Recognising that informal (also termed family, whānau, aiga or unpaid) caregivers/carers are a vital part of Aotearoa New Zealand’s health system, providing care and support for loved ones, whānau, friends and neighbours, this study aimed to explore the experiences of older informal caregivers during the COVID-19 pandemic. Priority research questions were: how did informal caregivers experience caregiving during the pandemic, and how might we support them during another pandemic, disaster, or national emergency? To our knowledge, this is the first exploration of such experiences in Aotearoa New Zealand. We wanted to understand the unprecedented challenges and barriers informal caregivers faced during the pandemic and highlight the resilience and mana (power, strength) of informal caregivers in overcoming them. To explore the lived experiences of informal caregiving during the pandemic, the research team travelled across New Zealand between May 2023 and February 2024 to conduct 81 in-depth interviews, with 73 completed face-to-face, four via Zoom and four by phone. A total of 34 male and 47 female informal caregivers were interviewed, including 35 Māori and 46 non-Māori. The mean age of participants was 66 years old. Thirty-nine rural and 42 urban-dwelling informal caregivers were interviewed, and the study covered both the North and South Islands. A Kaupapa Māori researcher and a Māori adviser oversaw appropriate tikanga (processes), kōrero (discussion) and manaakitanga (care and support) for all the Māori participants interviewed. The COVID-19 pandemic placed significant strain on older informal caregivers in Aotearoa New Zealand, exacerbating existing challenges and exposing critical gaps in support systems. Many participants experienced heightened emotional and psychological distress due to increased caregiving demands, social isolation, and the disruption of formal and informal support networks. The closure of essential services meant that informal caregivers in this study had to navigate complex healthcare systems with little guidance, often facing bureaucratic hurdles and limited access to respite care. Financial strain further compounded these difficulties, with some participants struggling to meet the rising costs associated with informal caregiving while experiencing reduced income or employment instability. For Māori participants, the inability to engage in kanohi ki te kanohi (face-to-face) interactions with whānau and communities disrupted cultural traditions such as whanaungatanga, tangihanga (funeral practices), and communal caregiving, intensifying feelings of isolation and distress. Despite these challenges, participants demonstrated remarkable resilience and adaptability, drawing on their life experiences (or "resilience in older people") and existing support systems to navigate the pandemic. Many participants relied on self-sufficiency, using strategies learned from past crises and disasters such as the 2010-2011 Canterbury earthquakes and the 1940s/1950s polio epidemics to manage caregiving responsibilities and everyday challenges with limited external assistance. Strengthened relationships with care recipients and an increased sense of community support were positive outcomes for some participants, who found solace in tighter family bonds and mutual aid from neighbours and local groups. Māori participants, in particular, emphasised the importance of cultural and community-based networks, with iwi and extended whānau playing crucial roles in providing informal support. These findings underscore the need for policies that recognise and support the diverse needs of informal caregivers, including tailored caregiving assistance, clearer communication about available services, and culturally responsive caregiving frameworks that strengthen resilience in future health crises. Findings from this study highlight the need for: 1) tailored, context-specific support systems: Formal support services must be more flexible to accommodate the diverse needs of informal caregivers, particularly those in rural and Māori communities; 2) Improved access to information and services: Many participants were unaware of available support, pointing to the need for clearer, caregiver-specific communication and helplines; 3) Enhancing emotional and social support mechanisms: Regular check-ins from healthcare providers and community groups could alleviate the emotional burden of caregiving; and 4) Resilience-based and bicultural approaches to caregiving support: Policies should integrate Māori perspectives on informal caregiving and strengthen social capital among informal caregivers. It is clear from this research that no one-size-fits-all approach is appropriate for supporting informal caregivers. This research provides a critical evidence base for improving the support structures available to informal caregivers, ensuring they are better prepared for future pandemics, disasters, and national emergencies.
