ROOM 429 LEVEL 4 12 pm to 1 pmp p

Dr Mere KēpaP j M & I iProject Manager & Investigator

Te Kūpenga Hauora Māori & Department of General PracticePractice

School of Population Health, Tāmaki Campus, the UoA

One of many ideas being investigated in the quantitative study, Lifeand Living in Advanced Age: A Cohort Study in New Zealand is theand Living in Advanced Age: A Cohort Study in New Zealand is theconception of well-being and that I interpret as happiness. I rejectJohn Stuart Mill’s Utilitarian definition of happiness as pleasureand the absence of pain; a matter of feeling good or being pleased.I understand happiness as a virtue a desirable quality a goodI understand happiness as a virtue, a desirable quality, a goodvalue, and a conception of high merit lived over a whole life. Inthe presentation, I will draw upon the virtuosity or knowledge ofthe LiLACS NZ RōpūKaitiakia o Ngā Tikanga Māori, Protectors ofPrinciples of Conduct in Māori Research to discuss the conceptualPrinciples of Conduct in Māori Research to discuss the conceptualrole of happiness in carrying out the longitudinal researchbetween Māori and non Māori people in the University ofAuckland and the researched sites in the Bay of Plenty. Therefore,I shall commence by setting the scene for LiLACS NZ and then II shall commence by setting the scene for LiLACS NZ and then Ishall convey the duties or responsibilities carried out by the RōpūKaitiaki, in turn to depict the conceptual role of happiness.

To present :pKnowledge about Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu. Life and Living in Advanced Age: A Cohort St d i NZ (LiLACS NZ) dStudy in NZ (LiLACS NZ); and

Ngā Wā o te KoroheketangaNgā Wā o te KoroheketangaA space to contemplate happiness as a virtue, a desirable

quality, a good value, and a conception of high merit lived over a whole life

1. The Feasibility study took place 2007 to 2008Rotorua, Eastern Bay of PlentyInterviewed 75 to 79 years old Māori and Non Māori45 l it d 33 i t i d (NZMJM h 45 people recruited, 33 were interviewed (NZMJMarch 2011, Vol 124. No 13331)

2. The LiLACS NZ Cohort Study Commenced in 2009Recruiting and enrolling the top 1% of the population

600 Māori women and men aged 80 to 90 years old andg y600 non Māori men and woman aged 85 years oldPeople living in their own homes, with a family member, with whānau, or in residential carePeople in poor healthPeople suffering psychological trouble People suffering psychological trouble People who are frailPeople who are leaders and organisers, movers and People who are leaders and organisers, movers and shakersPeople living in the Bay of Plenty

Currently there are few Māori people who live Currently there are few Māori people who live to the age of 85 years old80 to 90 years old represents the oldest old or y padvanced age for Māori peopleFor ease of recruitment Māori people aged 80 p p gto 90 years have been invited participate

P l 85 ld th f t t People over age 85 years old are the fastest growing population in NZThe group of oldest old people makes up 1% of The group of oldest old people makes up 1% of the populationBy 2050 this proportion will have grown to 60%By 2050 this proportion will have grown to 60%Little is known about the oldest old group

The Researched Sites in theWestern Bay of Plenty are:y y

Western Bay of Plenty PHO; andNgā Matāpuna Ōranga Kaupapa Māori PHO.

Eastern Bay of Plenty are:Eastern Bay of Plenty are:Te Rūnunga o Ngāti Awa, Whakatāne;Te Rūnunga o Ngāti Irapuaia, Ōpotiki; andT K h M di l C T K hTe Kaha Medical Centre, Te Kaha.

Rotorua are:Te Rūnunga o Ngāti Pikiao & Te Korowai Aroha g gHealth Services; &Rotorua Area Primary Health Services (non Māori participants only).p p y)

Enhancing the intergenerational relationship are:

H K t Wh k tōh & T AHone Kameta-Whakatōhea & Te Arawa;Florence Kameta-Ngāi Tai & Ngāti Pōrou;Paea Smith-Ngāti Apa & Ngāti Kahungunu;Paea Smith-Ngāti Apa & Ngāti Kahungunu;Betty McPherson-Te Rārawa; &Leianna Raipae Reynolds-Ngāti Rehia & Ngāti p y g gTūwharetoa

