Palliative care services for Indian migrants in Australia: a constructivist grounded theory study of experiences of the family members of terminally ill patients

The current global health care system faces a massive challenge in providing needs-based care to people, particularly in the palliative care setting. Presently, palliative care focuses on comprehensive care not only for the patient, but also for their families and caregivers. The palliative care approach aims to improve the quality of life of individuals facing a life-threatening illness and their families, by preventing and relieving suffering through early identification and by assessment and treatment of pain and other problems related to physical, psychosocial and spiritual factors. This approach facilitates identification of the wishes of patients and their families about care throughout a period of declining health and especially during end-of-life care (World Health Organization, 2003). Changing patterns in the care of terminally ill people, and a preference for death at home, mean there is heavy reliance on family caregivers to provide the majority of the care needed. The main purpose of this study was to explore the experiences of the family members of terminally ill Indian patients in Victoria, Australia. This study used a constructivist grounded theory approach. The study was conducted in two major health care providers of Melbourne, an inpatient service and a home-based service. Convenience and snowball sampling techniques were used to recruit the participants. In total, six participants were recruited for the study and data was gathered by using semi-structured interviews. A grounded theory coding was used to analyse the data and three major themes were identified. They were experiences of health system issues; cultural issues; and caring experiences. The study identified that caring for terminally ill people is hard work for the family members and they faced many cultural issues while accessing palliative care services in in-patient palliative care services. The main cultural issues were food, clothing, religious practices and aspects of death and dying. Australia is a multicultural country; it is therefore essential that culturally competent care is incorporated in palliative care practice to improve quality of life at the end of life for all who require such care.