Pluralities of identity, belonging, home and place: an exploration of relationality during death and dying for ethnic minority migrants in Western countries

Abstract

There is limited knowledge on the influence of culture, relationality and migration experiences at end-of-life for ethnic minority communities (EMCs). Dying well depends on many variables that encompass physical, emotional, sociocultural and spiritual domains. In this narrative review of published literature, we explored the influence of relationality on end-of-life experiences for EMCs living in Western countries. The literature highlights the multiple realities of identity, belonging, home and place held by EMCs, and how a lack of congruence between these realities can contribute to feelings of isolation and existential despair at end-of-life. Many relational factors and barriers to accessing palliative care and hospice support exacerbated the distress and risks of isolation experienced at end-of-life by EMCs, including a disconnect between the adopted country’s social norms and cultural expectations and changing family structures and customs whilst being detached geographically and socially from family and community support systems. To attain peace and spiritual fulfilment at the end-of-life, EMCs need support to share stories and traditional wisdom, and access sources of strength and meaning embedded in cultural and spiritual knowledges and practices. To enable EMCs to die well, relational family-centred care must be prioritised, recognising them as valid ‘experts’ in the design of services.