Kaitiakitanga Assisted Dying Pathway

Hina-te-Ao | Phase 3

Kaitiakitanga (guardianship) after death

Ka tō a Tama-nui-te-rā, ka rere a Hina

Every ending brings its own rising.

Hina-te-Ao – Phase 3

Following Hina-te-pō (the dark moon), Hina-te-Ao (the waxing moon) rises again, returning to the night sky. Slowly, clarity replaces confusion, and grief begins to soften. Whānau come to see that death too, follows a rhythm written into the cosmos. The journey of their loved one, though painful, is held within a larger pattern of light and darkness, of descent and return. Like Hina (Moon) herself, who moves through shadow and re-emerges luminous, whānau learn that love continues its orbit long after the sun has set.

Introduction

Hina-te-Ao, the third phase on the Kaitiakitanga Assisted Dying Pathway marks the time following death and includes Māori post-death customs including tangihanga and it also encompasses whānau bereavement. Whānau pani (bereaved families) have the responsibility to care for the person’s wairua and body after they die. Whānau, iwi and hapū uphold tikanga (cultural customs) that are required. The tūpāpaku (body) is cared for, the tangihanga (funeral customs) and nehu (burial) or cremation are taken care of. This pathway includes everything that supports and oversees the care of person’s tūpāpaku (body) and their wairua (spirit) after they die, including conducting tangihanga [funeral customs] and ensuring the person’s wishes (or the tikanga of their iwi/hapū), are upheld with regards to burial or cremation.

Advance Care Plans – Tangihanga planning

Because people knew when they were going to die it gave them time to plan for their death and arrange what they wanted to happen following death, including organising details of their tangihanga. One whānau commented on how helpful the Advanced Care Planning document was for their whānau as their kuia had set all her wishes down on paper:

Oh, I read out that thing [advance care plan]… she [Nan] had like a nurse who came over and they filled out this like… she had told the lady [what her wishes were] and the lady wrote it… she [Nan] started to believe in God when her son passed away because, she had to believe he was with somebody [in heaven]… All our religions got a um, feature in her send off. So, we’re (name of Maori religion), oh well me and my dad’s side (name of Maori religion), and then my mum she’s (name of Christian religion) and we have other whānau members who in the space who were different religions, so we all just said whatever karakia we wanted to… (Ella, mokopuna)

Linda’s mother chose not to have a tangihanga however, her end of life was made easier knowing where her ashes were going after she died and the urupā she was going to:

Oh yeah, she would even say like ‘oh it’s going to be lovely’. It’s ‘going to be lovely’ because that’s her marae, that’s our urupā; she will be next to her parents, next to her son, next to her brother. Her brother will be on the other side… And she would sit there on a chair and be like looking around, ‘oh this is going to be great you know!’ And for us I, I don’t even know if she knew what she was doing but for us- that makes us feel better. The girls [mokopuna] do, feel a bit mamae like they say, ‘oh can we just keep her [ashes] forever’ and I have to be practical and say, when you travel overseas, where’s Nan? Are you going to be- put her in a suitcase? Put her in a backpack? Kao, kao. She wants to rest. She’s giving yous’ time, let her rest. (Linda, daughter)

Because funeral directors had often been approached before the assisted death they were aware of the date and time the person would die and were on call to transfer the tūpāpaku (body) to their services or to the place they would lie in state. This was done quite promptly. Normal protocols for tangihanga prevailed although one kuia wanted to avoid having a tangihanga and her immediate whānau (who were present at the assisted death) organised her cremation.

During this time, whānau pani often chose not tell extended whanaunga (relatives) about the assisted death to protect the privacy and mana of their loved person who had died. After the tangihanga had finished, whānau often reflected on their own loss and grief for the first time.

Talking about assisted dying at tangihanga

Several whānau we interviewed in the Waerea study said the assisted death was mentioned at the tangihanga (funeral) proceedings but, only briefly. Jackie-X told us her cousin spoke briefly about Mr Zion’s choice to have an assisted death, and this opened up a space for other whānau to choose this method of dying if they wish to in the future:

Oh, what happened was the cousin got up to speak on the actual [tangi] day. And he spoke directly to, well whānau; ‘this is one of these unique tangihanga that the cousin has chosen to do this because-’, and he spoke to the whole lot and everyone was like, ‘wow’ and [full of] admiration, I think. And now that they know there’s an option because look at our whānau – we’ve done it. We’ve come together to do it, we’ve supported it. We haven’t had any like, go to court battle… or any fall-outs with each other; we haven’t gone there. (Jackie-X, sister)

Hiri said his whānau openly discussed assisted dying at his father’s tangihanga; they advised everyone they met about the strict assisted dying criteria that need to be followed:

Yeah, we talked about [AD] it right through so whoever asked yeah… It was just you know… we wouldn’t advertise it but if people asked, we just said, ‘yeah he, he got an assisted dying.’ And we just gave it, ‘it’s a great way to go ah, if your whānau [is] suffering and wants to go right – get the criteria done.’ And, yeah well, it’s not an easy process you know, it’s quite strict. (Hiri, son)

Ruski said most people he told his wife had an assisted death were accepting. It was openly spoken about at her tangihanga:

Yeah, yeah there was no, you know [negativity]. People just took it in their stride. Everyone, I basically knew because a couple of people I spoke to… I said, you know that, ‘she, she had assisted dying.’’ They said, ‘yes, yes we know, someone told me’… And they were quite, quite blasé about it all. (Ruski, husband)

Moving into the Hine-te-Ao Phase on the assisted dying pathway signals the opportunity for healing, understanding and new growth. What helped whānau bereavement following an assisted death? Whānau felt proud of the person having the assisted death as they used their own mana or agency to realise their choice to have an assisted death; this helped to console families after someone died. Whanau felt proud they helped the person achieve their wish. Carlos reflected, “Yeah, I think everyone sort of just saw… all the mana in it; you know in seeing Granddad [choose assisted dying] because he’s such a strong, part of the marae and you know.”

Whānau valued the person being a trail-blazer in the family and a role-model; they were grateful they had a peaceful and dignified death:

[S]eeing the way he [grandfather] went away peacefully… with dignity [helped]. I think just his stoicism and stuff you know like just how strong he is as a person and how, how he’s always been that to me through my life you know. I think, he’s always had that, that presence… and I think ah he you know… yeah, he’s just always had that strength to me and he, he’s a role model for me. (Carlos, mokopuna)

Pōuritanga – grieving

Tess Moeke-Maxwell

Pōuritanga – grieving

Tui Kaimoana and Tau Huirama