Working with Parry sound area local Canadian First Nations to describe a good death and ensure cultural sensitivity at the end-of-life.

Abstract

This study explores the culturally sensitive palliative and end-of-life care within First Nations communities in the Parry Sound area: Shawanaga, Wasauksing, and Moose Deer Point First Nations communities in Canada. The legacy of colonialism, particularly the Indian Act of 1876, has significantly disrupted Indigenous health practices, contributing to mistrust in Western healthcare systems. This research addresses gaps in culturally appropriate palliative and end-of-life care by identifying how First Nations communities define a "good death" and how Western healthcare providers can respect and integrate these traditions, particularly in rural and remote communities. Using a community-driven approach, three sharing sessions were conducted with 19 participants, exploring their insights into palliative and end-of-life care. Data analysis revealed five key themes: (1) Family members as primary caregivers, (2) Local healthcare providers support family in palliative and end-of-life care, (3) Make 'final journey' at home, (4) Community (the 'clan family') is involved in palliative and end-of-life care, and (5) Individual wishes for end-of-life care vary and should be followed by healthcare providers. These findings emphasize the role of family, community, and spiritual beliefs in shaping a "good death." The study calls for healthcare providers to incorporate cultural sensitivity, support home-based care, and collaborate with community leaders to bridge gaps between Western medicine and Indigenous traditions. Recommendations include fostering trust with healthcare providers, ensuring care aligns with cultural values, and enhancing collaboration between healthcare systems and Indigenous communities. This research contributes to improving palliative and end-of-life care for First Nations communities by promoting culturally safe, person-centred care practices.