Insights on end-of-life ceremonial practices of Australian Aboriginal peoples

Article Outline

• Summary
• Introduction
• Methodology
  • Ethics clearance
  • Research focus
  • Participant group
  • Data collection
  • Data analysis
• Findings
  • Smoking ceremony
    • Spiritual rationale for the practice of ‘smoking’
    • The place for smoking
    • A description of the smoking process
    • Different rules about staying in the home after it is smoked
  • Marking the house of the deceased
    • Spiritual rationale for the ochre ring mark
    • Local differences
  • Death ceremonies
    • The ceremonial process
• Discussion
• Limitations of the findings
• Implications for nursing practice
• Conclusion
• Acknowledgements
• References
• Copyright

Summary 

The ceremonies surrounding death are extremely important to Aboriginal peoples and take precedence over all other activities. This article presents research findings on Aboriginal mortuary ceremonies in the hope that it will be useful for non-Indigenous nurses working with Aboriginal peoples. A qualitative research methodology was used, whereby data were collected by conducting 72 open-ended interviews with patients, carers, Aboriginal health care workers, health care workers and interpreters in four geographical areas in the Northern Territory. A descriptive phenomenological approach was taken to the recording and analysis of the data. The findings reveal that traditional practices including the smoking ceremony (a spiritual ritual conducted in the deceased's living space with the rationale of driving the deceased's spirit away), painting ochre on all living spaces inhabited by the deceased, or alternatively of putting up “flags” (which is considered to drive away the deceased's spirit and also to notify to the community that this is the house of a deceased) and the death ceremony (which includes practices such as keeping the deceased's body in the home, painting the bodies of the mourners and bringing kinship communities together to share food, song and dance) are of great significance in many Aboriginal cultures. It is the authors’ hope and expectation that an understanding of these rituals, and their significance for different cultural groups, will assist nurses by increasing their knowledge of Aboriginal cultural and ceremonial practices associated with caring for the deceased and so aid their important work in this area.

Keywords: Aboriginal, Palliative care, Death ceremonies

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Introduction 

The differences between Western and Aboriginal mortuary and grieving practices are considerable and times of mourning poignantly reveal these cultural differences (Abrahams, 2005). As Wake, Martin, and Dineen (1999) argue, central and northern Australian Aboriginal peoples have distinguished themselves in the way they have retained adherence to their traditional mourning rituals at a time when most industrial societies have shown a significant departure from grief and mortuary ceremonies since World War One. In particular, the ceremonies around death are extremely important to Aboriginal peoples and take precedence over all other activities (Maddocks & Rayner, 2003). While the strong Aboriginal traditions in this area are to be applauded and respected, misunderstandings can arise particularly in the cross-cultural context of Western biomedical health care. This article presents research findings on Aboriginal mortuary ceremonies in the hope that it will be useful for non-Indigenous nurses working with Aboriginal peoples.

Despite the importance of an awareness and understanding of the existence of the ceremonies associated with death for nurses working with Aboriginal peoples, there is a dearth of research available on this topic. To address this deficit in the nursing literature, this article provides an outline of findings from a 2-year research project, funded by the National Health and Medical Research Council (NHMRC), which aimed to develop an innovative model for Indigenous palliative care. This objective has been achieved and the model is now available (McGrath & Holewa, 2006). The findings from the study presented in this article provide information on mortuary ceremonies for Aboriginal peoples in the Northern Territory.

The following discussion is set in the context of the notion of cultural safety: a concept developed by Ramsden (1992) that originated in the nursing education setting in New Zealand as a response to colonizing processes in Aotearoa/New Zealand (Smye & Browne, 2002). The notion of cultural safety involves the recognition of the social, economic and political position of certain cultural groups within society (Ramsden, 1992; Smye & Browne, 2002). As Smye (2006) argues, the notion of cultural safety reminds us that we are all bearers of culture and that culture influences the care we provide. It is a practice that respects, supports and empowers the cultural identity and well being of individuals (NPCP, 2004). It is hoped that sharing the generous insights provided by the participants of the study will provide useful insights for nurses who care for Aboriginal peoples during death and dying.

