'I don't want to be in that big city; this is my country here': research findings on Aboriginal peoples' preference to die at home

Abstract

Objective: The present article provides findings from a two-year study on Indigenous palliative care conducted in the Northern Territory that explored and documented wishes in relation to place of death for rural and remote Aboriginal people.

Design: Qualitative, open-ended interviews, audio-recorded, transcribed verbatim, and thematically analysed.

Participants: There were a total of 72 interviews completed with Indigenous patients (n = 10), Indigenous caregivers (n = 19), Indigenous and non-Indigenous health care workers (n = 41), and interpreters (n = 2).

Results: The findings provide a clear articulation of the wish of Aboriginal people from rural and remote areas to die at home connected to land and family. Strong cultural reasons were given for this preference, including the strong connection with land and community, a belief in 'death country', the importance of passing on sacred knowledge to the appropriate family member, the significance of ensuring that the dying individual's 'animal spirit' is able to return to the land, and the imperative that the 'right person' in the family network is available to provide the care.

Conclusion: The strong wish to die at home informs the importance of building up local health and palliative care services and avoiding, where possible, the need for relocation for health care to the major metropolitan hospitals during end-of-life care.