(Transcript from World News Radio)
In multicultural Australia, attitudes to death and dying are many and varied.
And groups helping individuals cope with a loved one approaching death, say consideration of cultural sensitivities is of crucial importance.
Samantha Yap reports.
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Most palliative care services available in Australia are free of charge and easily accessible.
But workers in the field say not enough care is being taken in responding to differing cultural attitudes towards death.
To tackle this issue, a new project has been launched in Victoria to provide free bilingual palliative care sessions to five ethnic communities in the state.
It's a joint initiative by the state's Ethnic Communities' Council and Palliative Care Victoria
The Turkish, Vietnamese, Chinese, Italian and Maltese communities have been selected for the program.
Chairman of the Ethnic Communities' Council, Eddie Micallef, says these communities all have a large ageing population in need of culturally-sensitive palliative care services.
"Each of them has their own cultural sensitivities and yes there are some differences. Some are religious, some are cultural, some are just beliefs that have been held in the community forever that have been transferred from one country to another in a much different set of circumstances. So each of the working parties have set out a set of criteria and a set of recommendations that can be adopted by each of the communities to make them able to utilise the services in a way that is culturally sensitive."
Paul Lia is a bilingual health worker from the Maltese Community Council of Victoria.
He says the mainly Catholic Maltese community commonly face religious issues when dealing with death.
"Religion takes on a very deep and important part towards the end of life, not only for the person who has the illness but also for the family. They tend to look for consolation, guidance and assistance from the priest. It's very important that a priest be present if a person is about to die to give them their last rites."
Senior groups, care support groups and people taking care of their ageing parents attend the palliative care education sessions.
Paul Lia says helping them to avoid distressing situations often involves listening to their wishes.
"For a lot of the Maltese it's important for them to die at home. We had a person who discussed that her husband had to be taken to hospital and it wasn't his wish exactly. So the wishes of the person who was about to pass away weren't exactly met."
Chairman of Palliative Care Victoria, Michael Bramwell says it's about delivering care on a case-by-case basis.
"Even within specific cultural groups, there will be a different understanding within that group, according to your age, your position in life, your cultural heritage or maybe you've adopted a new cultural awareness. So it is almost person specific, so you wouldn't want to ever make generalisations."
Michael Bramwell says people generally have different ideas of a what is a good death and bad death.
"It's about understanding how you'd like to live the rest of your days in a satisfying, important way. And a good death in my notion is this ability about being pain free, about being surrounded by the people I care for and who love me and probably for me it would be about dying at home. Now each person has their own concept of what a good death might look like."
Mr Bramwell recalls participating in a Turkish community discussion and learning about its specific cultural needs.
"So it's about looking at, if it's a personal care and it's a orthodox Muslim man that we need to provide that care, that care is to be provided by another male. So some of those simple awareness arising on both sides of the equation."
As a volunteer palliative care worker for 30 years, Colleen Kannegiesser has cared for people from various ethnic backgrounds.
She says she's had to study different cultures to know their needs.
"For instance, a lot of cultures believe that you must take off your shoes before you enter the house. And we have an Occ[upational] health and safety issue around that, of course, and so we have to come up with ways that we could be respectful of their beliefs and yet still be safe within our ownself so we now carry little shoes that we can put on over the top of ours so that we don't offend."
Language can also be a significant barrier to providing appropriate palliative care.
Paul Lia says like many older migrants, many Maltese turn to their native language.
"As the community ages, they are tending to revert back to Maltese, when they get to certain issues especially when it comes to issues of health, issues of palliative care, death and dying. It's very difficult to understand what their needs are, what's going on."
And even after death, Colleen Kannegiesser says there are culturally different ways of dealing with the body.
"People believe that the spirit must leave the body before you can touch it after a death. Whereas in Australia we believe that you can touch a body at all times. These are different ways around that and we have to be sensitive to that after a death."