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Methodology 

The data for the model development was collected through open-ended, qualitative interviews with a cross-section of participants (consumers and health professionals) throughout the Northern Territory. The model developed from the data was assessed by a national peer-review panel of experts in Indigenous health and a meeting of the Northern Territory Aboriginal Reference group. The model and the seven principles which form the foundation for the model (equity; autonomy/empowerment; trust; humane non-judgmental care; seamless care; emphasis on living; and cultural respect) have been affirmed by a wide range of national audiences and international peer-review (McGrath & Holewa, 2006). The qualitative data collected to inform the model development is extensive and rich and hence is being published in a number of articles in order to do the material justice. The findings under discussion in this article refer to the data on the cultural ceremonies and practices that directly follow the death of an Aboriginal person.

Ethics clearance 

This project was conducted in compliance with the NH&MRC guidelines on ethical matters in Aboriginal and Torres Strait Islander Health Research (NHMRC, 2004), and the Australian Institute of Aboriginal and Torres Strait Islander Studies’ guidelines for ethical research in Indigenous Studies (AIATSIHR, 2004). Permission and authorisation was obtained from a number of research ethics committees: The Human Research Ethics Committee of the Department of Health and Community Services (formerly Territory Health Services); Menzies School of Health Research, Darwin; the Central Australian Ethics Committee, Alice Springs; the Human Research Ethics Committee of Charles Darwin University (formerly Northern Territory University); and the Central Queensland University Ethics Committee. Approval was sought from relevant Community Councils (Chairs/Elders as appropriate) and from all individuals prior to participating in the project.

Research focus 

The research questions informing the data collection included:

In short, the research was concerned with: what is? what works? what is needed? The outcome is a “Living Model” (McGrath, Watson, Derschow, Murphy, & Rayner, 2004), which is a generic model incorporating all important factors that can be applied to the unique circumstances of each health care service working with Indigenous peoples during the end-of-life trajectory. The full findings from the study are extensive and rich and so are being published in separate articles on specific topics including communication issues (McGrath, Ogilvie, Rayner, Holewa, & Patton, 2005), the importance of the family meeting (McGrath et al., 2006a, McGrath et al., 2006b, McGrath et al., 2006c), the need for respite (McGrath et al., 2006a, McGrath et al., 2006b, McGrath et al., 2006c), relocation issues (McGrath & Patton, 2006; McGrath, 2006a, McGrath, 2006b), the Aboriginal view of cancer (McGrath et al., 2006a, McGrath et al., 2006b, McGrath et al., 2006c), obstacles to service provision (McGrath et al., 2007a, McGrath et al., 2007b, McGrath et al., 2007c), pain management (McGrath, 2006a, McGrath, 2006b), principles for the model (McGrath & Holewa, 2006), Aboriginal understandings of palliative care (McGrath & Patton, 2007), the preference to die at home (McGrath, 2007; McGrath & Phillips, 2008), the lack of local services (McGrath et al., 2007a, McGrath et al., 2007b, McGrath et al., 2007c), language issues (McGrath and Holewa, 2007a, McGrath and Holewa, 2007b), caring for a deceased person (McGrath, 2007; McGrath & Phillips, 2008) and employment issues (McGrath et al., 2007a, McGrath et al., 2007b, McGrath et al., 2007c). The focus on this article is on the cultural ceremonies and practices that directly follow the death of an Aboriginal person.

Participant group 

The research team included an Aboriginal health care worker, who co-ordinated all communications with Aboriginal people and Communities regarding introduction, progress and review of the project. Ongoing consultation assured informed and mutual understanding of the research process during data collection, while respecting Aboriginal knowledge systems and recognising the diversity and uniqueness of each community and its individuals. Stories and sources of information are only used in publications with the permission of the person and the community involved.

The Project Officer for enrolling participants is a well-respected Aboriginal person who has been working in palliative care for over a decade in the Northern Territory. She has the trust of key peoples in the communities. The participants were enrolled through a “snowballing” process based on consultation with both the Aboriginal communities and the health professionals who provide services in the following areas. The interviews were conducted in four geographical areas in the Northern Territory: East Arnhem Land (Maningrida, Millingimbi, Elcho Island, Nhulunbuy, Yirrkala, Angurugu), Katherine Region (Borroloola, Ngukurr, Katherine), Alice Springs and Darwin. As the following Australian Bureau of Statistics’ (ABS, 2004) figures demonstrate, the populations in these areas are small (Table 1).

