Find out about the MANA

The MANA is a suite of tools for the holistic assessment of mate wareware (dementia) in Māori. It includes wairua and well-being, cognitive, and functional components. 

Nau mai! Kia ora! Welcome to the new diagnostic suite for mate wareware for use with Māori whānau. It’s called the MANA  — the Māori Assessment of Neuropsychological Abilities suite of tools. 

The MANA was developed in research led by Māori for Māori. Over 400 kaumātua contributed to the development of the MANA suite and the cognitive assessment tool was validated on 92 Māori.

The MANA  is not simply a cognitive screening measure but rather a whole toolkit for a comprehensive assessment that is sensitive to Māori cultural needs. It is a kaupapa Māori guide for how health professionals, whether they are Māori or tau iwi (non-Māori), can better engage in the process of assessment and support planning for a  Māori person and their whānau who may be living with mate wareware. 

 

Ko te take me whakahou: The need for change

The standard cognitive screening and assessment tests used to help with the diagnostic process for dementia mate wareware in Aotearoa NZ have not been validated on Māori, for example, the Mini-ACE. These instruments have poor specificity and sensitivity when applied to people from diverse cultural and linguistic backgrounds. Studies have shown that cognitive testing is culturally biased (1,2), and this has been reiterated in studies conducted with Māori (3,4). That's why the MANA is so important. It's a culturally validated and appropriate suite of tools including a cognitive test that can improve the accuracy of dementia mate wareware diagnosis for clinicians working with Māori whānau. Let's work together to ensure that all people, regardless of their cultural background, receive accurate and timely diagnosis of dementia mate wareware.

Mō te MANA: About the MANA

The MANA tool has four key components:

  • A history-taking tool that guides you through taking a comprehensive history when seeing a person and their whānau for an assessment of possible dementia mate wareware.
  • A wairua and well-being tool. This component covers areas such as wairua (spirit), role, and identity that were identified as important in the preparatory research.
  • A cognitive tool, that is scored, with lower scores suggestive of dementia mate wareware.
  • A whānau or family tool that assesses symptoms and signs from a whānau, friend, or care-giver perspective. This component is also scored.

The MANA suite may take up to an hour to work through, in much the same way as the whole of the general Cognitive Impairment Community Health Pathway may take an hour to work through. Similarly, splitting the MANA process into sections and involving more than one clinician may be essential, especially in the primary care setting. 

Ngā whaikupu matua mō te uiui: Tips for the interview

The Hui Process will provide a helpful approach for the interview. The Hui Process adapts the traditional structure of the hui (a meeting or coming together) to the health professional's interaction. The four components are: 

  • Mihimihi: Initial greeting and engagement. This includes introducing yourself and describing your role and the specific purpose of the consultation.
  • Whakawhanaungatanga: Connect at a personal level with the person and any whānau present.
  • Kaupapa: The focus moves to history-taking and assessment.
  • Poroporoaki/whakamutunga: Identify that the consultation has finished and ensure clarity about the next steps for the person and whānau.

The Hui Process has been described by Cameron Lacey and his colleagues. 

Read about the Hui Process

 

Training video version 1. Whakapākehā: Using English

This training video introduces the MANA and explains how to administer the MANA cognitive tool, including a mock assessment in English.

Watch the video

Training video version 2. Whakamāori ā-waha: Using an interpreter

This version of the training video introduces the MANA and explains how to administer the MANA cognitive tool, with the mock assessment in Te Reo using an interpreter. A Te Reo version of the MANA will be made available at a later date.

Watch the video

 

 

 
Putanga reo Pākehā: English language version

You can download the English language version of the MANA below. The English version provides phonetic pronunciation for Māori words. The images for the picture recognition task are provided in the manual.

            Manual           

 

    History tool    

 

 

 Well-being tool 

 

 

  Cognitive tool  

 

 

     Family tool