Mauri ora, Mauri mate;

Reflections on developing models

of

Palliative Care for Māori

Ria Earp

Chair Te Rōpū Taki Māori

Hospice New Zealand

1 March 2018

Palliative Care Lecture Series 2018

Hospice New Zealand & Cancer Research Trust New Zealand

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Reflection

Whakarongo……

Ki t e tangi ā te manu e karanga nei,

‘Tui, tui, Tuituia!’

Tuia ki runga, tuia i raro, tuia i roto

Tuia ite kāwai tāngata i heke mai i Hawaiki nui,

i Hawaiki roa, i Hawaiki pāmamao….

I te hono ki wairua, ki te whai ao, i te aomarama…..

Ka rongo te pō , ka rongo te awatea.

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ReflectionListen….

To the sound of the bird: 'Tui, Tui, Tuia!'

Connecting to those above, to those below, to that

within.

Connecting with those who have migrated on their

final journey to Hawaiki,

long Hawaiki, distant Hawaiki…..

In a healing spirit, move from darkness into the world

of light….

Sense the night, be aware of the coming dawn.

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Mauri ora, Mauri mate

Reflections on developing models of

Palliative Care for Māori

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• Births, birth rates, and total population

• Numbers or percentages in age ‘bands’

• Whānau size, dependents and living

arrangements

• Life expectancy - how long are we going to live?

• Age of death, death rates?

• Future planning- projections for total population

Shape of Population

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Total Māori Population

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Births by Ethnicity Projected 2016

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9

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

2013 2018 2023 2028 2033 2038

Maori

Projected Māori Population Growth

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Projected Māori age of dying

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Projected Māori Deaths(year 2016 – 2038)

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Future for Māori

Palliative Care

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• Twenty year projections

• Health workers – working with kaumātua

• Health services – working with kaumātua

• Whānau support to care for kaumātua

• Aged care? What do we want ARC services to

look and feel like for kaumātua?

• Palliative care for kaumātua

So, what does this all mean?

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Kaupapa Māori - Aged Care

• Whare Tiaki – Māori aged care, supported

living house within ARC facility

• Chch Methodist Mission redeveloped their

facility – WesleyCare - approached Kai Tahu

iwi about the development of 8 bedroom villa

• Worked with Kai Tahu and Māori health

worker (DHB) to set up Kaupapa Māori

supported living house

• Benefits of ARC facility combined with a Māori

approach

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Kaupapa Māori - Aged Care

• Future hope for service development that

meets cultural and quality health needs

• Te Karaka, the Kai Tahu magazine highlights

the service in their Dec 2017 edition

• Very positive quotes from residents and their

family members

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Whānau quote

“She didn’t want to live with me because she’d be

home all day alone while I’m at work...

You might think that the whānau are not looking

after their kaumātua, but actually it’s that the

kaumātua are wanting something that the

whānau can’t provide..”

- daughter of resident

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Kaumātua Care

• Research and practice data - care by the

whanau at home the main preference for

Māori patients

• Important that services delivered in community

to support home care, be culturally appropriate

too

• ‘Youtube Māori Digital Stories’, Te Arai

(University of Auckland)

• Options that allow choice for culturally

appropriate services that meet needs

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Research Recommendations

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Research Review

• References given at the end of slides

• Research on ‘Māori Health Literacy in

Palliative Care’ focuses on ‘communication’

and quality of service

• Valuable considering cultural appropriate

service and quality care. Introduce the concept

of cultural literacy.

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• Health Literacy Research recommendations can be a little overwhelming and challenging

• Looking for a way to break these down into practical, affordable and phased approaches

• Using future population projections and considering Māori population as a whole;

• options

• phased changes

Research Review

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• Professor Heather McLeod; demographer and actuary

• Vanessa Eldridge, Mary Potter Hospice

• Te Arai - Palliative Care & End of Life Research

Group, School of Nursing, Auckland University

• LiLACS (Life and Living in Advanced Age: a cohort

study in NZ), School of Population Health, Auckland

University

• Statistics NZ, Hospice NZ, Palliative Care Council NZ,

Te Kete Hauora - MoH

Ngā mihi nui ki a

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• Brankin, Anna and Beck Eleven, “Kaumātua Care, A Kaupapa Māori Model”, in Te Karaka, Dec 18, 2017

• Kidd, Jacquie Dr; Susan Reid, Nicola Colling, Dr Veronique Gibbons, Stella Black, Rawiri Blundell, Tamti Peni, Matua Hone Ahu, Kai Mau te Kahu Whakamauru; Health Literacy in Palliative Care, 2014, AUT, HRC, Ministry of Health (Ministry of Health website)

• LiLACS NZ – (Life and Living in Advanced Age: a cohort study in New Zealand), School of Population Health, University of Auckland

• Mead, Hirini Moko, & JuneTe Rina Mead, People of the Land, 2010 (source for photos)

• Ministry of Health, Palliative care and Māori from a Palliative Care Perspective, 2014, (Ministry of Health website)

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References – Māori Palliative Care

• Ministry of Health, The Guide to He Korowai Oranga, Māori Health Strategy, 2014, (Ministry of Health website)

• Rauawaawa Kaumātua Charitable Trust Research Project Team, Māori Health Literacy and Communication in Palliative Care: Kaumātua Led Models, 2014 (Ministry of Health website)

• Slater, Tania, Anna Matheson, Cheryl Davies, Cheryl Goodyer, Maureen Holdaway, and Lis Ellison-Loschmann, “The role and Potential of Community Based Cancer Care for Māori in Aotearoa/New Zealand”, 2016, New Zealand Medical Journal

• Slater, Tania, Anna Matheson, Cheryl Davies, Ria Earp, Kate Gellatly, Maureen Holdaway, and Lis Ellison-Loschmann, “Exploring Māori Cancer patients, their Families’, Community and Hospice Views of Hospice Care”, 2015, International Journal of Palliative Nursing

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References – Māori Palliative Care

• Taylor-Johnston, Elizabeth, Shirley Simmonds, Ria Earp,

Puhiwahine Tibble, “Māori Perspectives on Hospice Care”,

2014, Diversity and Equality in Health and Care

• Te Arai, Palliative Care and End of Life Research Group,

School of Nursing, faculty of Health Science, University of

Auckland, “Maori Digital Stories about Whanau

Caregiving”,(www.youtube.com/watch?v+G9zXJOnRuEI)

[Note favourite vignette: The Lucky Ones – Red 12.38-15.09]

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References - Māori Palliative Care

Kia ora koutou

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