It's not special treatment… That's part of the Treaty of Waitangi! Organisational barriers to enhancing the Aged Residential Care environment for older Māori and Whānau in New Zealand.

Abstract

New Zealand's older Indigenous Māori people experience poorer health and reduced access to healthcare than their older non-Māori counterparts. Organisational factors (such as leadership or workforce) may influence the attitudes and perceptions of older Māori and their family (whānau) to use aged residential care services. Currently, there is a paucity of research surrounding the organisational barriers that impact the experiences of older Māori people who seek care in aged residential care (ARC) services. This study used a Kaupapa Māori qualitative research approach that legitimises Māori knowledge and critiques structures that subjugate Māori autonomy and control over their wellbeing. Interviews regarding their experiences of care were carried out with older Māori (n=30) and whānau (family) members (n=18) who had used, or declined to use an aged residential care facility. Narrative data were analysed inductively for themes that illustrated organisational barriers. The key organisational theme was 'Culturally safe care', within which there were three barriers: 'Acceptability and Adequacy of Facility', 'Interface Between Aged Residential Care and Whānau Models of Care', and 'Workforce'. Collectively, these barriers emphasise the importance of an organisational approach to improving the quality of care delivered to older Māori and whānau in ARC. Fostering a collective culture of equity within ARC provider services and equipping healthcare leaders and staff with the skills and knowledge to deliver culturally safe care is critical to addressing organisational barriers to ARC.