Palliative care, Mercy Hospice and Pacific community
Death is final, it is not selective and the one certainty in life.
In New Zealand deaths reached a record high 30,080 by December 2011. And according to NZ Statistics “…deaths will continue to increase, and are expected to surpass 40,000 in 2029 and 50,000 in 2042.”
But for a growing segment of New Zealand’s population, death is happening and unexpectedly, usually as a result of cancer.
This group is termed ‘end of life’ or commonly ‘with life limiting illness’. For them, they know death is coming in a matter of days or months. It is therefore not only a physical experience it is also a deeply spiritual one because they are leaving families and loved ones behind, much quicker than expected.
As a result, a specialized group of providers had been established to care for them and their families. But is generally unknown to the Pacific community. It is called Palliative care and hospice services. New Zealand has 35 hospices nationally providing this free service to its communities.
One of the longest serving is Mercy Hospice in Auckland.
And one of the challenges they face is how to extend their care to more Pacific islanders. One of the problem issues is the misconception and lack of understanding about the service.
“A Hospice is a place where people receive ‘end of life’ care,” explains Mercy Hospice’s community social worker, Mrs Maree Goh tells the New Zealand Pacific.
While palliative care is provided after a patient would have been told by a doctor, there is nothing more they could do.
The patient is then referred to a hospice or family to await their time of death.
“Palliative care is an approach that essentially says to the unwell person, ‘look you’ve got an illness and we’re not going to pump you full of drugs and medicine because it is not going to work,” says Mrs Goh.
“But we can deal with the things that’s worrying you. We can deal with your pain, and we can make whatever time you have left worthwhile and with quality for you and your family.”
The Mercy Hospice care service is based on a holistic model that caters to the mind, body and spirit. The aim is to remove fears so when the individual dies, their fi nal days have been lived in peace and with dignity.
It is this service that Mercy Hospice has targeted to increase from its current 12 per cent.
In 2003, Mercy hired Mrs Rita Ryan-Lefau to reach out to the Pacific, especially the Samoan community.
Says Mrs Goh, “The hope is to engage with the Pacific community, to have a conversation with them about what services they would like. What would they like their families to get when they come to hospice, what their needs are.”
What they have found so far is that “Pasifi ka people may use the service but can be quite fearful or apprehensive about it,” says Mrs Goh.
“They might think it’s a palagi service or that the palagi people won’t understand what they need, or won’t be able to communicate with them. And that is a lot of the feeling behind developing Rita’s role.”
It was, and still is a diffi cult job convincing the Samoan and Pacific community according to Mrs Ryan-Lefau.
“I tell them, we have beds and other services to make your last days comfortable. You will have your own room, it’s like a hotel, your own bathroom, a family member can stay and our nurses are on call if you need things. You can bring your own food. Have your own faifeau visit or conduct your funeral service. But we don’t treat you to get better because we can’t.”
There is also the unproven comments in the community such as going to Hospice will make death come quicker.
Continues Mrs Goh, “That by going to hospice you accept you’re going to die and so you give in. Or fears that someone came to hospice and was given morphine and died. So there is that apprehension, mistrust and I think that is across many cultures.”
It’s a tough generalization to respond to she admits.
“It’s a tough one because we live in a culture where people are taught to be positive thinkers, that whatever you put your mind to, you can do it.
“But when you’re dying, that positive thinking won’t work because you can’t unthink death when you have a terminal condition,” she says.
“So it’s a matter of working with that person and acknowledging those fears, about how scary it is, that it’s a time of uncertainty, and not knowing what tomorrow brings.
“So having Rita here will hopefully enable more Pasifi ka families come and see what a hospice looks like because there is a transfer of trust, a link to someone familiar.”
One of the benefi ts Mrs Ryan-Lefau likes to tell people is about Mercy Hospice’s ‘Respite Programme’.
The programme gives families a break from caring for an ill family member.
“Most people when they are unwell want to be at home but they can become a burden for families. And we have seen this in particular with our Pacific families where they’ve come to New Zealand and most of them work and care for their families and sometimes they need extra support to do that,” says Mrs Ryan-Lefau.
“So what we do at hospice is to support people doing that. So the patient can come in for say six nights and we take care of them so the caregivers have some respite.”
Since hiring Mrs Ryan-Lefau, Mercy has also hired a Tonga nurse and Niuean social worker, building up a Pacific unit to further their goal of a wider Pacific catchment.
This year they have stepped up their Pacific campaign by setting up, for the fi rst time, a stall at the upcoming Pasifi ka Festival starting on 9 March.
The Mercy team is excited and looking forward to their fi rst time foray to the festival.
“We are engaging with the Pasifi ka community so we get to hear more about what is it that they want,” says Mrs Goh.
“What would they like our service to be for them. It’s all very well for us to sit there and say we’ll do this, we’ll do that, but we want to hear what the Pacific people want. What is it that’s meaningful to them.”
Apart from telling people that they exist, the key message they want people to know is their mode of operation is based on partnership.
“It is about a partnership,” says Mrs Goh. “That we work alongside your family to provide the care. It is not about us taking over in a palagi way.
“What we are saying is that ‘palliative care’ is something we understand. While from your side, you understand the person best because they are your family. So together we make a good partnership of providing the care the way you want it to be.”
Adds Mrs Ryan-Lefau: We’re here to support families. And we have had situations where the patient has come to the hospice where we provide all the equipment and so forth, while the family provided the care. And that’s what is available.”
New Zealand is a country of migrants, especially in Auckland where one in three of its residents is born overseas.
“So you have that component, that complexity with people and their health where they may have grown up in another society where they have different health ideas, about their deaths,” says Mrs Ryan-Lefau.
“So for a Pacific islander or Samoan, when you’re dying you want to be cared for by hands that love you and are familiar to you. You don’t want stranger hands. I think that is what people want at end of life.
“And is what Mercy hospice can do for our Pacific people. This is not a place to be scared of,” she smiles.
Adds Mrs Goh, “We accommodate for people’s cultural ilk. Where we place the person who is coming to the end of their life in the middle. That they spend their fi nal days in dignity, free of pain and surrounded by those who love them.”
The service provided by Mercy Hospice is free and caters to residents and non-residents.
New Zealand Pacific (March 1, 2013)
Writer: Aigaletaule’ ale’ a F. Tauafiafi. Photo: Aigaletaule’ ale’ a F. Tauafiafi.