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

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.

Cultural singularities: indigenous elderly access to Public Health Service

“…In other IT units, the geographical aspect is a major barrier for the elderly to access health services. Although arising from the inevitable aging process, the isolation of some ethnic groups, the rejection of the urban communities, and the low availability of services in the villages are the main barriers that contribute to the limited access of indigenous health services (5)(6)12) . (13) , located in the municipalities of Cândido de Abreu and Ivaiporã -Paraná.…”

“…This situation is worse in some regions of Brazil because even though the indigenous live in precarious economic conditions and there is limited transport in the villages, there is still a shortage of primary care services in IT to meet the population (5) , conditions also observed in international studies (6,12) . The difficulties in shifting the community to health centers or hospitals can reduce the indigenous elderly's access to health services (6) . In order to minimize these health disparities in the United States, telemedicine technology is being evaluated as a strategy to improve access and quality of health care in remote indigenous communities (14) .…”

“…Although health professionals recognize the importance of a comprehensive and differentiated assistance to the Kaingang elderly, mishaps in the service organization limit individualized and curative care (13) . Often, health professionals don't have information to understand how culture influences the perception of the indigenous in seeking professional assistance (6) , even though respecting the cultural aspects of indigenous peoples is provided in PNASPI (1) . This leads to disappointing the elderly with the provision of care and in some cases leads to these Indians being reluctant to use the health service (6) .…”

“…Often, health professionals don't have information to understand how culture influences the perception of the indigenous in seeking professional assistance (6) , even though respecting the cultural aspects of indigenous peoples is provided in PNASPI (1) . This leads to disappointing the elderly with the provision of care and in some cases leads to these Indians being reluctant to use the health service (6) . Therefore, health professionals and especially nursing must be prepared to promote and provide culturally congruent care.…”

“…Until now, studies that portray the access of indigenous elderly to health services haven't been identified in national databases. However, the issue is already being addressed in international studies (6) . Access to health services can be identified in two components: geographic and socio-organizational (7) .…”