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Table 5 Summary of Education Related Recommendations to Advance Palliative Care Program Development in the Communities

From: “If you understand you cope better with it”: the role of education in building palliative care capacity in four First Nations communities in Canada

Overarching Recommendation: The palliative care program needs to be advanced and supported by creating a culturally appropriate palliative care education and training plan along with educational resources to implement it. The plan needs to include providing annual education for the: Principal and Internal Caregiving Networks (family caregivers, community members, including internal health care provides), and the External Caregiving Network (external health care providers who service the residents of the First Nations community).

The education plan for the Internal and Principal Caregiving Networks should include, but is not limited to:

- Understanding palliative and end-of-life care as a continuum of care that begins when someone is identified as having a life-limiting illness.

- Knowledge and skills for providing palliative and end-of-life care.

- Culturally appropriate palliative care practices for community residents.

- Training on advanced care planning and how to have advanced care planning discussions with individuals and families.

- Illness specific information (e.g., disease progression, illness specific resources).

- Education about grief and bereavement support strategies.

- Family education and support related to caregiving, advance care planning, preventing caregiver stress, and managing grief and loss.

- Community education on topics such as wound care, what to expect at end-of-life, roles and responsibilities of different health care providers, grief and health education in general.

The education plan for External Caregiving Network should include, but is not limited to:

- Understanding the historical context of living in a First Nations community, the structure and organization of First Nations communities in general and health services in particular, federal funding of health service delivery, and funding of medical equipment.

- Understanding the importance of kinship/relationships and taking time in their care of the First Nations community clients and families.

- Developing skills in culturally effective communication strategies to ensure that clients, families, and community members fully understand and are aware of decisions and health care services.

- Understanding that for some First Nations clients, talking about death and dying is not culturally acceptable and knowledge of alternative strategies when providing services.

- Understanding that First Nations clients may have different understandings of health and illness.

- Understanding that the spiritual and cultural practices of individuals and families are highly individualized and health care providers should proactively ask what practices would offer comfort and support.

- Understanding what services are available within First Nations communities and how to refer clients to these services.

- Understanding that provincial health services have an obligation to provide palliative care services to residents living in First Nations communities.