‘Our loved ones aren’t contracts’: Pacific families fear losing trusted home carers

For Sapini Unoi, finding the right support for his mother, Mutalau, who is living with dementia, has taken time.

He says finding a service, building trust with support workers and becoming used to familiar faces can give families a sense of stability.

Now, that stability could be disrupted.

Lifewise is one of three long-standing Auckland providers that have not secured new Te Whatu Ora Health New Zealand home and community support contracts, with the changes expected to begin in March 2027.

Health NZ expects most affected support workers to move to new providers, but has not confirmed whether they will be able to stay with the clients they currently care for.

For Unoi, the issue is not about changing providers.

Sapini Unoi with his mother, Mutalau, who is living with dementia. He says familiarity and trusted relationships are especially important for families navigating care. Photo/Supplied

“Different provider. Different staff. Different systems. More uncertainty,” he wrote on social media on 28 August.

“For someone living with dementia, familiarity matters. For a caregiver, trust matters. Knowing who is coming through your door matters.

“Our loved ones aren’t contracts!! They aren’t numbers!!”

Unoi tells PMN News he is also hearing from families through Le Malaga, a Pacific-focused carers support group, about the challenges of keeping loved ones adequately supported at home.

Jessica Heimuli, TOA Pacific general manager, says continuity of care is essential for Pacific elders.

“Trust is what makes the care work, and our elders build that trust with a person, not an organisation,” Heimuli tells PMN News.

“When the worker changes, many elders will not complain; they quietly stop accepting support, and nothing in the system records why.

“Continuity should be measured by whether the elder is still letting someone through the door, not by whether a replacement has been allocated.”

Heimuli says a change in worker can be especially difficult for people living with dementia or memory loss.

Jessica Heimuli says language, cultural protocols and familiarity can be as important as the care itself for Pacific elders receiving support at home. Photo/PMN composite

“A familiar worker is part of how they stay settled; that person knows how they communicate and what comforts them,” she says.

“A new worker arrives as a stranger, and being showered or dressed by someone the elder does not recognise is frightening.”

She says language, culture and personal needs also matter, including whether a worker can speak the elder’s language, understands cultural protocols and is the right gender for personal care.

For Heimuli, equity is not about giving every elder exactly the same service.

“It is giving each elder what they need to experience the same dignity and safety as anyone else; a worker who speaks their language or understands the protocols of entering their home, and enough time in the visit to build trust rather than work through a task list.”

Health NZ says maintaining continuity of care and retaining experienced support workers will be priorities during the transition.

“It’s our view that most of these support workers are likely to transfer to new employers,” Danny Wu, Health NZ’s Northern Region planning, funding and outcomes director, tells PMN News.

The changes are part of Health NZ’s move to a nationally consistent “restorative” model, aimed at helping people stay independent and remain in their homes for longer.

Wu says the current model is based on contracts that, in many cases, are more than 20 years old and “no longer reflect best practice”.

Sixteen providers currently deliver services covered by the procurement, with eight preferred providers now in final negotiations.

Visionwest and Presbyterian Support Northern’s Enliven service have also not secured new contracts. Presbyterian Support Northern says more than 1200 support workers across the three providers are affected by the decision.

Health NZ says providers had to show how they would deliver services for Māori, Pacific people, priority groups and harder-to-reach communities and were assessed against those requirements.

Health NZ is moving from 16 current home and community support providers to eight preferred providers, with the transition expected to begin in March 2027. Photo/Vaka Tautua

But Health NZ has not provided figures requested by PMN News showing how many clients and workers affected by the changes are Pacific.

It also did not explain why Lifewise, Visionwest and Enliven were not selected, or provide details of any assessment of the risks changing providers or workers could pose to vulnerable clients.

With the transition expected to begin in March 2027, Health NZ says continuity of care will be a priority.

For families like Unoi’s, the question is whether continuity will also mean keeping the familiar workers their loved ones know and trust.