Accepting diveristy

Respecting whānau and not judging them is important for building a trusting relationship.

No matter who the whānau is, where they are from, what their background is, where they live, what their ethnic composition is, how rich or poor they are, what spiritual faith they follow (if any), what their sexual or gender orientation is, and what they look like, how can health services and health professionals make the kaumātua and whānau feel safe and comfortable? What support can be offered to them?

Mary Te Awhi, a hospice kaitakawaenga, explained:

And sometimes they [patient] says to me, ‘Oh, Whaea. I like to have a smoke; I like a bit of dope.’ And I say, ‘Buddy that’s your choice. I’m not here to tell you how to live your life. I’m just here to offer you some support. To let you know that, yes, hospice might be a scary thing for you, and you do not necessarily have to come to hospice. Do you realise that 60% of our patients never come to the hospice because they don’t have to? They’re cared for in the home.’

Furthermore, the hospice kaitakawaenga, Mary Te Awhi, has observed that there is a lot of mistrust with whānau:

And that happens sometimes. They might feel some mamae to tell me that perhaps they like a bit of dope, I just say ‘I’m not Interested… I’m not the dope police. It’s not what I’m here for. I’m not here to judge you.’ You know occasionally I’ve walked away around the corner and somebody might be just wailing away with a cup of coffee and a cigarette and they say, ‘Oh sorry Whaea. Sorry Whaea.’ And I say, ‘Do you know what, I’m a visitor to your home. This is your whare. What you do in your whare is actually your business.’ … And there is, there’s a lot of mistrust out there for all manner of reasons.

Many of the whānau Dr K. sees have complex lives. Allowing Māori whānau to talk openly with acceptance and having a ‘non- judgmental’ approach was considered important in building an open and trusting relationship with them:

I know I’ve only done this for 10 years, I’m not an expert but, [being] non-judgemental [matters]. So, if you can be open enough and have that, good communication, a good trusting relationship that they can bring to the table whatever it is (i.e. that they’re doing or using or whatever it is), and you remain, non-judgemental and open. Ah then I think… that’s key. I don’t know if that’s right but, I find that even not even dealing with palliative but dealing with young people perhaps on drugs and you know, other chaos that’s going on in their lives, they’ll often open up more when you remain totally non-judgemental. ‘So, you’re not telling off?’ You’re not, judging them for the situation that they have found themselves in.

Recommendations

  • Treat every kaumātua and their whānau on a person-by-person and whānau-by-whānau basis, thinking about the specific needs of each kaumātua and their whānau.
  • Think broadly about the needs of the kaumātua and their whānau. For example, if a kaumātua is takatāpui, gay, lesbian, homosexual, transgendered, bi-sexual, inter-sexed or queer then their sexual identity may not be accepted by their whānau; if they have a partner, they may not be accepted by the whānau either.

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