Findings from the first ever study exploring older Māori people’s experiences of injury care and recovery have just been published by Dr Hikaka and a team of researchers.

After canvassing the views of 23 Māori aged 65 to 74 and 21 healthcare workers, the study found healthcare and ACC systems were difficult to navigate.

“A revamp of ACC and injury care is needed to enable equal access for older Māori,” says Dr Hikaka.

A recent study by Waipapa Taumata Rau, University of Auckland, and Te Arawa Whānau Ora Collective showed the ACC claim rate for Māori over the age of 50 was 46 per cent lower than for non-Māori in the Bay of Plenty, Lakes Taupō and Rotorua regions between 2014 and 2018.

Yet older Māori have similar rates of hospitalisation for accidental injuries as other New Zealanders, says Dr Hikaka.

The older Māori who participated in the most recent study often saw the ACC system as a barrier to accessing care for injuries, she says.

“Our kaumātua deserve to be able to access ACC when they suffer injuries, but instead they often found the system impenetrable.

“Many were frustrated when they tried to get ACC cover, which added to the psychological burden of their injuries.

“Our health system needs to be equipped to help tangata whenua, rather than adding to their distress,” says Dr Hikaka.

Participants said barriers to ACC included lack of information, inaccessible language, and a lack of transparency about whether injuries were covered.

Almost all the older Māori participants reported that ACC only worked well for people who had a knowledgeable advocate.

“They wanted ACC to be more proactive in advising of the type of care that’s available when people get injured. People shouldn’t face a struggle to find out,” says Dr Hikaka.

Injuries are a major cause of illness among older Māori, who are less able to access treatment for injuries than other New Zealanders, she says. Increasingly, injuries are reported as a cause of death for older Māori too, says Dr Hikaka.

“The solution the kaumātua in our research called for was having someone to guide them through the health care system and help them get ACC. They want an advocate or health navigator.

“These health navigators, paeārahi, may be particularly important for older people without family or support people who can advocate with them or on their behalf,” says Dr Hikaka.

The research participants reported failings in care, including long waiting times for surgery and inadequate pain relief.

Many felt the health system was too focussed on physical care, when they needed a more holistic approach. Some reported suffering problems with mental, spiritual, and wider family health well, even after they recovered physically.

Dr Hikaka says injuries are associated with reduced quality of life for older people, compared to younger people.

Research shows older people suffer from higher rates of depression and anxiety after an injury, and are more likely to experience loneliness and social exclusion.

Financial pressures often increased after people were injured, the research found. This led some people to return to work before they had fully recovered.

Many of the research participants said current services often lacked appropriate cultural practices.

Recently, ACC has funded rongoā practitioners, who are trained in Māori medicine and offer holistic care, for people who have suffered injuries.

“People wanted to see rongoā practitioners, but few participants in our research had been able to find one.

“Systems of oppression have reduced the number of people practicing rongoā and passing on these knowledge systems.

"It’s important ACC keeps funding these practitioners, to make sure the holistic, culturally appropriate care that many kaumātua want to receive is available,” says Dr Hikaka.

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