Cultural competency is a vital part of individualized patient care. End-of-life views and practices are strongly influenced by cultural beliefs and values. Knowledge of the influence of culture and beliefs on specific end-of-life rituals, such as funeral and burial practices, is essential. It helps assure that care is compassionate, respectful, and culturally competent, and it provides the dying person and his or her family with dignity and understanding during a very difficult time. As the patient receives care, health care providers should also examine their own cultural values and beliefs to ensure they do not interfere with a patient’s care. Part of cultural competency is acknowledging one’s own biases before providing care (Saccomano & Abbatiello, 2014).
Cultural diversity in patient care involves the acceptance of individual characteristics, such as skin color, religion, gender, income, and geographic location. Providing culturally competent care means that providers help facilitate equal access to culturally competent care, refer patients to culturally appropriate resources (such as qualified medical interpreters, appropriate religious and spiritual support, etc.) and obtain appropriate training in evidence-based, cross-cultural practices (Saccomano & Abbatiello, 2014).
The discussions that physicians, nurse practitioners, nurses, social workers, and other health-care providers have with a client about end-of-life care be a challenge and can be influenced (positively or negatively) by the provider’s training and experience in endof-life care, the provider’s comfort level in discussing these sensitive issues, the patient’s diagnosis and prognosis, the level of family support, the availability of adequate time to discuss the issues surrounding end-of-life care, and the quality of the rapport between the patient, family, and care providers. A lack of understanding and sensitivity may lead to poor communication, misinterpretation of symptoms, misdiagnoses, and failed interventions (Meiner, 2010; Munoz & Luckmann, 2005).
Honoring the belief systems of the individual and the family is paramount, particularly during and after the death of the loved one. Understanding cultural influences by asking the patient and the family about their preferences surrounding the end-of-life process helps ensure a compassionate and respectful response to their requests, and it minimizes the chances of offending them. In the United States, there are many different cultural groups, and within each group there is much diversity. This makes it difficult for health-care providers to be experts on end-of-life care for any one cultural group. One of the most effective methods for supporting patients and their families is through effective communication based on compassion and humility, and the establishment of a rapport based on empathy, trust, respect, and clinical competence (Corr & Corr, 2012; Meiner, 2010; Munoz & Luckmann, 2005).
Effective transcultural communication helps facilitate planning and intervention strategies that can be used to support grieving families. Health-care professionals can help grieving families by encouraging them to discuss their loss; encouraging them to express feelings such as anger, anxiety, guilt, and helplessness; providing them adequate time to grieve; allowing for cultural differences; and providing continuing support as necessary (Meiner, 2010; Munoz & Luckmann, 2005).