Climate change and population growth will increase vulnerability to natural and human-made disasters or pandemics. Longitudinal research studies may be adversely impacted by a lack of access to study resources, inability to travel around the urban environment, reluctance of sample members to attend appointments, sample members moving residence and potentially also the destruction of research facilities. One of the key advantages of longitudinal research is the ability to assess associations between exposures and outcomes by limiting the influence of sample selection bias. However, ensuring the validity and reliability of findings in longitudinal research requires the recruitment and retention of respondents who are willing and able to be repeatedly assessed over an extended period of time. This study examined recruitment and retention strategies of 11 longitudinal cohort studies operating during the Christchurch, New Zealand earthquake sequence which began in September 2010, including staff perceptions of the major impediments to study operations during/after the earthquakes and respondents’ barriers to participation. Successful strategies to assist recruitment and retention after a natural disaster are discussed. With the current COVID-19 pandemic, longitudinal studies are potentially encountering some of the issues highlighted in this paper including: closure of facilities, restricted movement of research staff and sample members, and reluctance of sample members to attend appointments. It is possible that suggestions in this paper may be implemented so that longitudinal studies can protect the operation of their research programmes.<br /><br />Key messages<br /><ul><li>Recruitment and retention of longitudinal study participants is challenging following a natural disaster.</li><br /><li>The long-lasting, global effects of the Covid 19 pandemic will increase this problem.</li><br /><li>Longitudinal study researchers should develop protocols to support retention before a disaster occurs.</li><br /><li>Researchers need to be pragmatic and flexible in the design and implementation of their studies.</li></ul>
From 2010, Canterbury, a province of Aotearoa New Zealand, experienced three major disaster events. This study considers the socio-ecological impacts on cross-sectoral suicide prevention agencies and their service users of the 2010 – 2016 Canterbury earthquake sequence, the 2019 Christchurch mosque attacks and the COVID-19 pandemic in Canterbury. This study found the prolonged stress caused by these events contributed to a rise in suicide risk factors including anxiety, fear, trauma, distress, alcohol misuse, relationship breakdown, childhood adversity, economic loss and deprivation. The prolonged negative comment by the media on wellbeing in Canterbury was also unhelpful and affected morale. The legacy of these impacts was a rise in referrals to mental health services that has not diminished. This adversity in the socio-ecological system also produced post-traumatic growth, allowing Cantabrians to acquire resilience and help-seeking abilities to support them psychologically through the COVID-19 pandemic. Supporting parental and teacher responses, intergenerational support and targeted public health campaigns, as well as Māori family-centred programmes, strengthened wellbeing. The rise in suicide risk led to the question of what services were required and being delivered in Canterbury and how to enable effective cross-sectoral suicide prevention in Canterbury, deemed essential in all international and national suicide prevention strategies. Components from both the World Health Organisation Suicide Prevention Framework (WHO, 2012; WHO 2021) and the Collective Impact model (Hanleybrown et al., 2012) were considered by participants. The effectiveness of dynamic leadership and the essential conditions of resourcing a supporting agency were found as were the importance of processes that supported equity, lived experience and the partnership of Māori and non-Māori stakeholders. Cross-sectoral suicide prevention was found to enhance the wellbeing of participants, hastening learning, supporting innovation and raising awareness across sectors which might lower stigma. Effective communication was essential in all areas of cross-sectoral suicide prevention and clear action plans enabled measurement of progress. Identified components were combined to create a Collective Impact Suicide Prevention framework that strengthens suicide prevention implementation and can be applied at a local, regional and national level. This study contributes to cross-sectoral suicide prevention planning by considering the socio- ecological, policy and practice mitigations required to lower suicide risk and to increase wellbeing and post-traumatic growth, post-disaster. This study also adds to the growing awareness of the contribution that social work can provide to suicide prevention and conceptualises an alternative governance framework and practice and policy suggestions to support effective cross-sectoral suicide prevention.
The Covid-19 pandemic has brought to the foreground the importance of social connectedness for wellbeing, at the individual, community and societal level. Within the context of the local community, pro-connection facilities are fundamental to foster community development, resilience and public health. Through identifying the gap in social connectedness literature for Māori, this has created space for new opportunities and to reflect on what is already occurring in Ōtautahi. It is well documented that Māori experience unequal societal impacts across all health outcomes. Therefore, narrowing the inequities between Māori and non-Māori across a spectrum of dimensions is a priority. Evaluating the #WellconnectedNZ project, which explores the intersections between social connection and wellbeing is one way to trigger these conversations. This was achieved by curating a dissimilar set of community pro-connection facilities and organizing them into a Geographic Information System (GIS). Which firstly involved, the collecting and processing of raw data, followed by spatial analysis through creating maps, this highlighted the alignment between the distribution of places, population and social data. Secondly, statistical analysis focusing on the relationship between deprivation and accessibility. Finally, semi-structured interviews providing perceptions of community experience. This study describes findings following a kaupapa Māori research approach. Results demonstrated that, in general some meshblocks in Ōtautahi benefit from a high level of accessibility to pro-connection facilities; but with an urban-rural gradient (as is expected, further from the central business district (CBD) are less facilities). Additionally, more-deprived meshblocks in the Southern and Eastern suburbs of Christchurch have poorer accessibility, suggesting underlying social and spatial inequalities, likely exacerbated by Covid-19 and the Christchurch earthquakes. In this context, it is timely to (re)consider pro-connection places and their role in the development of social infrastructure for connected communities, in the community facility planning space. ‘We are all interwoven, we just need to make better connections’.
