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Caregiving for Elders in First Nations Communities: Social System Perspective on Barriers and Challenges*

Published online by Cambridge University Press:  21 May 2012

Sonja Habjan ,
Holly Prince  and
Mary Lou Kelley
Sonja Habjan
Affiliation:
Lakehead University
Holly Prince*
Affiliation:
Lakehead University
Mary Lou Kelley
Affiliation:
Lakehead University
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Holly Prince, M.S.W. Lakehead University Centre for Education and Research on Aging and Health 955 Oliver Road Thunder Bay, ON P7B 5E1 ([email protected])
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Abstract

This research examined the perspectives and experiences of First Nations community members regarding health and social support for elderly people living in 13 First Nations communities in northwestern Ontario. Surveys (n = 216) and focus groups (n = 70) were conducted in 2005 and 2006 with elderly Aboriginal people and their formal and informal caregivers. Results indicated a strong preference (69%) for helping people to age and die at home; however, barriers and challenges existed at the family, community, health system, and social policy levels. Barriers included a lack of family caregivers and shortage of health care providers and programs; changing community values; and limited access to provincial health services and culturally relevant and safe care, all of which hindered social policy and community empowerment. Enabling elderly people to age within First Nations communities will require multi-level and multi-sectoral system changes.

Résumé

Cette recherche a examiné les perspectives et les expériences des membres de la communauté des Premières Nations concernant le soutien sanitaire et social pour les personnes âgées demeurant dans 13 nations du nord-ouest de l’Ontario. Des enquêtes (n = 216) et des groupes de discussion (n = 70) ont été menées en 2005 et 2006 avec les peuples autochtones aînés et leurs aidants formels et informels. Les résultats ont indiqué une forte préférence (69%) pour aider les gens à vieillir et mourir à domicile ; pourtant les obstacles et les défis existaient aux niveaux de la famille, de la communauté, du système de santé, et de la politique sociale. Il s’agissait notamment d’un manque d’aidants proches, des ressources locales humaines et de la santé, les valeurs changeants à travers de la communauté, et d’un accès limité aux services de santé provinciaux et des soins adaptés à la culture et à la sécurité des personnes âgées, tous ce qui a entravé la politique sociale et l’autonomisation des communautés. Un meilleur soutien qui permet aux personnes âgées de vieillir au sein des communautés des Premières Nations exigera des changements du système à plusieurs niveaux et à plusieurs secteurs.

Keywords

vieillissementaînésprestation de soinsPremières Nationsla santé autochtoneagingelderlycaregivingFirst NationsAboriginal health
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 2 , June 2012 , pp. 209 - 222
Copyright
Copyright © Canadian Association on Gerontology 2012

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Footnotes

*

We thank the community members and the leadership of participating First Nations communities who shared their knowledge and experiences with researchers. We also thank our organizational partners, Kenora Chiefs Advisory and the Gizhewaadiziwin Health Access Centre, for providing their support and guidance to the project. In addition, we thank Tricia McGuire Adams for her assistance in the early stages of article development, and the Ontario Ministry of Health and Long-Term Care for their financial support of this research.

