CVD is the leading cause of mortality and morbidity for Māori, whose high burden of CVD risk factors is expected to contribute markedly to an increase in older Māori deaths within the next 30 years. This has important consequences for health and palliative care service provision in New Zealand. As discussed in this article, Māori currently face many obstacles that prevent them from easily accessing quality palliative care services. Māori families are the major caregivers at end-of-life, but can become fatigued with the challenges that accompany long-term progressive illnesses, such as CVD. Importantly, families are often burdened with the high financial costs associated with end-of-life care, in addition to the need to engage with the Western model of care at end-of-life. The Western biomedical approach represents a major barrier when holistic care is preferable. Moreover, low health literacy among many Māori is compounded by their experiences of poor relationship building and a lack of good communication with health professionals. This article calls for cultural safety training to support health professionals to work successfully with Māori. Increasing understanding of Māori cultural traditions and their holistic end-of-life preferences would help to strengthen rapport between the health sector and Māori, as well as create the respectful communication that is necessary for effective informational exchanges. Another effective way to support Māori preferences and outcomes at end-of-life would be to increase the Māori palliative care workforce. Encouragingly, a study that is currently collecting information on traditional care customs will make this information available as an online resource for whānau and the health and palliative care sectors. In future, Māori whānau experiences of caregiving could benefit greatly from palliative care services.
