NUR272 Palliative, Rehabilitation and Continuing Care

Introduction

Palliative care is considered to be one of the most important as well as the medical care option which is opted for the patients who are suffering from life taking diseases or have very less hope for survival (Radbruch et al., 2020). The care given at the end of the life is known as the palliative care. It aims to improve the quality of life being lived by the patients and also encourages the family for supporting the requirements of the patient together with releasing the family burden as well (Arya et al., 2020). The section of people considered for this essay is the Indigenous population who are as it is deprived of the fundamentals in Australia because of discrimination and therefore, access to care concerned with the palliative care requirements are more far for them. The paper will discuss about the resistances faced by the Indigenous population of Australia with respect to the access of the palliative care.

Search Strategy

The evidences for the concerned topic required research and the research strategy revolved around the finding of the evidences for the difficulties in access to the care for the patients who are critically ill with life-threatening diseases. The research was condutedby the use of different key words from different databases which include PubMed as well as Cochrane library. Google scholar was also searched for the relevant papers. The key terms used for the research included “Indigenous”, “rural Australia”, “palliative care”, “inaccessibility of palliative care”, “end-of-life conditions and care”, “lack of education”. The appropriate papers which were chosen were the ones which were published after 2015. The use of the Boolean terms was also done such as “AND”, “OR” to get more f the focused results in the databases. The lists of the papers are included in the table below with the issues addressed in each of them.

Discussion 

Discussion include 4 paragraph, 100 words in first paragraph and 300 word each in all 3 three issues and it should relate to the article.

Every year 40 million of the population is found to have the need for the palliative care. Amongst the data given by the World Health Organization, 78% of the 40 million patients are found to be the residents of the low- as well as middle-income nations (WHO, 2021). Only about 14% of the suffering patient is found to receive the palliative care properly form the huge numbers (WHO, 2021).  Current paper has included ten research articles on the concerned topic after thorough research and the issues of the main themes were identified amongst them. The research article displayed three main themes which include lack of access for the palliative care services, lack of patient and family education or the lack of knowledge as well as the economic factors which revolves around the affordability of the care being provided.

90 % of the this here is unnecessary. We need to write 3 separate paragaraph of each issues and relate that to article and what are the straterigies they have use to tracle that issues if the got some.

Difficulty In Access Of Care   

This cannot be issues as the issues is what are the issues that make it diificulttpacess palliative care?

There are seven papers which have been identified with the major issue for the Aboriginal people being the difficulties in access of the palliative care. The importance of the palliative care has been found to be associated with the rate of death in the Aboriginal region of Australia. It was found that both the genders of the population are equally suffering from the lack of the palliative care. Due to the reason identified there has been a great increase in the medical conditions of the Indigenous population. The studies have been identified that the elderly population is in urgent need of the systematic care with respect to the end-of-life situation and there are situations where proper care can improve the quality of life for the patient as well as the family also (Spelton et al., 2019). Palliative care is found to be associated with the improvements of the quality of the life of the patients as well as the families of the patients which are found to be facing challenges with the condition of their patients. It has been found that the Indigenous people prefer to die near their home and wants family involvement during their end times which restricts the uptake of the palliative care services (Shahid et al., 2018). It has been already established that the population is in more vulnerable position from long before and lack of space has lead to the spread of different type of communicable diseases in large scale amongst the Indigenous population of Australia together with the inaccessibility of the palliative care for the elderly adds on to the burden of the disease for the patient because communicable diseases infects more to the low immunity person (Rowe et al., 2019). The models which are attempted to close the gap are community engagement as well as ownership, flexibility in the approach and positive engagement towards the Indigenous population (Shahid et al., 2018). The recommendations provided in the papers are the use of the online platform for the care taking of the patient and devising an accessibility plan (Whitehall, Lee & O’Connor, 2016).

Lack Of Knowledge

The people of the Aboriginal origin are not very much inclined towards the incorporation of education in their lives. They are known to be as the culturally as well as linguistically diverse population. The community has their own Indigenous language and they do not prefer to know other or the most acceptable language English to be used. This issue has been prevalent in their society from a very long time and has made the situation difficult for the healthcare workers to provide proper knowledge to them because of the lack of the communicational factors as well (Wark et al., 2019). Lack of knowledge and its reason being the communicational aspect can be contributed to the inaccessibility of the palliative care. There is a major issue with the concept of the palliative care in the Indigenous population because of the low level of education. The Indigenous population are also one of these who live in remote areas and due to the lack of space and many street dwellers, it has been found that they are more vulnerable to the catch of any type of disease when compared with the non-indigenous population of Australia and this constitutes one of the indirect reason for the lack of knowledge. Limited money, no education, no job and therefore, lack of education. There are four papers which have identified the problem of communication with respect to the lack of knowledge prevalence in the Aboriginal population and the rest has identified the reason for the lack of knowledge attributed to the lower level of education or illiteracy (Butler et al., 2019).

Economic Factors

The above discussed issues can be attributed to the limited means of the resources as the Aboriginal society has been facing discrimination which leads to the lower level of education or no education for the children and therefore, less understanding of the palliative healthcare services available for the population (Shahid et al., 2018). There are seven papers in the list which has identified the economic factor as one of the major issues underlying the concept of inaccessibility of the palliative care for the Indigenous population. This restricts the population for adopting the healthcare services available for the palliative time of the patient (Williams et al., 2019). The stat also includes the population residing in the remote areas who in turn faces the different type of challenges for accessing the palliative care Patients are found to be suffering from the life risking diseases and for them it has become utmost important to have a plan so as to live in a moderate condition so that the life is eased a bit. The diseases can be of different aspects which include physical disability, social, spiritual or even psychological also and thus the demand for the different types of medical treatment requires a lot of money which is not affordable by Indigenous population. The quality of the life of the care givers are also found to be improved when associated with such patients (Kirkpatrick, Cantrell & Smeltzer, 2017).They constitute a large part of the population but the discrimination prevalent in the society has made them hesitant to seek the help. The discrimination has been observed on all the levels of the life which includes education, job, marriage, societal affairs, healthcare as well as upbringing of the child (Shirodkar, 2019). All these make them confined to their own place and thus, sufferings are more high with respect to the access of the health care services and thus adds up to the loss of life at a great rate.

