Can advance care planning (ACP) be a relational healing place for indigenous homeless people in Aotearoa New Zealand?

ABSTRACT

In this autoethnographic article, we explore one Māori person’s experience of engaging with advance care planning (ACP) while experiencing the distinct relational fracture as expressed into indigenous homelessness. We describe how ACP, envisioned as a relational space, and expressive of Māori holistic care and wellbeing, might be conducive in healing past traumatic experiences and restoring familial relationships and connections. Extending ACP beyond that for which it has been originally conceived for housed populations and by Western health models, may offer a pathway to assist indigenous homeless people with dignity and peace to fulfil tangihanga (traditional death customs and rituals) through re-establishing connections and healing at the end of life. We recommend that ACP in relation to Māori homelessness offers a Māori space, located within a web of Māori health professionals, to respond adequately to the specific demands that might arise from ACP. Essentially, these demands may relate to a) establishing restorative connections with whānau (extended family) and providing appropriate and consistent support whether in the context of the end of life or over time; b) addressing the needs and distress that may arise from expressing trauma events and offering a space to weave those experiences within a collective and transgenerational experience of trauma.

KEYWORDS:

• Advance care planning
• Māori
• indigenous
• homelessness
• death
• end of life

Acknowledgment

We are deeply grateful to Daniel for courageously sharing his story about his experiences so that other people can learn and grow. We acknowledge Māori leaders who provided their feedback on the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Notes

1. The reflection below is those of the first author.

Additional information

Funding

This work was supported by the Māori Psychology Research Unit of the University of Waikato.

Notes on contributors

Sandrine Charvin-Fabre

Sandrine Charvin-Fabre is a PhD student at Te Huataki Waiora School of Health at the Univeristy of Waikato. Her research focuses on homelessness and the end of life in the context of Aoearoa New Zealand.

Tess Moeke-Maxwell

Tess Moeke-Maxwell (Ngāi Tai ki Tamaki & Ngāti Porou) is a Senior Reseach Fellow and co-director of the Te ārai Palliative Care and End of Life Research Group at the School of Nursing, Universityof Auckland. The research she leads on behalf of the Te ārai Kāhui Kaumātua is designed to give voice to whānau Māori about their end-of-life care tikanga (customs) and preferences.

Ottilie Stolte

Ottilie Stolte was born in the Netherlands, but has lived mostly in Aotearoa New Zealand. She works as a Senior Lecturer in community psychology and qualitative methods at the University of Waikato. Key research areas include poverty, homelessness, health inequalities, urban issues and everyday life. As a member of the Māori Psychology Research Unit, Ottilie works as an ally alongside Māori students and colleagues.

Ross Lawrenson

Ross Lawrenson is a public health physician and Professor of Population Health at the University of Waikato.