Palliative care is person and family-centred care for a person with a life-limiting disease or health condition that has little or no prospect of cure for whom the primary goal is to optimise the quality of life. Palliative care identifies and treats the individual’s physical, emotional, spiritual and social symptoms and needs.1
Early referral, access to and uptake of high-quality palliative care services can improve quality of life for people with cancer and in some cases may be associated with survival benefits.2,3,4 Cultural safety of palliative care services is important and requires consideration of Aboriginal and Torres Strait Islander beliefs about the causes of serious illness, the cyclical concept of life–death–life, kinship and spiritual connection to traditional lands.
A lack of culturally safe palliative care services has been identified as a significant service gap for Aboriginal and Torres Strait Islander people.5
Palliative care-related hospitalisations are reported as part of the National Health Morbidity Database (NHMD). This includes hospitalisations for Aboriginal and Torres Strait Islander people.6
However, there are currently no nationally available data on utilisation by Aboriginal and Torres Strait Islander people with cancer of all types of palliative care services, such as those delivered at home. There are also no data available about the cultural safety of palliative care services accessed by Aboriginal and Torres Strait Islander people with cancer.
Cancer Australia. National Aboriginal and Torres Strait Islander Cancer Framework. Priority area 5: Ensure Aboriginal and Torres Strait Islander people affected by cancer receive optimal and culturally appropriate treatment, services, and supportive and palliative care
Cancer Australia. Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer: Step 4: Treatment; Step 5: Care after initial treatment and recovery; Step 6: Managing recurrent, residual or metastatic disease; Step 7: End-of-life care.
Palliative Care Australia. Dying to talk Aboriginal and Torres Strait Islander discussion starter.
Program of Experience in the Palliative Approach. Cultural Considerations. Providing end of life care for Aboriginal peoples and Torres Strait Islander peoples.
1. Adapted from Palliative Care Australia. What is palliative care? [Accessed 1 June 2020]
2. Haines IE. Managing patients with advanced cancer: the benefits of early referral for palliative care’, Med J Aust 2011;194(3):107–108.
3. Temel JS, Greer JA, Muzikansky A et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363(8):733–742.
4. Zimmermann C, Swami N, Krzyzanowska M et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial, Lancet 2014;383(9930):1721–1730.
5. Shahid S, Taylor EV, Cheetham S et al. Key features of palliative care service delivery to Indigenous peoples in Australia, New Zealand, Canada and the United States: a comprehensive review. BMC Palliat Care 2018;17(72). https://doi.org/10.1186/s12904-018-0325-1
6. Australian Institute of Health and Welfare. Palliative care services in Australia. Web report. Last updated 13 Sep 2019. [Accessed 1 June 2020].