This case concerns the care provided to a kaumātua whose cultural needs and beliefs were not upheld while an inpatient in a regional hospital. The case highlighted the importance of an appropriate assessment pathway to consider cultural needs or options for culturally safe care.
Following assessment and observation in the Emergency Department, the kaumātua was transferred to a ward, where he was an inpatient for approximately four weeks. During the admission process and while the kaumātua was an inpatient, his cultural needs and beliefs were not considered.
Aged Care Commissioner, Carolyn Cooper considered that consideration of cultural needs of the kaumātua and appropriate options should have been made available from the time of his admission to hospital, to enable the whānau to exercise control in caring for their koroua, in accordance with their tikanga and kaupapa — mana whakahaere. Instead, the whānau were left to self-navigate the health services to determine the support available to their koroua.
Ms Cooper highlighted whānau involvement as fundamental in the health and wellbeing of their whanaunga. In her decision, Ms Cooper referenced He Korowai Oranga — Māori Health Strategy. The strategy clearly defines the importance of whānau to achieve Māori health and wellbeing, with the aspiration that “Māori families are supported to achieve the fullness of health and wellbeing within te ao Māori and New Zealand Society as a whole”.
Ms Cooper recommended that the hospital:
- Facilitate a whānau hui, to allow the kaumātua’s whānau (as part of their healing) to speak of the mamae they experienced while their koroua was a patient in hospital, and to allow the hospital to provide an apology;
- Reflect on the whānau experience, and consider how the navigation of separate health services for whānau can improve in the future, taking into consideration a whole-of-system approach;
- Review its protocols, outlining the cultural support pathway at the time of admission for all Māori patients, taking into consideration the whānau’s choice to engage in Māori services, and acknowledging that the option for cultural services should be provided in the first instance and not as an afterthought; and
- Outline in their kaupapa training framework how the practice of tikanga with patients and their whānau is developed with all hospital staff, and provide comment on how this framework aligns with the aspirations of Te Aka Whai Ora, with consideration of the elements of Pae Ora.
[1] Ministry of Health. 2020. Whakamaua: Māori Health Action Plan 2020–2025. Wellington: Ministry of Health.
[2] Ministry of Health. 2014. The Guide to He Korowai Oranga — Māori Health Strategy. Wellington: Ministry of Health.