Public Health Education General Practice CardiologyOccupational Therapy NursingNursingNutritionStatisticsStatisticsDemography

Principal Investigators Professor Ngaire Kerse & Dr Lorna Dyall the University of Professor Ngaire Kerse & Dr Lorna Dyall, the University of Auckland

InvestigatorsK H D M K P f P D i D J i Karen Hayman, Dr Mere Kēpa, Professor Peter Davis, Dr Janine Wiles, Dr Ruth Teh, Simon Moyes, Steve Vander Hoorn, Professor Robert Scragg, Professor Martin Connolly, the University of AucklandAucklandDr Carol Wham, Massey University, AlbanyDr Valerie Wright-St Clair, AUT UniversityProf Tim Wilkinson, Dr Sally Keeling, & Dr Santosh Jatrana, University of OtagoProfessor Ashley Adamson, Newcastle University, the UK

The University of AucklandMarama McDonald PH.D (Public Health)Judah Kohu, prospective PH.D (Māori Studies)

Massey Albany & UoAEruera Maxted, MasterateEruera Maxted, Masterate

Te Whare Wānanga o Awanuiārangi & UoAg gFlorence Kameta, prospective Masterate Candidate

Dr Pam Bennett, PsychiatryDr Marama Muru Lanning, AnthropologyDr Mere Kēpa, EducationDr Robin Manuel Academic DevelopmentDr Robin Manuel, Academic DevelopmentLisa Chant, Māori Studies, the University of AucklandDr Pip Pehi, Psychology, Te Whare Wānanga o Dr Pip Pehi, Psychology, Te Whare Wānanga o AwanuiārangiDr Anna Rolleston, Biology, Private sectorDr Jane McKendrick, Psychiatry, Private sectorDr Melissa Taitimu, Psychology, Private sector, AustraliaAustralia

OjectivesTimePracticePracticeImpacts Disseminations Disseminations Transformations

The objectives of total population cohort study are to:

Describe health, social status, & aspects of life;

Establish the determinants of successful ad anced Establish the determinants of successful advanced ageing;

Establish trajectories and pathways in advanced age;

Understand the relative importance of health, frailty, cultural, social, & economic factors to relevant outcomesoutcomes.

July 2009 to November 2009University of Auckland engagement with service providers from the

B f Pl t d L k Di t i t H lth B d (R t T Bay of Plenty and Lakes District Health Boards (Rotorua, Tauranga, Whakatāne, Ōpotiki, and Te Kaha)January 2010 to February 2011

Staff training & ReviewsFebruary 2010 to April 2011

Enrolment of participants and data collectionp pJanuary 2011 to July 2011

Analysis and write upDissemination to wider communityDissemination to wider communityWave 2 commences and considering areas of research for Waves 3, 4,

& 5

Ethics Approval from the Ministry of HealthRecruiting enrolling & interviewingRecruiting, enrolling, & interviewingA 71 page Questionnaire in English AND te reo Māori me ngā tikanga, 87 pages A Physical Assessment Medical Records AssessmentGathering the baseline information Wave 1 Gathering the baseline information-Wave 1 Following the participants until death, Waves 1 to 5Understanding better the important relations between health and psychology, environments and cultures, societies and money in growing older, healthier, and happier.pp

Strengthening the next generation through knowledge :

That informs good decisions about life and li iliving;That re-connects whānau and iwi; &That fosters diverse languages and cultures.

Disseminating knowledge about: Disseminating knowledge about: Physical, psychological & nutritional relationships in ageingp g gBiological relations, body constituents, & physiological activities that differ between p y gindividuals and may be important in ageingThe environment and harmful impacts on ageing to an advanced age.

