Indigenous Peoples' Experiences in Palliative and End-of-Life Care in Canada: A Scoping Review.
Lisa Weisgerber, Nahyeni Bassah, Anna Santos Salas
PMID 40372077WHAT IT FOUND
Indigenous people in Canada described barriers to palliative and end-of-life care, including delays, less home support, culturally unsafe practices, and isolation when transferred for care.
Many preferred dying at home with family and cultural practices.
Key findings
01In an included study, Indigenous participants experienced delays starting palliative radiotherapy, and only 43% received follow-up care from radiation or medical oncology.
02Included sources described culturally unsafe end-of-life care, including inflexible policies that restrict family gathering and ceremonies, pressure to complete advance directives, and frequent racism.
03Many Indigenous people preferred to die at home, but families often felt unprepared and rural communities lacked home care, equipment, and timely medication.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a scoping review, not a trial, and scoping reviews do not usually appraise study quality. It maps what has been written rather than proving that any care model works. The authors note that a scoping review may not be exhaustive. They also note it is usually not used as a final basis for policy because of potential bias. Most included sources were pan-Indigenous, non-Indigenous-led, or used Western research methods. That limits what they say about distinct First Nations, Inuit and Métis experiences. Only one included study used an Indigenous research methodology, and no systematic reviews were identified. The review included reports, resource manuals, videos and a course as well as research. The evidence base is mixed. Included sources were mostly from Ontario, Manitoba and Saskatchewan, with few from Alberta, British Columbia, Nunavut, Quebec and Nova Scotia. The paper reports an initial search in May 2022, an update in April 2024, and then an updated search in March 2024. The search timeline is unclear.
Declared interests
The authors declare no conflicts of interest. No funding statement is reported.
The easy way to misread this
Do not read the cultural-safety priorities as proven ways to improve Indigenous end-of-life outcomes. This is a scoping review of reported experiences and resources, not a trial, and the authors did not appraise the quality of the included sources.