the Anishinaabe community in northern Ontario.

1. Providing culturally safe care is important in end-of-life care for Indigenous patients. As Mrs. W’s primary nurse, it is important to find appropriate resources to meet her wishes and those of her family. One resource that could be used is the National Indigenous Palliative Care Resource Kit developed by the Indigenous Health Program at the Canadian Virtual Hospice. The kit provides information on culturally safe care for Indigenous patients and families, including traditional practices and protocols for end-of-life care. Another resource is the First Nations and Inuit Home and Community Care program developed by Indigenous Services Canada. This program provides home and community care services to First Nations people living on-reserve, Inuit in certain communities, and Indigenous people living in urban areas. The program includes culturally safe care for palliative patients and their families, and can provide support and resources for healthcare providers.

References:

• Indigenous Health Program at the Canadian Virtual Hospice. (2021). National Indigenous Palliative Care Resource Kit. Retrieved from https://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Resources/National+Indigenous+Palliative+Care+Resource+Kit.aspx
• Indigenous Services Canada. (2021). First Nations and Inuit Home and Community Care. Retrieved from https://www.sac-isc.gc.ca/eng/1100100016436/1533321721202

2. There are several challenges that healthcare providers may encounter when working with Indigenous patients and their families in end-of-life care. One challenge is the lack of cultural awareness and understanding of traditional practices and protocols. Another challenge is communication barriers due to language differences or cultural differences in communication styles. Healthcare providers may also encounter resistance to Western medical practices or mistrust of healthcare providers due to a history of colonization and mistreatment.

To address these challenges, healthcare providers should prioritize building relationships with Indigenous patients and families, listening to their concerns and wishes, and working collaboratively with them to develop culturally safe care plans. Providers should also educate themselves about traditional practices and protocols for end-of-life care, and seek guidance from Indigenous elders or community members as needed. Clear communication and respect for cultural differences in communication styles is also essential.

References:

• Browne, A. J., Varcoe, C., Lavoie, J., & Smye, V. (2016). The relevance of postcolonial theoretical perspectives to research in Aboriginal health. Canadian Journal of Nursing Research, 48(2), 6-13.
• First Nations Health Authority. (2018). Cultural safety: An overview. Retrieved from https://www.fnha.ca/Documents/FNHA-Cultural-Safety-Overview.pdf

3. To improve cultural awareness among healthcare providers with regards to Indigenous end-of-life practices and culturally safe care, several steps can be taken. One key step is to include Indigenous perspectives and voices in healthcare education and training programs. This can be achieved through partnerships with Indigenous communities and organizations, and by incorporating traditional practices and protocols into healthcare curricula. Healthcare organizations should also prioritize hiring Indigenous staff and creating safe and culturally welcoming work environments.

Ongoing education and training for healthcare providers on Indigenous history, culture, and experiences is also essential. This can include mandatory cultural safety training for all staff, as well as opportunities for ongoing learning and dialogue with Indigenous communities and organizations.

References:

• Browne, A. J., Varcoe, C., & Wong, S. T. (2019). Cultural safety and the challenges of translating critically oriented knowledge in practice. Nursing Philosophy, 20(1), e12251.
• Truth and Reconciliation Commission of Canada. (2015). Truth and Reconciliation Commission of Canada: Calls to Action. Retrieved from http://www.trc.ca/assets/pdf/Calls_to_Action_English2