Older First Nations women occupy distinct roles as knowledge-holders, Elders, and custodians of cultural protocols surrounding death and dying, yet Australian palliative care policy has not examined how these women are positioned within national frameworks. This study addresses that gap through a critical intersectional analysis of four major Australian palliative care frameworks, examining how they construct autonomy, place, family, and spiritual care in ways that recognise or erase older First Nations women's needs, knowledge, and authority. Critical policy analysis was applied to the National Palliative Care Standards Edition 5.1, the National Consensus Statement on End-of-Life Care, the National Framework for Advance Care Planning Documents, and the Palliative Care Outcomes Collaboration Clinical Manual. Analysis drew on intersectionality, cultural safety and sovereignty, and settler colonial theory to interrogate assumptions across four domains: autonomy and decision-making; place and Country; family and kinship; and cultural and spiritual care. While frameworks show increasing commitment to cultural safety, all four reproduce assumptions of individual autonomy, institutional settings, nuclear family structures, and biomedical spirituality that are structurally incompatible with Indigenous relational ontologies. Marginalisation operates not through explicit exclusion but through positioning Indigenous knowledge systems as supplementary rather than co-equal. Generic references to Aboriginal and Torres Strait Islander peoples further obscure the compounded marginalisation experienced by older First Nations women as Elders. Achieving equitable end-of-life care requires moving beyond additive cultural accommodations toward structural transformation through assessment tools that capture cultural roles, quality metrics that measure connection to Country, and accreditation processes that honour Indigenous authority structures.