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Evolving Palliative Care Practices among Marshall Islanders in Hawai'i: Generational Comparisons
Lauren Okamoto1, Sheldon Riklon2, Kamal Masaki1
1The John A. Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (LO, KM, CB).
Hawai'I Journal of Health & Social Welfare
|June 30, 2020
Summary
Marshallese palliative care involves family, cultural practices, and peaceful death. Generational differences and barriers like cost impact care, highlighting the need for culturally sensitive approaches.
Area of Science:
- Medical Anthropology
- Sociology
- Public Health
Background:
- Limited understanding of Marshallese palliative care practices.
- Exploration of traditional and contemporary approaches is needed.
- Generational differences in end-of-life care are significant.
Purpose of the Study:
- To explore traditional and contemporary Marshallese palliative care practices.
- To examine generational differences in these practices.
- To identify barriers affecting palliative care for Marshallese in Hawai'i.
Main Methods:
- Three focus groups conducted with Marshall Islanders in Hawai'i (2011-2012).
- Data analyzed using classical thematic triangulation.
- Participants included youth (17-27) and elders (46-79).
Main Results:
- A 'good death' is defined as peaceful, pain-free, and from natural causes, involving family and cultural practices.
- Factors like young age, suffering, accidents, or improper burial contribute to 'bad deaths'.
- Older Marshallese differ from younger generations on place of death, burial, life support, and cremation.
Conclusions:
- Cultural factors significantly influence perceptions of 'good' and 'bad' deaths.
- Attitudes toward palliative care vary by generation.
- A generalized approach to Micronesian palliative care is inappropriate; barriers must be overcome for culturally sensitive care.
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