Table 1. Demographics (Indigenous populations in parenthesis) (ABS, 2004)

Because of the small population base for the areas from which participants were enrolled, full details of participants cannot be given for confidentiality reasons. It will have to suffice to report that there were a total of 72 (n=72) interviews completed with a wide range of participants in the above named areas including patients (n=10), carers (n=19), Aboriginal health care workers (n=11), health care workers (n=30) and interpreters (n=2). For the purposes of this article the term Aboriginal health care worker refers to a worker in health care who is Aboriginal.

Data collection 

Data were collected by conducting open-ended interviews with Indigenous clients and service providers in the participating communities. The interviews were initiated with the focus questions outlined above, and proceeded with active listening, reflection and summary. The interviews were driven by an iterative, qualitative, descriptive phenomenological process. It is important to note that all of the data were collected by a respected Aboriginal health care worker skilled in palliative care. An interpreter was used if the participant spoke in their local language.

Data analysis 

The interviews were audio-recorded and transcribed verbatim. The language texts were then entered into the QSR NUD*IST N5 computer program and analysed thematically. A descriptive phenomenological approach was taken to the recording and analysis of the data. The aim of descriptive phenomenology is to describe particular phenomena, or the appearance of things, as lived experience (Streubert & Carpenter, 1995). The process is inductive and descriptive and seeks to record experiences from the viewpoint of the individual who had them without imposing a specific theoretical or conceptual framework on the study prior to collecting data (Polit & Hungler, 1995). All of the participants’ comments were coded into free nodes (files or codes in the NUD*IST computer program that are labeled and store similar language texts on one specific topic), which were then organised under thematic headings. The coding was established by an experienced qualitative researcher and completed by a number of research assistants for the project. There was complete team member agreement on the coding and emergent themes.

It is important to note that there is no identifying information associated with any quote from participants. Strict confidentiality was promised to participants in this study. A reassurance of strict confidentiality was an imperative for this study for two special reasons. First, strict confidentially is essential because of the sensitive nature of the cultural information provided by participants. Secondly, confidentiality is also important because of the small size of the communities from which data were collected where any information about a participant can potentially lead to identification.

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Findings 

In the following discussion, the Indigenous term “balanda” refers to non-Aboriginal or European people. The term is thought to have originated from the Indonesian word “hollander” or “ballander” as it refers to the early Dutch traders who sailed down from Indonesia to Arnhem Land on the annual monsoon winds (Jordan, 2005, Trudgen, 2000). It is thought to be predominantly an East Arnhem term, although there is evidence that it is used throughout the Northern Territory (Jordan, 2005, Trudgen, 2000).

Also, in the discussion of findings the participants use the term “jungai” as referring to “the boss for that person” (McGrath et al., 2004). There are many Aboriginal languages and the term can have other meanings elsewhere, for example it can also mean “meeting place” in Aboriginal language groups in other parts of Australia. Also, there are many different groups of Aboriginal peoples and within each specific group culture there will be differing understandings of kinship responsibilities (Maher, 1999). The “jungai” in the case of this research refers to a person within that network of kinship and community relationships who has decision-making responsibility for and power over the individual being spoken about.

Smoking ceremony 

The findings indicated that there are a number of formal ceremonial practices that can follow the death of an Aboriginal person in the Northern Territory. The first of such ceremonial practices discussed here is the “smoking ceremony”. Participants indicated that such ceremonies are very important in relation to dying for Aboriginal peoples, as the following statement reveals:

‘When an Aboriginal person dies in the community here some of the cultural thing that is done is smoking. [If you weren’t allowed to do that… how does it make you feel?] Really bad…’

And the traditional ceremonies are still practiced:

‘Aboriginal people are still strong in… the ceremonies and all that…’

The central reasoning given for the smoking ceremony is to drive the person's spirit away, as the following comment illustrates:

‘… [when someone dies do you get the house smoked out?] Yeah… [is that to help the spirit go?] Yeah… Go well… [Take [name] back to her country?] Yeah…They smoke the house and take all the spirit out so they won’t, you know…’

The smoking ceremony is also used on the occasions of births, but for different reasons:

‘… [at birth] same but it is different when… smoke… Secret ceremony called a smoking ceremony for – to women – for a women to have the smoke going into their body and also to that baby. So that mother and the child can be healthy when they grow to have a healthy body. That's [name location] way, that's what we do in our way…’

The smoking ceremony is associated with any living space occupied by the deceased. While it varies between communities, it is often the house of the deceased that is smoked, although it can be their room, their car or a special place, as the following comment shows:

‘Smoking of a room, a car or a place always occurs afterwards.’

