Purpose of reviewThis article provides an informed perspective on cardiovascular disease (CVD) and palliative care need among Ma ¯ori New Zealanders. High Ma ¯ori CVD risk factors will contribute to a sharp increase in older Ma ¯ori deaths which has implications for health and palliative care service provision.
Recent findingsCVD is New Zealand's leading cause of premature deaths and disability among Ma ¯ori. A projected rise in older Ma ¯ori deaths within the next 30 years will require increased palliative care. However, accessing palliative care and obtaining and understanding information can be challenging for families who are already often overburdened with high social and economic disadvantages. Meeting the high financial costs associated with end-of-life care make living with CVD challenging. Engaging with the health system's biomedical approach when holistic care is preferable can be a major barrier.
SummaryMa ¯ori families provide the bulk of care at end-of-life, but they can become fatigued with the challenges that accompany long-term progressive illnesses, such as CVD. They are also burdened by the financial costs associated with end-of-life. It is often difficult for Ma ¯ori to access palliative care and to obtain and understand information about the illness and treatment. Navigating an unfamiliar and complex health system, low health literacy among Ma ¯ori and poor relationship building and communication skills of health professionals are significant barriers. Cultural safety training would help to increase health and cardiovascular professionals' cultural understanding of Ma ¯ori and their holistic end-of-life preferences; this could go some way to strengthen rapport building and communication skills necessary for effective engagement and informational exchanges. Increasing the Ma ¯ori palliative care workforce and introducing cultural safety training among health professionals could help to bridge the gap. A current study to gather traditional care customs and present these to wha ¯nau and the health and palliative care sectors in the form of an online resource could contribute to this decolonizing objective.
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