Palliative care services in conjunction with the primary care and renal teams should play a role in educating community members in how they can support the person and the family, thus helping to meet the person’s choice of place to ‘finish up’ and helping family/community members feel they have appropriately supported the patient in the ‘finishing up’ process. As recommended by the American Society of Nephrology, Galla[9], there is a clear need to strengthen partnerships between palliative care and renal services if the best care and support is to be provided for a person opting for the non-dialysis pathway. Choice of place of death: being able to ‘finish up’ in the place of

their choice is very important to many indigenous Australians, with strong connections to traditional lands playing an important cultural role. However cultural practices selleck chemicals and requirements may vary from

community to community, and even within communities (particularly in urban areas). If a patient wishes to stay on or return to their homeland to die, these arrangements will need to Palbociclib datasheet be planned and supported. The effectiveness of renal supportive care may also strongly correlate with issues such as: person not being able to fully understand their illness; difficulties in communication and the length of time it takes to gain a person’s trust. Each indigenous person is different and therefore should not be stereotyped. One should not make assumptions of ATSI people and remember that each case is considered on an individual basis, without prejudice or judgement. Establish a commitment to the patient, build trust and be consistent. Respect ATSI cultural protocols, practices and customs. Respect ATSI decision-making processes. For most indigenous people having the family involved is extremely important. Families, tuclazepam as mentioned above can include an extensive range of relatives. However there are individual variations.

Institutions such as hospitals and dialysis units, nursing homes must take responsibility for facilitating culturally competent care. This includes knowing the groups that most frequently use the institution, seeking out and disseminating information about cultural beliefs that might affect attitudes towards illness and health care, providing adequate translation services, and identifying community resources. Hiring and training health care workers (at all levels) who are members of the ethnic group in question or knowledgeable about them and who have credibility within these communities may assist greatly in bridging the cultural chasm. Health professionals need to acknowledge the beliefs and practices of people who differ from them in age, occupation or social class, ethnic background, sex, sexuality, religious belief and disability.