In some places during the ceremony the deceased's clothing can also be burnt:

‘… [and clothing?] Well, we just burn it… We burn it… Burn it, in the holes – digging and just burn…’

Participants provided detailed descriptions of the smoking process which can involve building a fire in the house to enable the smoke to fill the house or by bringing buckets of smoking coals into the house, as one participant explained:

‘[How did you get around the smoking in the room?] That was fine, I mean they just… Didn’t worry them, they came in with their buckets of – with buckets of smoke or coals or whatever, and there was probably about 4 or 5 people with buckets and they just sort of did a little dance in the room and that was fine…’

Some will paint their bodies for the ceremony which can take place up to 2 weeks after the person dies.

‘… like it takes us about one or two weeks before they… like in the ceremony and like he’ll smoke the house and maybe if my brother or sister that have they – ceremony, they smoking my brother or sister or paint up like, you know, just… paint up.’

There is variation in the rules covering occupancy of the home after it has been smoked. The ceremony of smoking usually requires the family to move out temporarily.

‘[Do people move out of their houses here or not?] Oh, they leave that house for a little while because they have – for a couple of days, you know… Yeah and when they smokes it… Yeah, they got to go back to that house again…’

Some participants indicated that after smoking, family members are allowed to remain as long as they wish.

‘[And smoking, when people do die at home how do family leave their house for?] At least one – when you smoke you can stay there for long – forever… Forever…’

The following vignette provides insights into such a process with the remaining relatives in the house moving out temporarily, giving away the deceased's possessions and then moving back in after the smoking ceremony.

‘I had to live across the road with my big three bedroom tent; I had to live in my daughter's house… [until it was smoked out?] Yeah, until it was smoked out. I came in here and cooked and like had a shower but I – I’m not allowed to sleep in the house, so I stayed until the house was smoked, I moved in. Like everything in the house that belonged to my mother I had to give away because that's my custom.’

The differences in practices with regards to location can be seen by this quite different description of the smoking ceremony from another geographical region where only a totally different family is able to move back in to the house.

‘… in regards to smoking places they don’t do it straight away when you leave the house, it's really – it's quite different actually… Yeah, nobody's allowed to have the house whereas here other family members can move into the house as soon as it's smoked which could be a couple of days after that person's passed away. Whereas down – you know, in [name location] nobody can move in there for months. Yeah, and it's got to be a totally different family, you know, so – yeah…’

The participants indicated that, although there are some concerns about fire hazards, there is some understanding of the process among Western health professionals.

‘No, that was no problem at all and it was close to an exit too so – no it didn’t set off the alarms… We’ve had… well they don’t like – if somebody passes away in – at home they don’t like using that room again … For a period of time and then they have to smoke it.’

Marking the house of the deceased 

The second formal practice that is mentioned by participants in the study is that of marking the deceased's house with ochre. The following composite statement provides a description of the practice and how it is related to the practice of smoking:

‘[Mark around the house with the red ochre?] Yes, yes, they put the red ochre and put a big smoke in… Yeah, if someone can die or – we put that smoke, the fire you know, all the way and we put a red line near the house…[around the house]… That paint…Yes, they paint that house…’

The ochre can be painted on every space the deceased regularly lived in, such as their car:

‘They smoke it inside and put that red ochre around it then in the car right around. Whatever he touch or drove or lived in…’

There is wide variation in how long the red ochre stays, varying from according to instructions from the jungai or the family, to just wearing off naturally. In some areas ‘flags’ replace the ochre when it is wears off, as one participant explained:

‘[How long's that red ochre stay there for?] Same… [Depends on that jungai man to decide?] Yeah, sometimes it just wears off but they know there's a – I know [name location] they put flags up… Yeah, yeah, flagging that thing all right whereas we don’t do that, people know that red ochre, yeah… Sometime, it depend on which family.’

