He taonga tuku iho: Indigenous End of Life and Death Care Customs of New Zealand Māori

Abstract

Older Māori often have multiple and complex health issues that require a high level of end of life care. However, New Zealand’s bio-medical focused health system does not cater for the type and level of holistic care preferred by its indigenous population. In this chapter, we argue that all families, including the ethnically diverse, would benefit from a health system that could deliver culturally informed, and spiritually aligned, end of life care. Ancestors and elders played a vital role in the inter-generational transfer of end of life care cultural knowledge to whānau (family, including extended family). Today, however, not all Māori have been able to retain their traditional identities and tribal traditions. The forces of colonialism and increasing ethnic diversity continue to influence, shape and produce contemporary heterogeneous identities. We argue for holistic indigenous care informed by the practice of awhi. Awhi is the physical expression of a cognitive, emotional and spiritual response to caring that is informed by the spiritual. This metaphor is used to describe a model of care that includes customs and protocols that wrap around the ill person and his or her family before, during and following death. This approach extends upon a Western biomedical concept of health, and service delivery, which views end of life care solely in terms of the life or death of the body.