References

Adelson, N. (2005). The embodiment of inequality: Health disparities in aboriginal Canada. Canadian Journal of Public Health, 96, S45–S61.Google Scholar
Best, A., Stokols, D., Green, L., Leischow, S., Holmes, B., & Buchholz, K. (2003). An integrative framework for community partnering to translate theory into effective heath promotion strategy. American Journal of Health Promotion, 18(2), 168–176.Google Scholar
Brant Castellano, M. (2004). Ethics of aboriginal research. Journal of Aboriginal Health, 1(1), 98–114.Google Scholar
Buchignani, N., & Armstrong-Esther, C. (1999). Informal care and older Native Canadians. Ageing and Society, 19, 3–32.CrossRefGoogle Scholar
Canadian Institute for Health Information. (2004). Improving the health of Canadians. Ottawa, Ontario, Canada: CIHI.Google Scholar
Cargo, M., Peterson, L., Lévesque, L., & Macaulay, M.C. (2007). Perceived wholistic health and physical activity in Kanien’keha:ka youth. Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health, 5(1), 127–153.Google Scholar
Chansonneuve, D. (2007). Addictive behaviours among aboriginal people in Canada. Ottawa, Ontario, Canada: Aboriginal Healing Foundation.Google Scholar
Cooke, M., Guimond, E., & McWhirter, J. (2008). The changing well-being of older adult registered Indians: An analysis using the registered Indian human development index. Canadian Journal on Aging, 27(4), 385–397.CrossRefGoogle ScholarPubMed
Crosato, K.E., Ward-Griffin, C., & Leipert, B. (2007). Aboriginal women caregivers of the elderly in geographically isolated communities. Rural and Remote Health, 3(7). Article No. 796, 1–12. Retrieved April 11, 2012, fromhttp://www.rrh.org.au/articles/subviewnew.asp?ArticleID=796.Google Scholar
Dapice, A.N. (2006). The medicine wheel. Journal of Transcultural Nursing, 17(3), 251–260.Google Scholar
Dumbrill, G.C., & Green, J. (2008). Indigenous knowledge in the social work academy. Social Work Education, 27(5), 489–503.CrossRefGoogle Scholar
Dumont-Smith, C. (2002). Aboriginal elder abuse in Canada. Retrieved April 11. 2012, fromhttp://www.ahf.ca/publications/research-series.Google Scholar
du Plessis, V., Beshiri, R., Bollman, R., & Clemenson, H. (2002). Definitions of ‘rural’. Agriculture and Rural Working Paper Series, Working paper No. 61. Catalogue no. 21-601-MIE - No. 061. Statistics Canada, Agriculture Division. Retrieved April 11, 2012, fromhttp://ageconsearch.umn.edu/bitstream/28031/1/wp020061.pdf.Google Scholar
First Nations Information Governance Centre. (2007). First Nations Regional Longitudinal Health Survey 2002–2003; Results for adults, youth and children living in First Nations communities (2nd ed.). Assembly of First Nations First Nations Information Governance Committee. Retrieved April 11, 2012, fromhttp://www.rhs-ers.ca/sites/default/files/ENpdf/RHS_2002/rhs2002-03-the_peoples_report_afn.pdf.Google Scholar
Frohlich, K., Ross, N., & Richmond, C. (2006). Health disparities in Canada today: Some evidence and a theoretical framework. Health Policy, 79(2), 132–143.Google Scholar
Gao, S., Manns, B.J., Culleton, B.F., Tonelli, M., Quan, H., Crowshoe, L., et al. . (2008). Access to health care among status aboriginal people with chronic kidney disease. Canadian Medical Association Journal, 179(10), 1007–1012.CrossRefGoogle ScholarPubMed
Government of Ontario. (1994). Aboriginal health policy: Executive summary. Toronto, Ontario, Canada: Government of Ontario. Retrieved April 11, 2012, fromhttp://www.ahwsontario.ca/about/healthpolicy.html.Google Scholar
Hart, M.A. (2002). Seeking mino-pimatisiwin: An Aboriginal approach to helping. Halifax, Nova Scotia, Canada: Fernwood Publishing.Google Scholar
Health Canada. (2009). A statistical profile on the health of First Nations in Canada: Determinants of health, 1999–2003. Ottawa, Ontario, Canada: Health Canada.Google Scholar
Hotson, K.E., Macdonald, S.M., & Martin, B.D. (2004). Understanding death and dying in select first nations communities in northern Manitoba: Issues of culture and remote service delivery in palliative care. International Journal of Circumpolar Health, 63(1), 25–38.Google ScholarPubMed
Indian and Northern Affairs Canada. (2006). Aboriginal health. Retrieved April 11, 2012, fromhttp://www.ainc-inac.gc.ca/ai/mr/is/abhl-eng.asp.Google Scholar
Indian and Northern Affairs Canada. (2009). First Nation profiles. Retrieved April 11, 2012, fromhttp://pse5-esd5.ainc-inac.gc.ca/fnp/Main/Search/SearchFN.aspx?lang=eng.Google Scholar
Kagawa-Singer, M., & Kassim-Lakha, S. (2003). A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Academic Medicine, 78(6), 577–587.Google Scholar
MacDonald, C. (2008). Using components of the medicine wheel to develop a conceptual framework for understanding aboriginal women in the context of pap smear screening. Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health, 6(3), 95–108.Google Scholar
McCabe, G. (2008). Mind, body, emotions and spirit: Reaching to the ancestors for healing. Counselling Psychology Quarterly, 21(2), 143–152.CrossRefGoogle Scholar
McCormick, R. (1995). Culturally appropriate means and ends of counselling as described by the First Nations people of British Columbia. International Journal for the Advancement of Counselling, 18(3), 163–172.CrossRefGoogle Scholar
Miles, M., & Huberman, A.M. (1994). An expanded sourcebook qualitative data analysis. Thousand Oaks, CA: Sage Publications Inc.Google Scholar
