中華心理衛生協會

 Purpose: There is an urgent need to address the challenges surrounding long-term elder care in Taiwan. One of the key developmental strategies employed in the National Long-term Care Plan 2.0 is the expansion of community-based hospice and palliative care services. Most palliative care models are based on Taiwan's mainstream Han culture in urban areas. Little research has been conducted on the conceptualization of life and death, health cognition, or palliative care in the context of Taiwanese aboriginal cultures. In this article, we identify the challenges to develop a culturally appropriate community-based palliative care model for Taiwanese aboriginals and propose reforms. Methods: We conducted a narrative literature review on Airiti Library, PubMed, Google searching engine using 'indigenous people', 'community-based long-term care' and 'palliative care' as keywords. We included 11 academic articles and 5 policy papers to explore potential obstacles and propose suggestions for development of a palliative care model appropriate for Taiwanese aboriginal communities. Results: We found little policy support and inadequate research to guide delivery of culturally-appropriate care. We recommend: (1) a comprehensive and systematic culture investigation and database development; (2) the health inequality of indigenous people should be taken into account when creating policy based on individual needs; (3) and the cultivation of clinical and research talent to develop a cross-cultural palliative care model. Conclusions: We urge the government to secure funding to develop programs to support hospice and palliative care development by local stakeholders according to their individual needs and unique cultural backgrounds in order to allow aboriginal elderly people to age in place with a good death in the community.