A Matou Haerenga
Our Journey
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Dr Melissa Carey was awarded a Post-Doctoral Māori Health Research Fellowship in 2020 from the Health Research Council New Zealand to carry out a study on a community approach to support Māori ageing and end-of-life. Melissa was supervised by Dr Tess Moeke-Maxwell and Professor Merryn Gott at the School of Nursing, University of Auckland, and supported by research assistant, Kathleen Mason.
Aim: The aim of Keteparaha: A Community Framework to support Māori Ageing and End of Life study was to address Māori community healthy ageing, and end of life care needs through the development and identification of a Māori co-designed compassionate community toolkit for healthy ageing and end-of life-care for Māori communities.
Why? It has been predicted that by 2038 there will be a significant increase in the number of older Māori (over 65) deaths (McLeod, 2016). Many of these people will experience chronic and complex health issues at end-of-life, placing a significant responsibility on local communities and whānau (family and extended family members). Communities have a cultural obligation to provide good care across the ageing trajectory and at end-of-life. Many Māori experience racism, exclusion, and have an inherited intergenerational and lived experiences of cultural trauma.
Methodology: This project was a community co-design project underpinned by kaupapa Māori and was led by Māori for Māori. Kaupapa Māori is a theoretical framework and lens through which to view the world. It privileges Māori ways of knowing, being, and doing and requires research to benefit Māori (Pihama, 2017). Key principles inherent to kaupapa Māori research include: the use of te reo Māori (language), whakapapa (connection to people, place, spirit), tino rangatiratanga (self-determination), tikanga and kawa (customs, protocols and knowledge). A community co-design approach requires working relationships and research partnerships with community members and stakeholders to identify problems and develop joint solutions. Within an Indigenous context, co-design facilitates the joint development of solutions that are culturally relevant (Rolleston et al., 2022).
Methods: A literature review of Compassionate Community frameworks and an analysis of Māori models of health and wellbeing were undertaken. A series of focus groups with Māori kaumātua (elders) and whānau living in South Auckland, New Zealand were carried out to kōrero (discuss), share pūrākau (stories), explore information and resource gaps as well as community strengths and aspirations, and to test tools and resources. Interviews were also conducted with health and social care professionals serving South Auckland to gain their perspectives of what end-of-life care looks like for Māori living in the area. We also built an online platform called Te Kōpū to facilitate information sharing between research partners. Our research methods were impacted by the COVID-19 Pandemic, we adapted our methods accordingly, using online and interactive tools.
Findings: The kaupapa Māori informed community co-design process enabled the development of the Keteparaha Framework, Ngākau Arataki, as well as tools to support engagement with the framework. Research themes identified through the data analysis included community strengths, kaumātua values, assisted digital technologies, tools for kaumātua, self-assessment and support services and resources underpinned by the importance of whānau connectedness and communication. We will be publishing more information about the Keteparaha research methodology, and the findings. Once these are formally published they will be posted here.
Dissemination: This work has been presented at many community forums and events. We have presented the methodology and findings at the following conferences/events:
1. 2022: Auckland New Zealand
2. 2022: Auckland New Zealand Online NPM Indigenous research conference
3. 2022: Kansas University Centre for Community Health USA
4. 2023: EAPC Rotterdam Netherlands
5. 2024: ICT Granada Spain
6. 2024: NT Australia Council of Deans Nursing and Midwifery
Project linkages: This research links with the Pae Herenga: An investigation of Māori whānau end of life cultural care customs and to work of Te Ārai Palliative Care and End of Life Care Research Group.