Background

Western Sydney Local Health District (WSLHD) is a large rapidly growing region with a highly diverse population and low average socioeconomic status. Of the 1.1 million population, Hindi speakers (3.5%), are one of the three largest migrant groups. They are of particular interest because, although English is widely spoken (English is an official languages of India), they have cultural beliefs and practices which are often at odds with mainstream health care. 

Aim

This study aimed to understand the culturally specific end-of-life needs of the Hindi speaking communities and how service need to adapt. 

Method

Data was collected from the Hindi community through a focus group with EOL carers (10) a survey of their death literacy (DLI; 60 Hindi speaking respondents), photovoice in-depth interviews with three Hindi carers plus 49 key informant interviews with health services (6 Hindi).

Findings

Like other migrant groups, Hindi speakers had lower DLI than non-migrants. The strongest predictor of DLI was the number of years in Australia (not language used at home) suggesting that it is familiarity with Australian systems and culture that is important. 

The qualitative data revealed:

1. People needed support with grief from the end-of-life diagnosis not just after the patient had died.

2. The differences between Australian and traditional cultural expectations can be challenging e.g., Whether to wear white of black to a funeral. Collective decision-making for the patient, especially for women, conflicts with individual consent. Widows self-depreciating behaviour conflicts with our system of services.

3. However, Hindi beliefs and practices can bring great comfort to the patient and the bereaved e.g., chanting and prayers at the bedside, suitable food, a multitude of visitors, and always keeping the patient company are important. 

Conclusion: These needs can be challenging but the National Palliative Care Strategy 2018 requires end-of-life services to adapt.