‘It’s about having that knowledge, tino rangatiratanga!’ Understanding structural barriers to accessing aged residential care services among older Māori in New Zealand

Abstract

New Zealand’s older Indigenous people (Māori) are underserved and underrepresented as consumers of aged residential care services (ARC). This study seeks to ascertain, from the perspectives of older Māori and whānau (family), the influence of structural factors that impact the process of seeking aged residential care. This study used a qualitative Kaupapa Māori research approach. In-depth interviews were undertaken with older Māori (n = 30) and whānau members (n = 18). Interviews were audio recorded and transcribed with themes identified using thematic analysis. Structural barriers related to ‘Navigation’ and ‘Service design and locality’ were identified by older Māori and whānau which provide insight into the oppressive nature of structural racism and highlighting various factors that affect older Māori and whānau access to ARC. Equity approaches that focus on optimising Māori access to ARC are needed in order to move ARC services towards equity. ARC services provide an important service for older New Zealanders. Our findings challenge and disrupt the universalistic nature that underpin New Zealand health structures. Health decision-makers should consider these findings to address the powerful and damaging effects structural racism has that compromise older Māori and whānau uptake and access to ARC services.

Keywords

• Older Māori
• Indigenous people
• aged residential care
• access
• healthcare
• rest homes