Australia’s population is ageing and culturally diverse. The proportion of older people admitted to the Intensive Care Unit (ICU) is rapidly increasing. One in five people admitted to ICU will die. Cultural diversity, including language and religion, may impact end-of-life care and communication in the ICU.
To explore cultural characteristics of patients aged 65 years or over who died in an ICU at a tertiary teaching hospital in Melbourne.
Following ethics approval, a retrospective audit was conducted of deceased patients’ medical records. The study site was chosen because it serves one of the most culturally diverse and fastest growing older populations in Melbourne. Data were analysed using descriptive statistics.
In all, 202 patients died in the ICU during 2018. Of these deaths, 196 patient medical records were audited. In all, 54.1% (n=106) were aged 65 years or over at death, 59.5% (n=63) were male and 54.7% (n=58) were born overseas. 17.9% (n=19) spoke a language-other-than-English, with eight languages-other-than-English represented in the sample, including Greek (5.6%, n=6), Khmer (2.8%, n=3) and Mandarin (2.8%, n=3) being the most common. 16 religions were represented in the sample, with Christian religions (48.1%, n=51) including Catholic (25.6%, n=25) and Greek Orthodox (8.5%, n=9) being the most common. 27.4% (n=29) patients were documented as having no religion. The need for an interpreter to support communication between clinicians, patients and next-of-kin (NOK) was documented in only 9.4% (n=10) of cases.
Many older people from culturally diverse backgrounds receive end-of-life care in an ICU. Cultural factors such as language and religion may influence preferences for end-of-life care and communication. Based on clinician entries in the progress notes, it was not possible to collect data about cultural assessment, referral to Pastoral Care or specialist Palliative Care. Hence, it is not possible to determine whether undertaking a cultural assessment or referral practices influenced end-of-life care in this setting.
Consideration for how clinicians assess and document the cultural needs of patients and their families, and adapt their communication and care for patients and NOK is essential to ensure culturally appropriate end-of-life care.