Culture basically describes the characteristics of individual and group identities. An organized learning response group, a system of ready-made solutions to problems people face, learns through interaction with others in society.  Common component of culture; includes shared groups Emphasize customs and beliefs expressed in behaviour.  Culture provides the basis for schemas, which are used to process memories, form personality expressions, and determine appropriate responses to environmental stimuli, and cultural belief systems interact with all aspects of information deal with. 
Cultural sensitivity is the integration of cultural knowledge and awareness into individual and institutional behaviour.  This sensitivity affects how clinicians interact with each patient and influences communication choices, specific behaviors, and recommendations and choices during treatment provided to patients. A practitioner who recognizes cultural differences understands how these differences affect health habits and healthcare practice and then incorporates this understanding into his or her daily interactions with patients can be described as culturally sensitive.  Providing healthcare in a culturally sensitive manner involves responding to the attitudes, feelings and circumstances of people who share identifying characteristics such as race, religion, language and socioeconomic status.  Cultural competency needs to integrate this more deeply Sensitivity to practices and protocols to ensure that the care provided will accommodate cultural differences in health-related values and beliefs. 
Palliative care is an approach to improving the quality of life of patients and their families facing problems associated with life-threatening illnesses through early identification and impeccable assessment and treatment of pain and other disorders to prevent and alleviate suffering Physical, mental and spiritual problems.  Palliative care is specialized medical care for seriously ill patients. This care focuses on relieving the symptoms and stress of the illness. The goal is to improve the quality of life of patients and patients family
Palliative care is delivered by a team of specially trained doctors, nurses and other specialists who work with the patient’s other doctors to provide additional support. Palliative care is based on the needs of the patient, not on the patient’s prognosis. suitable for Serious illness at any age and at any stage, can be offered along with treatment. 
For people facing serious illness and their families, the stakes are high for the quality of care. Cultural beliefs and practices are particularly prominent in the distressing experiences of patients and family members.  However, they are often poorly understood by clinicians, especially when A clinician’s background is not the same as a patient’s.  Insufficient understanding of how patients’ cultural beliefs and practices inform the meaning of illness and its salience to individual members can lead to disparities in palliative care across care Continuum  For example, in the United States, hospice care is considered the standard for end-of-life palliative care and is disproportionately used by groups of white Nordic descent.  Although in some areas of critically ill patient care utilization of these services by different groups is improving Disease disparities persist. 
Overall disparities in care mean that people of color and people with disabilities who have different sexual orientations are less likely to receive the care they desire and report less satisfaction with end-of-life care than white people from dominant cultures .  ] The provision of culture Informed and responsive care may ultimately change how different groups perceive end-of-life care options. 
It is worth noting that, in addition to providing patients and families with palliative care that is sensitive and effective for diverse populations, a focus on culture can also benefit health systems.  For example, early high-quality palliative care has been shown to prevent costly unexpected end of life Subsequent interventions  have simultaneously improved the quality of life of patients  and their loved ones. 
Cultural sensitivity in palliative care can be illustrated in four areas; preferences for modes of nursing communication, meaning of distress, and decision-making processes. In basic biology, death is the last characteristic of all living organisms. no matter how or where we were born Uniting people of all cultures is the fact that everyone will eventually die. However, there are differences in how different cultures conceptualize death and what happens after death. In some cultures, death is considered to involve different circumstances, including sleep disorders and reaching a certain age. in other cultures Death is said to occur only when life ceases completely. Likewise, some cultural traditions view death as a transition to other forms of existence; others propose a continuous interaction between the dead and the living; some cultures envision a cyclical pattern of multiple deaths and rebirth; there are still others who believe that death is the final outcome and that nothing happens after death.
These different perceptions had a significant impact on how they lived, how prepared they were to die for a cause, how much they feared death, how grief and mourning were expressed, and the nature of funeral rituals. Any reasonably broad conceptualization of the problem of death necessarily has Merge these various cultural differences.  The difficulty of having a unified view of death or the experience of death can be better understood when we realize that even defining what it means to die is problematic. For more than 100 years, the clinical definition refers to The absence of a heartbeat and breathing is the basis for a person to be considered dead.  However, advances in medical technology have made it possible for machines to maintain vital signs, leading to a revision of the definition of global brain death to define death as Either “irreversible cessation of circulatory and respiratory functions, or of all functions of the entire brain, including the brainstem”.  It is not surprising, therefore, that there is debate surrounding the definition of death. Perceptions about death and dying vary across cultures.