Conclusion

From the above discussion it can be concluded that there is a huge requirement of the proper form of the palliative care for the Aboriginal people in Australia. The main issues or the theme identified are the inaccessibility to the care, lack of knowledge and the economic factors. The gaps in the services for the Indigenous people are required to be closed and treat them equally. The government is required to look in the matter with the major issues to be solved on top priority. Awareness program will be able to help the concerned population.

Reference

Arya, A., Buchman, S., Gagnon, B., &Downar, J. (2020). Pandemic palliative care: beyond ventilators and saving lives. Cmaj, 192(15), E400-E404. DOI: https://doi.org/10.1503/cmaj.200465

Bakitas, M. A., Elk, R., Astin, M., Ceronsky, L., Clifford, K. N., Dionne-Odom, J. N., ... & Smith, T. (2015). Systematic review of palliative care in the rural setting. Cancer Control, 22(4), 450-464. https://doi.org/10.1177/107327481502200411

Bindley, K., Lewis, J., Travaglia, J., & DiGiacomo, M. (2021). Social welfare needs of bereaved Australian carers: Implications of insights from palliative care and welfare workers. Health & Social Care in the Community, 29(3), 631-642. https://doi.org/10.1111/hsc.13339

 

Butler, T. L., Anderson, K., Garvey, G., Cunningham, J., Ratcliffe, J., Tong, A., ... & Howard, K. (2019). Aboriginal and Torres Strait Islander people's domains of wellbeing: A comprehensive literature review. Social science & medicine, 233, 138-157. https://doi.org/10.1016/j.socscimed.2019.06.004

Ding, J., Saunders, C., Cook, A., & Johnson, C. E. (2019). End-of-life care in rural general practice: how best to support commitment and meet challenges?. BMC palliative care, 18(1), 1-10.https://doi.org/10.1186/s12904-019-0435-4

Herrmann, A., Carey, M. L., Zucca, A. C., Boyd, L. A., & Roberts, B. J. (2019). Australian GPs’ perceptions of barriers and enablers to best practice palliative care: a qualitative study. BMC palliative care, 18(1), 1-14. https://doi.org/10.1186/s12904-019-0478-6

Kirkpatrick, A. J., Cantrell, M. A., & Smeltzer, S. C. (2017). A concept analysis of palliative care nursing. Advances in Nursing Science, 40(4), 356-369.  https://doi.org/10.1097/ANS.0000000000000187

LoGiudice, D. (2016). The health of older Aboriginal and Torres Strait Islander peoples. Australasian Journal on Ageing, 35(2), 82-85. https://doi.org/10.1111/ajag.12332

Radbruch, L., De Lima, L., Knaul, F., Wenk, R., Ali, Z., Bhatnaghar, S., ... & Pastrana, T. (2020). Redefining palliative Care—A new consensus-based definition. Journal of pain and symptom management, 60(4), 754-764. https://doi.org/10.1016/j.jpainsymman.2020.04.027

Rowe, S. L., Stephens, N., Cowie, B. C., Nolan, T., Leder, K., & Cheng, A. C. (2019). Use of data linkage to improve communicable disease surveillance and control in Australia: existing practices, barriers and enablers. Australian and New Zealand journal of public health, 43(1), 33-40. https://doi.org/10.1111/1753-6405.12846

Shahid, S., Taylor, E. V., Cheetham, S., Woods, J. A., Aoun, S. M., & Thompson, S. C. (2018). Key features of palliative care service delivery to Indigenous peoples in Australia, New Zealand, Canada and the United States: a comprehensive review. BMC palliative care, 17(1), 1-20. https://doi.org/10.1186/s12904-018-0325-1

Shirodkar, S. (2019). Bias against Indigenous Australians: Implicit association test results for Australia. Journal of Australian Indigenous Issues, 22(3-4), 3-34. https://search.informit.org/doi/abs/10.3316/informit.150032703197478

Spelten, E., Timmis, J., Heald, S., &Duijts, S. F. (2019). Rural palliative care to support dying at home can be realised; experiences of family members and nurses with a new model of care. Australian Journal of Rural Health, 27(4), 336-343.  https://doi.org/10.1111/ajr.12518

van Gaans, D., & Dent, E. (2018). Issues of accessibility to health services by older Australians: a review. Public health reviews, 39(1), 1-16. https://doi.org/10.1186/s40985-018-0097-4

Wark, S., Hussain, R., Muller, A., & Parmenter, T. (2019). Barriers and impediments to providing end-of-life care in rural Australia. The journey to a good life: Taking control. https://hdl.handle.net/1959.11/28655

Whittall, D., Lee, S., & O'Connor, M. (2016). Factors affecting rural volunteering in palliative care–an integrated review. Australian Journal of Rural Health, 24(6), 350-356. https://doi.org/10.1111/ajr.12313

WHO. (2021). Palliative Care. Who.int. Retrieved 23 June 2021, from https://www.who.int/news-room/fact-sheets/detail/palliative-care.

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