We used to go fishing in the fish shop. We come from the seaside in Whangaroa, where we were used to having kaimoana but living in the city our only option was the fish in the fish shop. This is where our nightmare began, in May of 2004. Ritihia slipped on the wet floor and we couldn’t help her to stand up as she was in terrible pain. We sought immediate medical attention from the GP – x-rays and CT scans. The diagnosis was aggressive lung cancer. Metastatic. Both our worlds crumbled. How could that be? She was a non-smoker. A second opinion confirmed a worst diagnosis, maybe she had four to six weeks. I loved her deeply. But it was time to shift to a different mode of quality care. I was a Kaiawhina with the He Kamaka Oranga Māori Health Services of Auckland District Health Board and it was time to use those skills in my own home. Coordinating my whānau as kaitiaki wasn’t always easy. We had whiteboard for medication charts, roster sheets for family members, four caregivers for each of the three shifts. Nieces cooked, brothers greeted visitors, did karakia. My sons and two other nieces handled transportation and hospital visits. It was a beehive, but a beehive of love. Tears were banned in front of Ritihia or mum. Ritihia We used to go fishing in the fish shop. We come from the seaside in Whangaroa, where we were used to having kaimoana but living in the city our only option was the fish in the fish shop. This is where our nightmare began, in May of 2004. Ritihia slipped on the wet floor and we couldn’t help her to stand up as she was in terrible pain. We sought immediate medical attention from the GP – x-rays and CT scans. The diagnosis was aggressive lung cancer. Metastatic. Both our worlds crumbled. How could that be? She was a non-smoker. A second opinion confirmed a worst diagnosis, maybe she had four to six weeks. I loved her deeply. But it was time to shift to a different mode of quality care.
I was a Kaiawhina with the He Kamaka Oranga Māori Health Services of Auckland District Health Board and it was time to use those skills in my own home. Coordinating my whānau as kaitiaki wasn’t always easy. We had whiteboard for medication charts, roster sheets for family members, four caregivers for each of the three shifts. Nieces cooked, brothers greeted visitors, did karakia. My sons and two other nieces handled transportation and hospital visits. It was a beehive, but a beehive of love. Tears were banned in front of Ritihia or mum. Ritihia ignored the six weeks to live and waited for our younger sister Ann’s 50th birthday in October. Days later she was admitted into hospital for the last time. The ward surged with family members bidding her a final goodbye. Now she’s returned to Waihapa, Pouakawhakahua Urupā and rests there with her son, John. She can fish anytime now.
Stella: Manaaki played a really important role in this story as the Kaitiaki. Tess can you explain a little bit more about that kaitiaki role?
Tess: Well I think she did an amazing job of actually showing what happens when you bring the traditional knowledge within a whānau with full whānau support and palliative health care literacy, because she is someone that has that particular body of knowledge and she was able to introduce that into the whānau. And awesome things happen when you bring those synergies together. And so, you can certainly see with her playing this leadership role ah to guide the whānau, and to put everything in place. Everyone had a role to play, everyone knew what their role was, and everyone actually knew who the kaitiaki was which was Manaaki. So you know ah, she did incredibly well there and, it just makes things run so smoothly and you can see the benefits across all aspects – physical, the medical situation, the environment, ah the whānau care that was provided was awesome.
Stella: So, what can health professionals learn from this story?
Tess: Well I think what’s critical here is that it demonstrates that whānau have all the skills needed to provide care, but actually health literacy goes a long way. So, providing information about the services that are available to help whanau provide care at end of life, ah information about the diagnosis, treatment options, and also the statutory entitlements. All of that stuff serves to empower whānau and whānau want to care. But actually sometimes, we just need that additional information and those resources to help us do the job really, really well.