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Last Updated: Monday, 27 June, 2005, 23:05 GMT 00:05 UK
Minorities' terminal care studied
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Some cultures may not understand what palliative care entails
A study has been launched to improve the care of terminally ill Sikh and Muslim patients.

With funding from the Chief Scientist Office, Professor Aziz Sheikh of Edinburgh University will ask patients and carers about end of life needs.

He says palliative care services are focused on the elderly dying from cancer - yet migrants to Britain often die younger and from other diseases.

A person's beliefs "must be understood if they are to die with dignity".

There is no special training given to medical students and student nurses, but there should be
Damyanti Patel from Macmillan Cancer Relief

He said: "No effective national provisions are in place for training of healthcare professionals in transcultural medicine, and few professionals will therefore have real opportunity to learn about death rites in different cultures.

"The importance of these and other rites of passage need to be understood by caregivers."

Cultural awareness

He plans to recruit about 25 terminally ill patients from Sikh and Muslim communities with the help of local GP surgeries, hospices and hospitals, as well as Indian and Pakistani community centres.

Damyanti Patel, Macmillan's National Network Development Coordinator for Black and Ethnic Minorities, said: "There is no special training given to medical students and student nurses, but there should be."

She said there were many cultural differences that needed to be understood to aid better care.

"Some patients will have many, many visitors. It is not the culture to send a card or flowers. You go and visit to show you care."

She said there could potentially be problems if visiting hours and rules, such as only two visitors per patient, were rigid.

For religious and cultural reasons, the patient may want to wear their own clothes, prepare their own food, may not want to stay on a mixed ward and may only be able to be cared for by a nurse of the same gender as themselves, she said.

Sensitivity

"When the loved one has died, the family will want somewhere to pray. There may be a chaplaincy in the hospital but they need a private room where there are no pictures of the cross or Christ.

It can be the simplest things that make a difference, like providing prayer mats
Rehanah Sadiq, a Muslim cleric

"Some will want to prepare the body themselves. It can also be hard waiting for a postmortem and burial. For most cultures, the quicker the burial the better."

She said Macmillan had produced some booklets to help nurses, doctors and other healthcare workers in cancer care better communicate with people from the Indian sub-continent, Pakistan and Bangladesh.

Bilquis Ahmad, Asian link worker and counsellor for Cyana - the charity Cancer: You Are Not Alone - said often people from ethnic minorities do not understand what palliative care is and therefore do not take advantage of services.

"For example, they might think palliative care means helping you die earlier. It's a lack of knowledge.

"Plus people often want to take their loved one home and care for them there. We are proud to look after our parents and believe we will be rewarded in the after life."

She said understanding and provision for the needs of different cultures varied from hospital to hospital and region by region, some having advocacy services and some not.

Rehanah Sadiq, a Muslim cleric who visits terminally ill people in acute NHS hospitals in Birmingham, said the situation was improving. "Things are getting better.

"It does not have to take much. It can be the simplest things that make a difference, like providing prayer mats or pointers showing which way is east when people want to pray."




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