Some South Pacific cultures believe that life, as commonly explained, leaves a person’s body in different situations, such as when sick or sleeping.  Thus, the conceptualized person can be said to “die” several times before finally dying. It also means that a person can  Defined as death that does not meet many of the criteria listed in the definition above or defined in the social and medical literature. Conceptual differences about death extend to what actually happens when a person dies, regardless of the definition. Some religious and cultural traditions, such as Birth and death, as envisioned in Hinduism, are a cyclical pattern where a person is believed to die and then reborn in a new identity. This exit and re-entry into life can happen multiple times. This is in stark contrast to the Christian view that death happens only once. Christians don’t Believe that everything stops at death. The person sheds his or her physical form, but continues to exist spiritually, and this has consequences: The faithful—the believers in their faith—get eternal bliss in heaven, while sinners go to hell, where there are endless pain and suffering. pain. In some Native American tribes and in some parts of Buddhism, the dead coexist with the living, and the dead can affect the well-being of the living. If the dead (ancestral spirits) are properly appeased, the likely outcome is a benevolent spirit that protects interests living. If not given proper treatment, the result is an unhappy spirit which may neglect the well-being of the living and thus cause suffering. In some cultures, of course, death marks a sudden and permanent separation. In some cases, people are even banned from The names of the dead are mentioned out of fear that doing so will actually endanger the lives of the living or prevent the ghosts from leaving this earth and gaining peace. [twenty three]
Cultural Beliefs about Death and Dying
No matter how death is defined, every culture has a concept of how death should happen. For the dying, there is a difference between an “acceptable death” and a “good death”.  Deaths that are said to be acceptable are non-dramatically disciplined and rarely emotion. This atmosphere seems to exist in structured settings such as Western hospitals where most people die. On the other hand, it is said that a good death is one that allows social adjustment and personal preparation for the dying person and their family. this is a time Dying people try to finish unfinished tasks to say goodbye and for families to begin preparing for life without dying. In Ghanaian Kwahu-Tafo, a good death is when the dying person has accomplished most of what he or she intended to do and has lived in peace with others before dying.  In Nigeria, the death of a person who lived a long and mostly successful life can often be inferred from the nature of the captions in their obituaries. In this case, the prologue follows the title “Thank God for a wonderful life…”. For someone who died young or under very tragic circumstances, this is never to be seen. Yet in other societies it may be a good death for a person to die in the service of his country or religion. In other words, the person is considered a martyr.  This is It is important to study these cultural differences in conceptions of death and dying because they have important implications for how people behave in life, whether or not they fear death, and how close to death they approach death with their funeral and funeral practices. One Obvious Implication About Concepts Death and end-of-life impact actions are a phenomenon of suicide bombings. This is a fairly new phenomenon, believed to have started in the early 1980s by Hezbollah, a Shia extremist Muslim organization in Lebanon, which was influenced by the way Iran used humans in their mine clearance operations War on Iraq. By 1994, two Palestinian organizations, Hamas and Islamic Jihad, had begun the practice. Only a handful of people joined Suicide Squad initially, and there wasn’t even much enthusiasm at the time. They have to undergo months of training that appears to be extreme indoctrination. Nowadays People are willing to compete for the privilege of being selected for the Suicide Squad. From the initial reluctance to the current enthusiasm, the biggest change seems to be the change in their conception of death and what awaits them after death. [twenty three]
Although all people may experience death, concepts of death and our responses to issues of death and dying vary widely across cultures. The world is shrinking due to the extensive interaction of people from different cultures all over the world, so understand Just as we deal with the problems of life, there are complexities surrounding the problems of death. This will better prepare us to respect and understand people from other cultures, and to respond to them in ways that are meaningful to them and our own, so that their lives and ours can be enriched in the process. [twenty three]
European Association for Palliative Care
Refugees receiving palliative care: what do they need? Series on palliative care in the context of humanitarian crises. We examine what it means to provide palliative and bereavement care for migrant refugees and people fleeing war-torn countries and conflict zones, and how The hospice and palliative care community can provide appropriate support.
International Children’s Palliative Care Network
Providing Palliative Care in Humanitarian Crisis Situations: Using Community Health Workers in Rohingya Refugee Camps Dr Megan Doherty and Mr Scott Gunn have written about the important work being done to provide palliative care in Rohingya refugee camps in Bangladesh.
- ↑ Jump up to:1.0 1.1 Seibert PS,Stridh-Igo P, Zimmerman CG. A checklist to facilitate cultural awareness and sensitivity. Journal of Medical Ethics. 2002; 28 (3):143-6.
- ↑ Jump up to:2.0 2.1 Wells MI. Beyond cultural competence: A model for individual and institutional cultural development.Journal of Community Health Nursing. 2000; 17 (4):189-99.
- ↑ Wells MI. Beyond cultural competence: A model for individual and institutional cultural development. Journal of Community Health Nursing. 2000; 17 (4):189-99.
- ↑ Jump up to:4.0 4.1 Wells MI. Beyond cultural competence: A model for individual and institutional cultural development. Journal of Community Health Nursing. 2000; 17 (4):189-99.
