Overcoming cultural difference in end-of-life planning

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New research from Advance Care Planning Australia has highlighted how cultural background affects our attitudes and behaviours to advance care planning.

Advance care planning (ACP) gives people control over the care they receive if they become too unwell to speak for themselves, and invariably involves planning end-of-life care – a topic considered discomforting in some cultures.

The study found that people born overseas were less likely to complete an Advance Care Directive (ACD) when compared to those born is Australia (22% versus 29%).

However they were more likely to have an advance care plan documented for them by a health professional or family member, than Australia-born people (46% versus 35%).

The findings are a result of a robust ACD prevalence study examining the health records of more than 4000 people aged 65 plus across Australian hospitals, GP clinics and aged care services.

The study also found that English language proficiency was an important predictor of completing an ACD.

“The study provides important new evidence for healthcare professionals working with culturally and linguistically diverse communities.

“While there is diversity within all cultures, a focus on autonomy and self-determination may have less resonance with certain cultural backgrounds that place stronger value on the involvement of extended family in making life decisions,” says Dr Craig Sinclair, lead study author and research fellow at the Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR) and UNSW Ageing Futures Institute.

Mary Patetsos, Chair of the Federation of Ethnic Communities Councils of Australia (FECCA), has welcomed the new study.

“The key take-out for healthcare professionals is that culture matters and wherever possible they should tailor their ACP approach to the preferred decision-making style of patients and families, rather than narrowly focussing on completion of ACD forms,” says Dr Sinclair.

Advance Care Planning Australia offers resources translated into 16 languages on its website.