Many Aboriginal and Torres Strait Islander people express the wish to be cared for at home or on Country at the end of their life but there are many barriers to achieving this. One barrier to staying at home or on Country is symptom management.
New resources that support clinicians to educate the family about how to help manage symptoms at home, including giving subcutaneous medicines, can help. Local clinicians, using the resources supported and educated the family in the story above to care for the man in his chosen place achieving an outcome wished for by the man and his family.
The new resources are packaged in a Palliative Care Clinic Box and are freely available to clinical services and applicable Australia-wide. They have been tailored from the standard caring@home resources, and include family tip sheets on symptom management, step-by-step guides about giving subcutaneous medicines, short training videos, a medicine book and wall chart. There are also specific resources for health professionals and clinical services to support teaching families and carers.
Evidence from anonymous surveys of carers who were educated using the standard caring@home resources shows that it provides the necessary knowledge, skills and confidence to safely and confidently manage breakthrough symptoms using subcutaneous medicines at home. Importantly, carers would recommend that other families undertake this role if their loved one wishes to stay at home to die.
caring@home for Aboriginal and Torres Strait Islander Families is a National Palliative Care Project, funded by the Australia Government. This project is conducted by a consortium involving Australian Indigenous HealthInfoNet, Palliative Care Australia, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) and led by Brisbane South Palliative Care Collaborative.
Author: Prof. Liz Reymond MBBS (Hons), PhD, FRACGP, FAChPM; Director, caring@home for Aboriginal and Torres Strait Islander Families project.
NB: The personal story featured in this article was shared with the permission of the family involved. We thank them for their generosity in allowing its publication.
“We gave that medicine; you know the one for sickness in the gut. Sis did real well using them easy instructions and tips in the {caring@home} resources. And I'll tell you what, after days of not eating, he smelt them roo tails being smoked on the barbie and a few hours after that sick medicine kicked in, he hoovered them tails right down. He says that the roo tail, this is the cultural symbolism used for balance and strength…and the roo tail is used to defend off harm and threats. The roo tails give us direction, propulsion and speed. And I'm telling you what, we all know he can use these as he nears the Dreaming.”
Family of an Aboriginal man who had chosen to be on Country in Queensland for his end-of-life journey
“He sat by the fire with his family tonight. At three, his spirit danced in the flames, his body now at rest…Now sis, you and your team need to realise that when you look at these things in your country, these beautiful elements, the stars, the skies and the waterways…the beauty of the lands, this will be your forever thank you, because you guys ensured that his spirit got to rest in the definition of his own peace.”