Oral Presentation Lowitja Institute International Indigenous Health and Wellbeing Conference 2016

Pae Herenga: retaining Māori end of life cultural care customs (#35)

Tess Moeke-Maxwell 1 , Merryn Gott 2 , Stella Black 2 , Rawiri Wharemate 2 , Whio Hansen 3
  1. University of Auckland, Auckland, New Zealand
  2. University of Auckland, Auckland, New Zealand
  3. Citizens Advice Bureau, Auckland, New Zealand

Māori whānau (families) have a treasured cultural obligation to provide end of life care. The increase in deaths among older Māori over the next 30 years places a high caregiving demand on whānau. The Te Ārai Palliative and End of Life Care Research Group kaumātua (Elders) are concerned that urbanised Māori may not have retained their cultural care customs. They also recognise that New Zealand palliative care services lack Indigenous care customs knowledge. Kaumātua called for the Pae Herenga study to investigate Māori end of life care customs. Five whānau (Ngāpuhi, Tainui, Ngāti Porou and Te Arawa) spoke about the cultural customs they employed across different care settings and their benefits in face to face interviews. A Kaupapa Māori and social constructivist analysis highlighted that whānau drew on whanaungatanga (relationships), aroha (care, empathy, compassion), kotahitanga (collective unity) and manaakitanga (care of mana/status) to care for their ill and dying. Customary knowledge strengthened whānau to provide care, however the depth and level of knowledge varied between whānau. This was related to the age of carers and prior exposure to cultural customs. Care customs were more likely to be held and utilised by whānau with kaumātua who had a high level of reo (language), tikanga and prior mentoring from their tūpuna (ancestors). Carers who did not have the same access to care customs knowledge did not have the same cohesive system of care. They lacked in-depth knowledge of te reo and tikanga and typically had not received end-of-life care mentoring and had less whānau support. Overall, their end-of-life cultural care aspirations were not well attended to by mainstream health services leading to increased stress and grief. Participants identified a larger more in-depth study of Indigenous care customs would strengthen whānau caregivers with the burgeoning care demand and increase palliative care provider knowledge. This has led to the development of the Pae Herenga Project. Our aim is to investigate the end of life cultural care customs among whānau within four Māori communities. Our aim is to develop a free online educational resource including digital stories, videos, brochures and written publications.