Julie Rose, recipient of the 2023 Outstanding Achievement in Aboriginal and Torres Strait Islander Palliative Care Award, shares how yarning has helped to create culturally safe palliative care models.

Julie Rose has worked in Aboriginal health care for many years, but palliative care wasn’t in her plans – mainly because she didn’t know if it would be successful in Indigenous communities.

“With our mob, sometimes talking about sickness or death makes people think it’s going to happen. It’s something we don’t talk about. I knew that was a barrier,” she says.

After some colleagues encouraged her to move into palliative care, sensing she would have a knack for this field, Julie decided to give it a go. “I started working with the team, and the people I worked with were so amazing and uplifting. I learnt more about it all and it changed my mind,” she says.

“I could see the benefits of me being there as an Aboriginal person being able to support our mob, and I’ve seen the difference it makes and how comfortable people feel having an Aboriginal health worker around.”

Seeing her passion for the role, and being the recipient of the 2023 Outstanding Achievement in Aboriginal and Torres Strait Islander Palliative Care Award, it’s clear that Julie’s colleagues were right. Palliative care is exactly where she belongs.

A new approach to Aboriginal palliative care

Julie is now a Senior Aboriginal Health Worker and Project Officer at Calvary Mater Hospital in Newcastle.

This began with simple changes that showed respect and understanding for where her community was at. “We’ve been doing palliative care our whole lives – we care for our people – but we don’t have a word for it in our language. And there’s still a lot of fear from our people around hospitals and institutions,” Julie says.

“So the first thing I did was take ‘palliative care worker’ off my badge, and then I tried to come at it from a different way, a softer approach. I just come in as an Aboriginal health worker and grow those relationships.”

Julie’s research and leadership have now shaped culturally safe and aware models of care for her local Aboriginal community, around a spirit of co-design and consultation.

Julie says this has changed the way she thinks about herself professionally. “I thought I was just an Aboriginal health worker, but I’ve actually now led a research project and that’s something I never thought I’d be able to do,” she says.

“I’m pushing myself, and that’s really empowered me to talk to other Aboriginal health workers about doing research and other different things.”

A focus on yarning to create culturally appropriate palliative care

A key part of Julie’s research findings incorporate – and have been sourced through – the yarning method. This is a way of connecting with the community in a way they’re comfortable with.

“I spoke to about 17 bereaved families one-on-one, and did yarning – not like a questionnaire or a focus group – with each of those families about their experiences. I asked them how we could do things better. I was really surprised that people wanted to talk about their experience, what worked well and what could be better,” Julie says.

She knew these families were providing great insights to help build a better palliative care response for Indigenous communities around Australia, but it was when she spoke to other health care workers that the picture really came to her – and it had lots of gaps in it.

“When I spoke to Aboriginal families, they said no one was really talking to them, they didn’t feel heard. Then, when I spoke to non-Aboriginal health professionals, they said they didn’t know what to say, they didn’t want to offend, they weren’t sure what to do. There’s a real gap there,” explains Julie.

Working together with thanks in part to Julie’s research, the teams are now able to help people access palliative care at home, be around their families and communities, and have their other wishes heard and enacted. She also helped establish some grief groups to support bereaved families.

“Employing more Aboriginal health workers to work across all areas would make a huge difference in getting our people to receive palliative care services,” Julie says.

“A lot of our bereaved families are really young – the people I talk to are a lot younger than I talk to in non-Aboriginal people – because a lot of Aboriginal people die earlier, so the people they leave behind are younger.”

And this highlights one of the main reasons Julie has gained so much satisfaction from working in palliative care.

“Our people could possibly live longer by having access to palliative care.”