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Review
End-of-life care for older first-generation migrants: a scoping review
  1. Katrin Gerber1,2,
  2. Emma Maharaj3,4,
  3. Bianca Brijnath3,5,6 and
  4. Josefine Antoniades3,7
  1. 1 Melbourne Ageing Research Collaboration, National Ageing Research Institute Inc, Parkville, Victoria, Australia
  2. 2 School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
  3. 3 Division of Social Gerontology, National Ageing Research Institute Inc, Parkville, Victoria, Australia
  4. 4 School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
  5. 5 Department of General Practice, Monash University, Clayton, Victoria, Australia
  6. 6 School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Bentley, Western Australia, Australia
  7. 7 Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Bentley, Western Australia, Australia
  1. Correspondence to Dr Katrin Gerber, Melbourne Ageing Research Collaboration, National Ageing Research Institute Inc, Parkville, VIC 3050, Australia; kgerber.research{at}gmail.com

Abstract

Background The unprecedented scale of contemporary migration across countries over the last decade means that ageing and dying occur in a more globalised, multicultural context. It is therefore essential to explore the end-of-life experiences of older people from migrant backgrounds.

Methods A scoping review of peer-reviewed articles published in English from 2008 to 2018. Included studies addressed end-of-life preferences, attitudes, values and beliefs of first-generation international migrants who were at least 50 years of age.

Results Fifteen studies met the inclusion criteria for this review, which addressed six key themes: (1) the reluctance among older migrants and their families to talk about death and dying; (2) difficult communication in patient-clinician relationships; (3) the contrast between collectivistic and individualistic norms and its associated end-of-life preferences; (4) limited health literacy in older adults from migrant backgrounds; (5) experiences with systemic barriers like time pressure, inflexibility of service provision and lack of cultural sensitivity and (6) the need for care providers to appreciate migrants’ ‘double home experience’ and what this means for end-of-life decision-making regarding place of care and place of death.

Discussion To respond effectively to an increasingly culturally diverse population, healthcare staff, researchers and policymakers need to invest in the provision of culturally sensitive end-of-life care. Areas for improvement include: (a) increased awareness of cultural needs and the role of family members; (b) cultural training for healthcare staff; (c) access to interpreters and translated information and (d) involvement of older migrants in end-of-life discussions, research and policymaking.

  • end-of-life care
  • terminal care
  • communication
  • family management
  • education and training
  • cultural issues

https://doi.org/10.1136/bmjspcare-2020-002617

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    Footnotes

    • X @DrKatrinGerber

    • Contributors All authors significantly contributed to this study. EM conducted the initial scoping review under supervision of JA and BB; KG re-assessed the identified themes and led the write-up of the manuscript. All authors approved its final version.

    • Funding This scoping review was funded by the National Ageing Research Institute.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.