End-of-life care for older first-generation migrants: A scoping review

Katrin Gerber, Emma Maharaj, Bianca Brijnath, Josefine Antoniades

Research output: Contribution to journalReview ArticleResearchpeer-review

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' â 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.

Original languageEnglish
Number of pages9
JournalBMJ Supportive and Palliative Care
DOIs
Publication statusAccepted/In press - 2020

Keywords

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

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