As with smoking, the ochre mark is believed to release the deceased from the place of living to go away and join the spirit world.

‘[What's that for, that mark around their house?] That's – that like a spirit – stay away, you know. Family… there and family abandoned… a body passed away, both… around the house.’

The obvious mark also communicates to the community that this is the place of the deceased.

‘[What's the red line do, that shows people that somebody's passed away in that house?] Yeah, yeah that's the one…’

The practice of marking with red ochre is not used everywhere, for example.

‘[That red ochre mark do they use that here?] … no not really, no…’

It is generally recorded as being practiced in places with more traditional cultures, as the following statement reveals:

‘[smoking of the house and people?] Yeah… Yeah they… Yeah, that red ochre, yeah… Yeah, they do that here… Where I come from they don’t – we… [name location] yeah we got really cultural things out there, you know, when someone passed away.’

Death ceremonies 

The third formal ceremony of significance to emerge from the data is the death ceremony. Death ceremonies can last for varying lengths of time, as one participant explained:

‘[the ceremonies and that, they can go for weeks when someone dies…?] Yeah, can take one week and a half to the young people and some are when we have old people die it takes us a couple of days, say two days, three days… [depends where people come from too?]’

Specific descriptions included examples which varied from two days to 2 weeks or, as the following description shows, even longer:

‘Go for weeks, might be four – four weeks or something like that, five weeks. Long time. Oh, might be one month, new month.’

As the following description demonstrates, the death ceremonies can include preliminary work decorating the home for the deceased.

‘Her dancing and her decorating – it took us two weeks and we had to decorate the house inside, put the… you know… get flowers, perfume, incense, we had to order some stuff from Darwin and make that little house a nice beautiful house for her to sleep in for the last two days before we put her into the ground.’

The descriptions include dancing, painting the bodies of the mourners and keeping the deceased body cool as an integral part of the ceremonial practice.

‘Dancing in the morning, afternoon, night time, every day. People painted up, really culturally… [that refrigerated coffin… keep the body cool?] No… It is cool anyway because we made that place really cool… We had couple of big fans… We had fans but like we made it really… but it was really cold and cool inside, yeah. And the breeze was coming in, you know. It was cool. So this time on Saturday we have the funeral…’

The following lengthy description provides an excellent insight into the length of the ceremony and the sheer number of participants in the ceremony, which brought many communities together to live, share food and dance:

‘Waited two weeks after death on the third week, on the Thursday, the coffin came in the morning, we took it – we took all the church for couple of hours, had a big service. And then after a big church service we took it here with traditional dancing all the way, … and we had dancing all afternoon, all night, until next day, dancing, followed by the – all day Saturday we had – all the people gathered from four communities, [names of communities] all the families… dance all around the… there was tents everywhere, on the other side people camping, here, on the other side in the bushes, tents everywhere on we had a good cultural ceremony all day starting seven o’clock in the morning on Saturday, all day, having lunch midday, continuing and then around about this time we all walked to the funeral ground and had the… [funeral] Yeah…’

Singing is also an important aspect of the ceremonies. As one health worker noted, the present Western hospital environments are not conducive for such ceremonies and so the increasing medicalisation of Aboriginal death is an obstacle to such practice:

‘Depending on how traditional they are there are certain songs and certain ceremonies that are associated with the passing away of an elder. And because of our tendency to hospitalise that denies the opportunity for that to happen. And that is an important part of culture… we have this wonderful system where in hospitals visiting times are between certain hours, you can only have two or three people. I mean how can the clan get around and do the ceremony and singing if we’re imposing these environments.’

The solution is to allow the ceremonies to happen in the homelands to meet the spiritual needs of the Aboriginal community.

‘… we have the dying person in homeland, they have this ceremony going on that is just for the dying person. That is not just today but it has been happening early. In the old days. [Special songs to sing that person who is dying so they die with the right songs?] Yeah, sort of ceremony just for that dying person, but that dying person have to give the family a ceremony in that clan. It is important to have that thing. For [name location] people, that ceremony important so the dying person will be happy and the families feel happy and the relatives feel happy and everybody happy. Especially in the homelands.’

