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Formal Dementia Care among First Nations in Southwestern Ontario*

Published online by Cambridge University Press:  25 July 2012

Sara A. Finkelstein ,
Dorothy A. Forbes  and
Chantelle A.M. Richmond
Sara A. Finkelstein*
Affiliation:
Department of Health and Rehabilitation Sciences, The University of Western Ontario
Dorothy A. Forbes
Affiliation:
Arthur Labatt Family School of Nursing, The University of Western Ontario
Chantelle A.M. Richmond
Affiliation:
Departments of Geography and First Nations Studies, The University of Western Ontario
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Sara A. Finkelstein, M.Sc. 6 Arbuckle Crescent Ottawa, Ontario K2G 5H2 ([email protected])
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Abstract

This article explores how dementia care is provided to First Nations communities in southwestern Ontario. Data were collected through in-depth interviews with health care providers and analysed using a constructivist grounded-theory methodology. Two interrelated frameworks for understanding dementia care were identified: a care delivery framework and a knowledge framework. The care delivery framework identified care goals, care elements being provided, care barriers, and strategies and solutions to deliver care and overcome barriers. The knowledge framework defined four groups of knowledge stakeholders: persons with dementia, informal care providers, formal care providers, and the First Nations community. It identified the knowledge each stakeholder held or needed and processes of sharing – or failing to share – knowledge in dementia care. Several barriers, many created by a lack of knowledge, negatively impacted dementia care. However, health care professionals had effective strategies for providing care, designed to overcome barriers and which encompassed elements of knowledge sharing.

Résumé

Cet article traite la façon dont les soins de la démence sont prévus pour les collectivités des Premiers Nations du sud-ouest de l’Ontario. Les données ont été saisies au moyen d’entretiens approfondis avec les prestataires de soins de santé et analysées en utilisant une méthodologie fondée sur une théorie constructiviste. Afin de comprendre les soins de la démence, deux cadres interdépendants ont été identifiés : un cadre de prestation des soins et un cadre de connaissances. Le cadre de prestation des soins a défini des objectifs de soins, des éléments de soins dispensés, les barrières de soins, et des stratégies et des solutions de prestation de soins pour surmonter les obstacles. Le cadre de connaissances a défini quatre groupes de parties prenantes : les personnes atteintes de la démence, les prestataires de soins informels, les prestataires de soins formels et la communauté des Premiers Nations. On a précisé les connaissances qu’il faut que chaque partie possède ou dont elle a besoin et les processus de partage – ou, à défaut de partage – des connaissances dans les soins de la démence. Plusieurs barrières, dont beaucoup sont créées par un manque de connaissances, ont eu un impact négatif sur les soins de la démence. Cependant, les professionels de soins de santé avaient des stratégies efficaces pour la prestation de soins qui ont été conçus pour surmonter les obstacles y compris le partage des connaissances.

Keywords

la démenceservices de santé autochtonesrecherche qualitativeprestation des soinscommunication sur la santédementiaindigenous health servicesqualitative researchhealth care deliveryhealth communication
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 3 , September 2012 , pp. 257 - 270
Copyright
Copyright © Canadian Association on Gerontology 2012

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Footnotes

*

Sara Finkelstein was provided funding for this research by the University of Toronto/McMaster University Indigenous Health Research Development Program Graduate Scholarship and Research Support, funded by the Canadian Institutes of Health Research–Institute of Aboriginal Peoples’ Health (CIHR–IAPH), and by The University of Western Ontario Western Graduate Research Scholarship. Chantelle Richmond holds a New Investigator Award in Aboriginal Health from the Canadian Institutes of Health Research.

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