Minore, B., & Boone, M. (2002). Realizing potential: Improving interdisciplinary professional/paraprofessional health care teams in Canada’s northern aboriginal communities through education. Journal of Interprofessional Care, 16(2), 139–147.CrossRefGoogle ScholarPubMed
Montour, L. (2000). The Medicine Wheel: Understanding “problem” patients in primary care. The Permanente Journal, 4(1). Retrieved April 11, 2012, fromhttp://xnet.kp.org/permanentejournal/winter00pj/wheel.html.Google Scholar
Naaldenberg, J., Vaandrager, L., Koelen, M., Wagemakers, A.M., Saa, H., & de Hoog, K. (2009). Elaborating on systems thinking in health promotion practice. Global Health Promotion, 16(1), 39–47.CrossRefGoogle ScholarPubMed
National Aboriginal Health Organization [NAHO]. (2003). What First Nations people think about their health and health care. Summary of findings. First Nations Centre: National Aboriginal Health Organization. Retrieved April 11, 2012, fromhttp://www.naho.ca/documents/fnc/english/FNC_SummaryofNAHOPoll.pdf.Google Scholar
National Aboriginal Health Organization [NAHO]. (2006). First Nations regional longitudinal health survey (RHS) 2002–2003. Report on First Nations seniors’ health and wellbeing. First Nations Centre: National Aboriginal Health Organization. Retrieved April 11, 2012, fromhttp://www.rhs-ers.ca/sites/default/files/ENpdf/RHS_2002/rhs2002-03-report_on_first_nations_seniors_health_and_wellbeing.pdf.Google Scholar
North West Local Health Integration Network [NW LHIN]. (2009). Aboriginal health forum pathways for collaboration: Summary report. Thunder Bay, Ontario, Canada: North West Local Health Integration Network.Google Scholar
North West Local Health Integration Network [NW LHIN]. (2010). Environmental scan: A supporting document to the Integrated Health Services Plan 2010–2013. Thunder Bay, Ontario, Canada: North West Local Health Integration Network.Google Scholar
Northwestern Ontario District Health Council (2001). Annual long-term care service plan for northwestern Ontario. Thunder Bay, ON: Northwestern Ontario District Health Council.Google Scholar
Parrack, S., & Joseph, G. (2007). The informal caregivers of aboriginal seniors: Perspectives and issues. First Peoples Child and Family Review, 3(4), 106–113.CrossRefGoogle Scholar
Peacock, T., & Wisuri, M. (2002). Ojibwe: We look in all directions. Afton, MN: Afton Historical Society Press.Google Scholar
Prince, H., & Kelley, M.L. (2010). An integrative framework for conducting palliative care research with First Nations communities. Journal of Palliative Care, 26(1), 47–53.Google Scholar
Ritzer, G., & Goodman, D. J. (2004). Sociological theory (6th ed.). New York, NY: The McGraw-Hill Companies, Inc.Google Scholar
Rourke, J. (1997). In search of a definition of “rural”. Canadian Journal of Rural Medicine, 2(3), 113–115.Google Scholar
Salvalaggio, G., Kelly, L., & Minore, B. (2003). Perspectives on health: Experiences of First Nations dialysis patients relocated from remote communities for treatment. Canadian Journal of Rural Medicine, 8(1), 19–24.Google Scholar
Smylie, J., Lessard, P., Bailey, K., Couchie, C., Driedger, M., Eason, E.L., et al. . (2001). A guide for health professionals working with aboriginal peoples: Health issues affecting aboriginal peoples. Journal of Society of Obstetricians and Gynaecologists of Canada, 23(1), 54–68.Google Scholar
Statistics Canada. (2005). Projections of the aboriginal populations, Canada, provinces and territories 2001-2017. Catalogue no. 91-547-XIE. Ottawa, Ontario, Canada: Minister of Industry.Google Scholar
Statistics Canada. (2006a). Women in Canada: A gender-based statistical report (5th ed.). Catalogue no. 89-503-XIE. Ottawa, Ontario, Canada: Minister of Industry. Retrieved April 11, 2012, fromhttp://www.statcan.gc.ca/pub/89-503-x/89-503-x2005001-eng.pdf.Google Scholar
Statistics Canada. (2006b). Aboriginal population profile, North West Health Integration Network. 2006 Census. Retrieved April 11, 2012, fromhttp://www12.statcan.ca/census-recensement/2006/dp-pd/prof/92-591/details/page.cfm?B1=All&Code1=3514&Code2=35&Custom=&Data=Count&Geo1=HR&Geo2=PR&Lang=E&SearchPR=01&SearchText=North+West+Health+Integration+Network&SearchType=Begins.Google Scholar
Statistics Canada. (2008a). Census 2006. Aboriginal Peoples. Release no. 5: January 15, 2008. Retrieved April 11, 2012, fromhttp://www12.statcan.gc.ca/census-recensement/2006/rt-td/ap-pa-eng.cfm.Google Scholar
Statistics Canada. (2008b). 2006 community profiles. Retrieved April 11, 2012, fromhttp://www12.statcan.ca/english/census06/data/profiles/community/Index.cfm?Lang=E.Google Scholar
Stewart, S.H., Conrod, P.J., Marlatt, G.A., Comeau, M.N., Thush, C., & Krank, M. (2005). New developments in prevention and early intervention for alcohol abuse in youths. Alcoholism, Clinical and Experimental Research, 29(2), 278–286.Google Scholar
Twigg, R.C., & Hengen, T. (2009). Going back to the roots: Using the medicine wheel in the healing process. First Peoples Child and Family Review, 4(1), 10–19.CrossRefGoogle Scholar
Wilson, K. (2003). Therapeutic landscapes and First Nations peoples: An exploration of culture, health and place. Health and Place, 9(2), 83–93.CrossRefGoogle ScholarPubMed
Wilson, K., Rosenberg, M.W., Abonyi, S., & Lovelace, R. (2010). Aging and health: An examination of differences between older aboriginal and non-aboriginal people. Canadian Journal on Aging, 29(3), 369–382.Google Scholar
World Health Organization. (1978). Primary health care. A joint report by the Director General of the WHO and the Executive Director of the UNICEF. Geneva, Switzerland: WHO.Google Scholar