As there are considerable costs involved in travelling to the homelands, it is noted that Aboriginal peoples need some warning from medical doctors that the patient is in the terminal stage.

‘The family just say they want to come back but got no money… come home. They get into thousands… so we need to give family plenty of time to get that money together… so doctors need to let family know earlier than… if they are at the last minute running around trying to get money together.’

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Discussion 

The findings indicate that once the deceased has returned home the smoking ceremony is of great significance in many localities, especially traditional communities. The spiritual rationale for smoking is to drive the deceased's spirit away. As Broome (1994:20) notes, without proper ceremonies the deceased's spirit cannot take its place in the afterlife but will become caught between death and future life. Wake et al. (1999) also note that many of the funerary rituals and practices of tribal Aboriginals are associated with encouraging the permanent departure of the dead person's spirit from this world. Performing the ritual of “smoking” a dwelling or room in which someone has died is seen as purifying it and cleansing it of bad spirits (Maddocks & Rayner, 2003; NPCP, 2004:84). Thus, the smoking ceremony will take place in any living space that the deceased inhabited such as their room, their car or their house. In some areas even the deceased's clothes will be burnt. The smoking process has been described as burning coals in a room or building a fire in a house. It is common for mourners to paint their bodies and for the ceremony to take up to 2 weeks to conclude. The family usually has to move out temporarily and then, depending on the area, may move in indefinitely or may not return. In the latter case, other members of the kin group will take up residence in the house. Maddocks and Rayner (2003) also report that when an Aboriginal person dies in a house it may mean that the family cannot re-occupy it for a period of time.

The work of Sullivan, Johnston, and Colyer (2003) affirms that Aboriginal post-death practices vary markedly from place to place and family to family. In some places the smoking is accompanied by or replaced by sweeping with branches (Wake et al., 1999). These ceremonies performed in the previous living space of the deceased serve to weaken the ties of the dead with the land of the living and, historically, are thought to have succeeded the ceremonial burning of belongings sometime in the 1930s (Berndt & Berndt, 1996; Wake et al., 1999). Research indicates that most aged care facilities and nursing homes in the Northern Territory support such cultural practices (Sullivan et al., 2003:80).

Another traditional practice associated with the smoking ceremony is that of painting ochre on all living spaces inhabited by the deceased such as the car, room or house. The ochre either wears off naturally or is removed by the instruction of the jungai or family. In some areas the custom of putting up “flags” replaces the ochre. The spiritual rationale for the ochre painting is similar to the smoking ceremony: that is, to drive away the deceased's spirit and also to notify to the community that this is the house of a deceased. There is scant mention of this mortuary practice of the ochre mark in either the peer-reviewed or lay literature. However, reference is made to the practice in the National Palliative Care Program Resource Kit where it is stated that in some cases the house, the vehicle, and other areas in the community used by the deceased may be marked with ochre (NPCP, 2004:34). This reference also affirms that there are conventions regulating both the time and the manner in which these kinds of markings, including body lmarkings, may be removed (NPCP, 2004:34).

The third ceremonial practice that the participants reported on is the death ceremony. Wake et al. (1999) caution that the attendance at funerals for non-Aboriginal peoples should only be by invitation and then only if accompanied by an experienced Aboriginal Liaison Officer, health worker or community elder. This ceremony can last for a period from 2 days to months. The process involves keeping the deceased's body in the home, painting the bodies of the mourners and bringing kinship communities together to share food, song and dance. It is noted that it is difficult for such ceremonies to happen in environments of modern Western hospitals and that the death ceremonies have been increasing thwarted by the medicalisation of Aboriginal dying. The solution is seen to ensure that the body is sent home. It is also noted elsewhere that in previous times relatives would have sung funerary songs to announce to the afterlife the coming of the dying relative and to ensure that they died in the correct song cycle, however nowadays this rarely happens (Wake et al., 1999).

