Coping with transition from life: the Indigenous Palliative Care Projects
In keeping with Vancouver Coastal Health’s (VCH) value of always learning, the North Shore Palliative Care team learned improving palliative care services for Indigenous communities required the guidance, knowledge and partnership from First Nations, their health teams and Indigenous Elders and Healers.
Indigenous People can experience barriers when accessing palliative care, including inadequate care coordination, poor transitions between health-care settings and limited access to palliative care services in First Nations communities. There is also fear and mistrust of the health system, stemming from experiences of racism and discrimination.
Having care conversations early allows patients and care providers to plan together so that final wishes can be followed and respected, leading to higher quality palliative care, empowering individuals to lead their care in a way that reflects their values and priorities, and providing palliative care professionals the knowledge to support these wishes.
Two-Eyed Seeing is the foundation of the Indigenous Palliative Care Projects, a partnership to improve palliative care services for and with Indigenous Peoples in the region. The project was a partnership between VCH’s North Shore Palliative Care team and Tsleil-Waututh Nation.
What is Two-Eyed Seeing?
Tsleil-Waututh Nation defines Two-Eyed Seeing as an approach which sees people come together to view something from both an Indigenous and Western perspective simultaneously.
“It is only through authentic partnership that we as both Nation and health authority teams can journey together towards providing high-quality, culturally safe palliative care to community members at any level and point in the care continuum,” said Sierra Roberts, VCH’s Project Manager for the Indigenous Palliative Care Projects and North Shore Palliative Care Program.
Tsleil-Waututh Nation and VCH identified gaps, barriers and priorities to improving palliative care services and then planned to integrate VCH and Tsleil-Waututh Nation resources so individuals are supported in their final journey. Goals of care conversations provide an opportunity for the client and their family to reflect on and express what matters most to them for their care, including cultural protocols and family traditions.
“We hear the voices of our ancestors and Elders and are guided by the knowledge keepers to reclaim what is rightfully ours as Tsleil-Waututh people,” said Andrea Aleck, Tsleil-Waututh Nation’s director of Health and Wellness. “It is with this spiritual guidance and ancestral presence that we strive to strengthen our partnership, whilst ensuring that our palliative care services are culturally and spiritually informed by our Indigenous ways of knowing and being.”
Together, Tsleil-Waututh Nation and VCH received a 2023 BC Quality Award in the “Coping with Transition from Life” category for their work towards providing high-quality, culturally safe palliative care to community members. L-R: Leonie Streeter (Tsleil-Waututh Nation), Sierra Roberts (VCH), Dr. Anis Lakha (VCH), and Andrea Aleck (Tsleil-Waututh Nation) receiving the Quality Awards.