UC Graduate's Award-Winning PhD on Māori Dementia Communication Support Shapes Aotearoa Aged Care Policy

Dr Megan Eustace's PhD Journey at University of Canterbury

Dr Megan Eustace (Taranaki, Ngāti Raukawa), a recent PhD graduate from Te Whare Wānanga o Waitaha | University of Canterbury (UC), has made significant strides in bridging the gap between academic research and practical policy in aged care. Her doctoral thesis, titled "Māori approaches to supportive communication – living well with mate wareware (dementia)," earned her the prestigious Jean Seabrook Prize, awarded by UC for outstanding contributions in speech and language pathology relevant to Aotearoa New Zealand populations. Originally enrolling in a Bachelor of Speech and Language Pathology at UC with little interest in policy, Eustace's path evolved over seven years, guided by supportive supervisors including Dr Catherine Theys, Dr Jeanette King, Dr Campbell Le Heron, and Katrina McGarr from UC's School of Psychology, Speech and Hearing.

What began as a passion for helping others transformed into a pioneering exploration of culturally grounded communication strategies for whānau (extended families) navigating dementia. Now based in Sydney as a Policy Officer for Catholic Health Australia—the peak body for Australia's largest not-for-profit health and aged care providers—Eustace is actively translating her findings into systemic change. "The best policy is evidence-based policy," she emphasizes, highlighting the tensions between research and real-world application that her work seeks to resolve.

Dementia Burden in Aotearoa: Disproportionate Impact on Māori Communities

Dementia, known as mate wareware in te reo Māori, represents a growing public health crisis in New Zealand. As of 2025, approximately 83,000 Kiwis live with the condition, with projections estimating nearly 170,000 by 2050—a near doubling driven by an ageing population. Economic costs are staggering, currently at $2.4 billion annually and forecasted to reach $10.65 billion by mid-century (in 2050 dollars). Alarmingly, up to 50% of cases remain undiagnosed, particularly among Asian communities, while one in four New Zealanders may die with dementia.

Māori and Pacific peoples bear a heavier burden, experiencing onset up to 10 years earlier, 45-80% higher risk, and compounded comorbidities like diabetes and traumatic brain injury. Social disadvantage, rather than ethnicity alone, drives these inequities, underscoring the need for culturally responsive interventions. Every hour, three New Zealanders develop dementia, with modifiable risk factors potentially preventing up to 50% of cases, yet access to support lags, especially in rural Māori communities where whānau often manage without formal diagnosis or services.

The Dementia Mate Wareware Action Plan 2026-2031 addresses this through five priorities: brain health promotion, timely diagnosis, community support, workforce development, and governance, with explicit Te Tiriti o Waitangi commitments and kaupapa Māori integration.

Exploring Mātauranga Māori: Ancestral Sayings as Communication Wisdom

Eustace's research commenced with a deep dive into mātauranga Māori, analyzing 2,669 pepeha (ancestral sayings) to uncover 368 relevant to communication. Themes emerged holistically: āhuatanga karere (message/messenger traits), mana reo (language's power), reo ā-tinana (body language), te whē (sound), tohu (signs/omens), whakarongo (listening), whanaungatanga (relationships), and whatumanawa (emotional expression). This revealed communication as social, spiritual, and environmental, far beyond verbal exchange.

A survey of 11 Māori speech-language therapists (SLTs), six students, and others affirmed mātauranga Māori's centrality to identity and manaakitanga (hospitality/care). Respondents valued its enhancement of practice but cited barriers like time, resources, and te reo access. "Mātauranga Māori is distinct from standard practice," participants noted, advocating integration for culturally safe therapy.

Indigenous Global Lessons: Systematic Review of Interventions

Eustace conducted a systematic review of six Indigenous-focused health communication interventions from Canada, the US, and Australia. Effectiveness hinged on cultural representation in resources, suitable knowledge-sharing methods (e.g., community settings), and collaboration fostering connection. Notably absent were dementia-specific tools, highlighting a critical gap her framework addresses. Access the full thesis here for detailed methodology.

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Whānau Voices: Lived Experiences with Mate Wareware

Semi-structured interviews with nine Māori individuals with dementia and eight whānau, plus a focus group, illuminated diverse communication changes triggering isolation and emotional distress. Strategies included storytelling, whakapapa sharing, photos, and group activities—echoing pepeha themes. Barriers: limited SLT access, funding shortages. Whānau sought tailored pathways respecting preferences, legal needs (e.g., enduring power of attorney), and holistic support.

• Non-verbal connections vital for maintaining mana and whanaungatanga.
• Social withdrawal from breakdowns exacerbates inequities.
• Need for whānau-inclusive, accessible services.

The Rongoā Reo Framework: Culturally Grounded Support

Synthesizing findings, Eustace developed "Rongoā reo" (language medicine)—a framework embedding mātauranga Māori into dementia care pathways. It promotes whānau-centred, flexible strategies across verbal/non-verbal domains, policy advocacy for SLT funding, and Kaupapa Māori research principles like He Awa Whiria (braided rivers of knowledge). Her 3MT presentation won third place at UC, showcasing this innovation.

Translating Research to Policy: Eustace's Policy Role

Post-PhD, Eustace joined Catholic Health Australia, leveraging her expertise to reform aged care. Her work aligns with NZ's Action Plan, pushing for SLT specialists amid calls from NZSTA for 10 nationwide dementia roles. "Communication isn't just words; it's connection through whakapapa and shared activities," she notes, urging evidence-based funding to combat isolation.

UC's nurturing environment was pivotal: "I wouldn’t have ended up in research or policy without the people around me." This exemplifies how NZ universities foster Indigenous-led innovation.

Funding Gaps and Calls for Action in SLT Services

Despite needs, dementia SLT funding is severely limited in NZ, contributing to undiagnosed cases and carer burden (53 million unpaid hours/year). Rural Māori whānau face acute shortages, prompting initiatives like marae outreach. Eustace's advocacy targets these inequities, aligning with Whakamaua Māori Health Action Plan.

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UC's Commitment to Kaupapa Māori Scholarship

UC's School of Psychology, Speech and Hearing champions Māori research, supporting theses like Eustace's via Ngāi Tahu scholarships. This positions UC as a leader in health equity, producing graduates influencing policy trans-Tasman.

Future Outlook: Equitable, Culturally Safe Dementia Care

Eustace's framework offers actionable insights for the Action Plan's implementation, promising reduced isolation and better outcomes. Ongoing research, workforce plans, and data collection are essential. For researchers eyeing similar paths, UC exemplifies supportive PhD environments. Explore New Zealand university jobs or research positions to contribute.

As Aotearoa grapples with rising mate wareware, voices like Eustace's ensure Māori perspectives shape compassionate, effective care.