The “sorry time” of the funeral and mourning takes precedence over all other matters (Jacob, 1991). Word of impending death is known to spread quickly through the Aboriginal community and members will begin a pilgrimage to either the bedside of the dying person or to their funeral site (Wake et al., 1999). The mourners will include family but also other community members will attend out of a sense of social obligation (Wake et al., 1999). Everywhere there is an expectation that kin, including extended families, will make considerable effort to attend the rites associated with death, mourning, funerals and burial (Gray, 1976; NPCP, 2003:33). As there are considerable costs to Aboriginal relatives to attend the death ceremonies it is noted that it is important for doctors to provide sufficient notice to relatives that the patient is in the dying trajectory. Funerals often have to be delayed until people can afford to attend as many Aboriginal people have to wait for payment to be able to travel to a funeral (NPCP, 2003:89).

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Limitations of the findings 

It is important to note that the findings can only represent, at best, the information that Aboriginal peoples are prepared to share with a Western research study. The researchers took all possible precautions to ensure that the study was guided by principles of cultural safety (for example, the research originated from a request within the Aboriginal community, the ongoing support and collaboration of the Aboriginal elders and communities was obtained before and during the project, the data were collected by a well respected Aboriginal health care worker, an open-ended qualitative approach was chosen based on active listening so that the work was “user friendly” and empowering to Aboriginal participants and the findings were returned formally to the Aboriginal communities that were involved). However, it is our belief that part of cultural respect is an understanding that ultimately there will be limits to the information that Aboriginal peoples will be prepared to put into the public domain through the mode of Western academic research. All of the information provided from the study needs to be humbly viewed from an understanding that in Aboriginal cultures information needs to be earned. It is not freely placed in the public domain as in Western culture, as one participant stated:

‘But lot of these old people are still traditional, they don’t give out too much information and why should they, because they have to keep some secrets for themselves. You have to earn the right to learn it… [Even culturally an Aboriginal person has to earn the right to be – to that information?] Yep that's right.’ (emphasis added).

The fact that some of the information shared was previously not general knowledge for non-Aboriginal peoples was acknowledged by participants, as the following statement exemplifies:

‘…the gathering of hair and possessions is something that occurs but it occurs in a way that's sort of almost transparent to Europeans.’

At other times participants qualified their insights as hearsay:

‘And what they do with it after that I’m never too sure… what you may have heard it's probably a – a thing that does happen.’

Thus, in no way does the presentation of the findings from the study seek to act as a definitive statement on these sensitive cultural issues. Rather, the aim of sharing the insights from such a wide collaboration of peoples who are part of or directly involved in the Aboriginal communities is to begin a useful cross-cultural dialogue. The central message is respect for cultural difference situated in the humility of knowing that there can be many different cultural beliefs and practices that shape the human response to death and dying.

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Implications for nursing practice 

An understanding of the practices of Australian Aboriginal peoples with respect to mortuary ceremonies is essential to enable nurses working with dying Aboriginal patients and their families to respond in an appropriate and timely manner. An awareness of the specific requirements of each Aboriginal patient with respect to their body, house and possessions upon their death is imperative to enable arrangements to be made for the specific cultural rituals to be performed. For example, in many Aboriginal cultures, the performance of the death ceremony requires that the deceased's body be located in the deceased's home or living space for a period following their death. This will necessitate in many instances that arrangements be made for the Aboriginal person to die at home or arrangements made to return the body home to the community. Furthermore, many Indigenous cultures prioritise very highly the attendance by kinship or community members at ceremonies associated with the death of an Aboriginal person. Accordingly, providing as much notice as possible of the prognosis of an Aboriginal patient in the dying trajectory to all appropriate members of the cultural group is of fundamental importance in enabling arrangements to be made for their attendance. Other rituals, such as singing by members of the cultural group around the time of the death, need also to be understood and accommodated at hospitals or nursing settings where Aboriginal people die.

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Conclusion 

It is the authors’ hope and expectation that the insights so generously provided by the participants in this research will go some way to informing nurses about Aboriginal cultural and ceremonial practices associated with caring for the deceased to assist their important work in this area. For as Wake et al. (1999:15) state:

‘It is their (Aboriginal peoples) right to mourn in a way appropriate to their culture, and our responsibility to show compassion and respect rather than bewilderment and misunderstanding.’

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Acknowledgements 

The authors would like to thank NH&MRC for the funding and others involved in conducting the study including Jennifer Watson, Beverley Derschow, Simon Murphy, Rob Rayner, Hamish Holewa, Mary Anne Patton, and Katherine Ogilvie.

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