The Gwandalan National Palliative Care Project is reframing how healthcare workers see end-of-life care and supporting safe return to Spirit for Aboriginal and Torres Strait Islander people.

The project is facilitated by Australian General Practice Accreditation Limited (AGPAL) and has designed training to upskill healthcare workers to both deliver more culturally sensitive palliative care and improve community awareness and understanding of palliative care.

Gwandalan works closely with Indigenous Program of Experience in the Palliative Approach (IPEPA) to break down the barriers to palliative care for Aboriginal and Torres Strait Islander people across Australia.

Gamilaroi woman Eliza Munro is the Indigenous Project Coordinator at AGPAL and said end-of-life care is a crucial service for patients and families.

“Palliative and end-of-life care embraces the physical, emotional, spiritual and cultural wellbeing of a patient and their family,” she said.

“The patient can be supported holistically, ensuring the end-of-life journey is one of comfort, dignity, cultural respect, fulfilled wishes, and of the best possible quality of life.”

IPEPA National Indigenous Project Manager Nicole Hewlett said lack of culturally appropriate palliative care can be traumatic.

“In 2018, approximately nine Aboriginal and Torres Strait Islander people passed each day, leaving some communities in a continuous spiral of ongoing Sorry Business,” said Hewlett.

“Grief itself causes significant emotional, cultural and spiritual distress for one’s wellbeing … The undignified passing of a loved one causes trauma and complicated grief for individuals, family and community, ultimately undermining the healing journey.”

Munro said rethinking the delivery of palliative care is one way to better support the healing journey.

“Reframing palliative and end-of-life care for Aboriginal and Torres Strait Islander communities can increase access to and understanding of the supports and resources available,” Munro added.

Hewlett said that accessing appropriate end-of-life care “facilitates a safe return to Spirit” and “can bring much healing to loved ones, families and communities, and break perpetual grief and trauma spirals”.

On July 19, the Gwandalan Project launched eLearning modules for healthcare workers about supporting First Nations people in their last days.

The eLearning modules teach healthcare workers about Aboriginal and Torres Strait Islander history and culture relevant to the palliative and end-of-life care journey, and the cultural protocols associated with returning to Spirit.

Healthcare workers can learn about safe communications, supporting choices at end-of-life, delivering culturally responsive care in partnerships, and community engagement.

Though AGPAL only has three years of funding to deliver the training, the project aims to make a long-term difference through ‘Gwandalan Champions’ who receive training at Gwandalan workshops before passing the training on at home.

“Gwandalan Champions have the opportunity to go back to their own communities and contextualise the actual training to make it fit and relevant and appropriate for that local community,” Munro said.

Gwandalan means rest, peace or resting place in the Darkinjung and Awaba language, and Munro said it’s about making palliative care more accessible and culturally safe.

“In the palliative care space we talk about a good death and what that can look like, and for our mob it’s about taking into account all those things that are important to our communities; returning to Country and having family around,” she said.

By Sarah Smit