Changes for the better in:Changes for the better in:Government funding;Training health professionals;Training health professionals;Community development; & T f i i tTransforming society

A space to contemplate happiness as a virtue, a A space to contemplate happiness as a virtue, a desirable quality, a good value, and a conception of high merit lived over a whole life

The BibleThe BibleGovernmentMāori societyMāori societyThe RōpūKaitiaki

Cast me not off in the time of old age: forsake me not Cast me not off in the time of old age: forsake me not when my strength faileth. Psalm 71: 09With the ancient is wisdom: and in the length of days understanding Job 12: 12understanding. Job 12: 12So teach us to number our days, that we apply our hearts unto wisdom. Psalm 90: 12

SYNOPSISHappiness as a virtue, a desirable quality, a good value,

and a conception of high merit lived over a whole lifeand a conception of high merit lived over a whole life

Aft l hi th Mi i t f S i l D l t tAfter launching the Ministry of Social Development reportThe Business of Ageing, Realising the economic potential ofolder people in New Zealand: 2011-2051, senior citizensminister John Carter said valuing the skills, knowledgeand economic power of older people would benefitNew Zealand’s economic competitiveness in the nextNew Zealand s economic competitiveness in the next40 years. (Ministry of Social Development)

SYNOPSISHappiness as money, influence, & rivalry

“We need to think outside the square to maximise theqopportunities that come with an ageing population thatis like no other before it. This report poses someexciting possibilities ” Carter saidexciting possibilities, Carter said.

The reports looks at enabling older people to remainactive in the workforce and tapping into the growingpp g g gconsumer market an ageing population presents.

SYNOPSISSYNOPSISHappiness as consumption by older people

“The standing of a tribe, its mana – as distinct from its size– relates more to the visible presence and authority ofits elders than to the vigorous activities of its youngermembers,” said Durie. “Executive and industrialleadership may well rest with the young and theeade s p ay e est t t e you g a d t emiddle-aged but it is the older generation who carrythe standing tradition and integrity of their people.Without leadership at that level a Maori communityWithout leadership at that level a Maori communitywill be the poorer and, at least in other Maori eyes,unable to function effectively or to fulfill itsobligations.” (M. Durie, Insite 9 May 2011)

SYNOPSIS: Happiness as philosophy, leadership, &honourhonour

“the transformation of Maori health, education,iti d i i th t t d dcommunities and iwi over the past two decades owes

much to older people, and that the leadership is alsoevident in public and community areas.”

SYNOPSISHappiness as a virtue, a desirable quality, a good value,

and a conception of high merit lived over a whole life

Whakapapa, as an obligation to live life in harmony with, not offend, natureWhanaungatanga, as an obligation to live life in harmony with, not offend, kin and ancestors

k bl l l f hTuakana-Teina, as an obligation to live life in harmony with, not offend, people junior to ourselvesKaitiakitanga as an obligation to live life in harmony Kaitiakitanga, as an obligation to live life in harmony with, not offend nature, people, and heaven; thereby …

SYNOPSISHappiness as a virtue, a desirable quality, a good value,

and a conception of high merit lived over a whole lifeand a conception of high merit lived over a whole life

Leading ritual ceremony and an ethical research Leading the LiLACS NZ investigators on principles of conduct in Leading the LiLACS NZ investigators on principles of conduct in Māori researchExtending research relations to include Primary Health Organisation and Rūnanga Organisation and Rūnanga Contributing questions for the Māori section of the LiLACS NZ questionnaireT l i h i i hi l d Translating the questionnaires, ethical documents, etc.,Contributing to training meetingsContributing to promoting the researchCo constructing academic papersCo presenting conference papers; thereby

d hMāori and nonMāori to set research prioritiesMāori and nonMāori to set research questionsMāori to extend research relations to include Rūnanga

h h d hMāori to enhance approaches to data gatheringMāori to participate in and contribute to the

hresearchMāori, non Māori, and the world to share the b fit f th h th f benefits from the research; therefore,

Enhances the ancient thought that a conceptualrole of happiness as a virtue, a desirablepp ,quality, a good value, and a conception of highmerit is lived over a whole life.

Ngā Pae o te Māramatanga, New Zealand’s Māori g g ,Centre of Research Excellence, hosted by the University of Auckland

Health Research Council of New Zealand

Oakley Mental Health Research Foundationy

The BibleThe Bible

The Business of Ageing, Realising the economic potential of older people in New Zealand: 2011-2051 January 2011 by: Ministry of Social Development PO Box 1556 Wellington 6140 New Zealandp gwww.msd.govt.nz ISBN 978-0-478-33517-0 (Online) 978-0-478-33516-3 (Print)

Aged Care Insite. New report echoes age-old Māori views (p. 1). 9 M 2011 A ti lMay 2011. Article-http://www.insitenewspaper.co.nz/pages/section/article.php?s=Breaking+News&idArticle=20837