Anjana Vaja Cultural Support Worker

LOROS

May 2010

Language Permission to tell story Gatekeepers Collusion with family Gender Reaction of others about views/beliefs Strange unfamiliar environment Helpers’ fear of asking

“Overwhelmed by ethnicity”

Health professionals want to provide a high standard of care to all patients but are often filled with uncertainty when there are ethnic or cultural differences.

Common perception 2

If I ask the patient about their cultural needs they might think I’m racist

So I’d better not ask

Common perception 3

If I don’t ask the patient they might think I’m racist.

So I’d better ask, but how?

Common perception 4

I need to become an expert in every culture

So I must read more cultural factfiles

“All of life’s creativity flourishes not in certainty, but the questions thatflow from uncertainty.”

Susan Jeffers

Open Questions Looking for similarities Pictures – family/religious Artefacts Keeping a journal Memory boxes Reminiscence Group therapy – giving a voice Prayers/dirges at bedside Tears/distress

South Asian Palliative Care Awareness Arts(SAPCAA) Project:Art can help with emotional, spiritual andsensory dimensions

“You know for the first time we are seeing peopleTalking, asking questions and sharing their personalStories – it is not normally easy to do this”

Writing can ‘purge’ (unburden, released from beingbottled’ and ‘integrate’

‘Some days nobody speaks to me for hours. I cannot understand English but I am still a person. I feel better when somebody greets me, even a wave or a smile or “Good Morning”. You would be surprised what a difference it makes’ – Greek patient [Henley and Schott 1999]

If women can’t speak English they cannot communicate their fear and must be left with some degree of emotional trauma. I’ve seen staff being rough and brutal and shouting at women who are terrified of being examined, often because they don’t understand what is going on’ – English health professional [Henley and Schott 1999]

‘Some days nobody speaks to me for hours. I cannot understand English but I am still a person. I feel better when somebody greets me, even a wave or a smile or “Good Morning”. You would be surprised what a difference it makes’ – Greek patient [Henley and Schott 1999]

Suresh And RameshA Hindu GP warned Ramesh that his father was terminally ill with prostate cancer and, later, tuberculosis. Ramesh did not want his father told his prognosis. Unfortunately, the doctors reassured Ramesh that Suresh would recover, and his prognosis was never discussed properly. However, he was clearly aware that he was dying, giving his books away, talking about dying and obtaining a gold chain for his granddaughter’s marriage, but colluding with his son’s silence. When Suresh dies unexpectedly in his son’s absence, Ramesh was racked with guilt because he had not been present and to give his father the last rites or say goodbye.[Firth, 1997]

FRIENDS

PAIN

KARMA

FAM

ILY

HOBBIES

LEISUREPETS

COMMUNITY

REBIRTH

“People are pretty much alike. Its only that our differences are

more susceptible to definition than our similarities”

Linda Ellerbee

‘Culture, Religion and Patient Care in a Multi-Ethnic Society’ – Alix Henley and Judith Schott

‘Palliative Care for South Asians: Muslims, Hindus and Sikhs’ – Rashid Gatrad, Erica Brown, Aziz Sheikh

‘PROCEED Project’ (Ed, J Kai): Cancer Research UK,

2005. Copyright @ University of Nottingham