We added the video of our February 2025 Kōkua Mau Meeting to our YouTube channel.
Native Hawaiian Elders has examined the end-of-life care preferences of Native Hawaiian kūpuna (Elders). Led by Laguna Pueblo and Quechan woman, Assistant Professor Miquela Ibrao, researchers from UH and ALU LIKE, Inc. identified culturally specific approaches to support kūpuna values in healthcare.
“Death is not an end but a transition that honors relationality, ancestors and the land,” Assistant Professor Ibrao said. “Decolonizing end-of-life care means respecting cultural beliefs and embracing Indigenous wisdom about healing and living well.” The study, published in the Journal of Palliative Medicine, is based on interviews with 20 kūpuna aged 60 and over from rural areas across Hawaiʻi. It highlights four key themes.
Cultural perspectives on death: Kūpuna view death as a transition that acknowledges relationships with ancestors and the land.
Traditional healing practices: Lāʻau lapaʻau (herbal medicine) and lomilomi (massage) are essential aspects of care.
Family-centered decision-making: ʻOhana (family) plays a central role in healthcare choices, with deceased ancestors and the ʻāina (land) seen as sources of guidance and healing.
Preference for home-based care: Many kūpuna wish to age and die at home but fear burdening their families, with limited long-term care options in rural areas adding to the challenge.