Add cultural component in palliative care

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At the Prince George Civic Centre on Oct. 7 and 8, more than 200 health professionals and volunteers from northern British Columbia gathered to learn about palliative care. The conference sponsored by Northern Health touched on such topics as Building Teams to Support Palliative Caregivers; How to best Deal With Death and Dying in Hospitals; and Better Communication Among Teams of Care Givers.

Sarah Hein, Carrier-Sekani Family Services' Home Care Co-ordinator attended the conference along with two other home care workers. She said they got a lot of excellent material and information about palliative care and that the Northern Health Authority put on a really good conference based on its theme of Communication, Caring and Community. She said that it was done professionally, but it would have been more beneficial if the conference had added a cultural component to it. For example, a workshop on how Aboriginal people deal with dying and saying goodbye to their loved ones.

The knowledge they acquired was unique and specific to people who are in their end stages of life, said Hein, but she added, "I'm not being negative, but I want to emphasize there is a lack of cultural emphasis in the hospitals, such as cultural norms and Aboriginal culture. I'm not saying that just Aboriginal people have different protocols, but other ethnic groups have them as well, and we do have a heavy population of First Nations people in this area-particularly of the Carrier Sekani territory," she said.

Hein also believes that First Nations should have a palliative care program or team that would teach First Nations protocols. She said that palliative care is presently available on the reserves, but reacts to need only when it arises, and is based on a one-on-one home care setting.

"Under the Carrier-Sekani Family Services, we service health care needs for 10 communities in this area, and there are 10 bands with each band having their own chief and CHRs.

"We have our own cultural beliefs we call a clan system, and within our territory the clan system is extremely important to each person and the community, especially during the end stages of life. The clans show support to the family members and their friends in the community. We also have our own spirituality, which is really strong within our own culture. We have our own do's and don'ts when someone dies in our community." she said.

"For example, a lot of the mainstream health workers do not understand why a whole group of Aboriginal people gather in the room when a community member is dying, and that is where our cultural differences come in. A lot of Aboriginal people come from large families and that is how we show support. This is why I truly, truly believe that all hospitals should have a cultural room where we can gather when someone is dying. When I was working in the hospital I used to instruct the nurses of the importance and the values of our beliefs, that this is the way we give support to the family and friends, that this is the way the clan system works," she said.

Hein believes that mainstream society needs to be educated on how Aboriginal people deal with death.

"Another example is hair being really important to the Elders. To them it is really, really sacred at the end stages of their lives that not just anyone touch their hair. Usually they give permission of who can touch or braid their hair during their final hour. A lot of our people have no choice; they sometimes die in the hospitals, and a lot of time the health care professionals do not know how to respond to Aboriginal people and their culture. They just treat everyone the same, but ... we are different," she said.

"This conference is going to be held every two years, and it will interesting if we can have a cultural component in the next one. For example, maybe one of our First Nations' group can do a presentation specifically to Palliative Care for First Nations and Aboriginal people, such as bringing inour cultural norms and explaining them," Sarah Hein said.

Hein has been in the health profession since 1966. She started out as a licensed practical nurse, took her registered nurse's training in 1980, and graduated in 1981. She is now in the process of obtaining her degree. "I am just a few credits away from getting my bachelor's of nursing, so I keep plugging away, I never stop. I love my job and I will never trade it for anything else. I just wish and hope that there were more First Nations nurses, Aboriginal nurses all throughout Canada ... I encourage more and more Aboriginal people to go into training," she said.

Margaret Jones, Northern Health Manager of Community Services and a co-organizer of the conference, said the conference was a huge success, that they were expecting about 150 people but 235 attended. She said the Northern Health Authority is in the process of developing a plan for palliative care and she said that they would be recognizing the need to be sensitive to Aboriginal cultural practices in that.

"We will be working with representatives from First Nations communities, including the Native liaison worker, a member of the Prince George Palliative Group," she said.