- ↑ World Health Organization. Cancer – WHO Definition of Palliative Care. Available from; https://www.who.int/cancer/palliative/definition/en/ (last accessed 17/June/2020)
- ↑ Jump up to:6.0 6.1 Centre to Advance Palliative Care. What is Palliative Care?. Available from; https://getpalliativecare.org/whatis/ (last accessed 17/June/2020)
- ↑ Jump up to:7.0 7.1 7.2 Cain CL, Surbone A, Elk S, Kagawa-Singer M. Culture and Palliative Care: Preferences, Communication, Meaning and Mutual Decision Making. Journal of Pain and Symptom Management. 2018; 55 (5): 1408-19
- ↑ Periyakoil VS, Neri E, Kraemer H. Patient-reported Barriers to High-quality, End-of-life Care: A Multiethnic, Multilingual, Mixed-methods Study. Journal of Palliative Medicine. 2016; 19: 373-9
- ↑ Worster B, Bell DK, Roy V, Cunningham A, LaNoue M, Parks S. Race as a Predictor of Palliative Care Referral Time, Hospice Utilization, and Hospital Length of Stay: A Retrospective Noncomparative Analysis. American Journal of Hospice and Palliative Medicine. 2018; 35: 110-16
- ↑ Karikari-Martin P, McCann JJ, Farran CJ, Hebert LE, Haffer SC, Phillips M. Race, Any Cancer, Income, or Cognitive Function: What Influences Hospice or Aggressive Services Use at the End of Life Among Community-dwelling Medicare Beneficiaries?. American Journal of Hospice and Palliative Medicine. 2015; 33: 537-45
- ↑ Koss CS, Baker TA. Race Differences in Advance Directive Completion. Journal of Aging and Health. 2017 ;29 (2): 324-42.
- ↑ Koss CS, Baker TA. Race Differences in Advance Directive Completion. Journal of Aging and Health. 2017 ;29 (2): 324-42.
- ↑ Lee JJ, Long AC, Curtis JR, Engelberg RA. The Influence of Race/Ethnicity and Education on Family Ratings of the Quality of Dying in the ICU. Journal of Pain and Symptom Management. 2016; 51(1): 9-16.
- ↑ Gomes B, Higginson IJ. Where people die (1974—2030): past trends, future projections and implications for care. Journal of Palliative Medicine. 2008; 22: 33-41
- ↑ Khandelwal N, Benkeser DC, Coe NB, Curtis JR. Potential influence of advance care planning and palliative care consultation on ICU costs for patients with chronic and serious illness. Crit Care Medicine. 2016; 44: 1474-1481
- ↑ Smith S, Brick A, O’Hara S, Normand C. Evidence on the cost and cost-effectiveness of palliative care: a literature review. Journal of Palliative Medicine. 2013; 28: 130-150
- ↑ Zimmermann C, Swami N, Krzyzanowska M, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. The Lancet. 2014; 383: 1721-1730
- ↑ Meier DE. Increased access to palliative care and hospice services: opportunities to improve value in health care. The Milbank Quarterly. 2011; 89: 343-380
- ↑ Gelfman LP, Meier DE, Morrison RS. Does palliative care improve quality? A survey of bereaved family members. Journal of Pain and Symptom Management. 2008; 36: 22-28
- ↑ Sarmento VP, Gysels M, Higginson IJ, Gomes B. Home palliative care works: but how? A meta-ethnography of the experiences of patients and family caregivers. BMJ Support and Palliative Care. 2017; 7: 0
- ↑ Brandstätter M, Kögler M, Baumann U, et al. Experience of meaning in life in bereaved informal caregivers of palliative care patients.Support Care in Cancer. 2014; 22: 1391-1399
- ↑ Dionne-Odom JN, Azuero A, Lyons KD, et al. Benefits of early versus delayed palliative care to informal family caregivers of patients with advanced cancer: outcomes from the ENABLE III randomized controlled trial. Journal of Clinical Oncology. 2015; 33: 1446-1452
- ↑ Jump up to:23.0 23.1 23.2 23.3 23.4 23.5 Gire J. How Death Imitates Life: Cultural Influences on Conceptions of Death and Dying.Online Readings in Psychology and Culture. 2014; 6(2)
- ↑ President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1981). Defining death: A report on the medical, legal and ethical issues in the determination of death. Washington, DC: Government Printing Office.
- ↑ Counts DA, Counts, DR. I’m not dead yet! Aging and death: Processes and experiences in Kalia. Aging and its transformations. 1985. (pp. 131-156). Langham, MD: University of America Press
- ↑ Kellahear A. Dying of cancer: The final year of life. London, England. 1990; Harwood Academic Publishers.
- ↑ Van der Geest S. Dying peacefully: Considering good death and bad death in Kwahu-Tafo, Ghana. Social Science & Medicine. 2004. 58(5), 899-911.
- ↑ Rosenblatt PC. Grief across cultures: A review and research agenda. In M. S. Stroebe, R. O. Hansson, H. Schut, & W. Stroebe (Eds.), Handbook of Bereavement research and practice: Advances in theory and intervention. 2008; (pp. 207-222). Washington, DC: American Psychological Association