Exploring the Appropriateness of Culturally Safe Dementia Information with Indigenous People in an Urban Northern Ontario Community

Webkamigad, Sharlene; Cote-Meek, Sheila; Pianosi, Birgit; Jacklin, Kristen

doi:10.1017/s0714980819000606

Cited by 7 publications

(12 citation statements)

References 12 publications

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“…The theme centrality of cultural safety describes efforts to include Indigenous knowledge in recent dementia research and delivery of health care (Goldberg et al, 2018; Pace, 2020; Webkamigad, Cote‐Meek, et al, 2020). Cultural safety is defined as ‘nursing or midwifery action to protect from danger and/or reduce risk to patient/client/community from hazards to health and well‐being’ (Papps & Ramsden, 1996, p. 493).…”

Section: Resultsmentioning

confidence: 99%

“…Understanding culture in Indigenous dementia care acknowledges the histories of assimilation and colonialism Indigenous peoples have experienced in different ways and various degrees (Alcock, 2019; Blix & Hamran, 2017; Johnston et al, 2020; Morgan et al, 2020; Webkamigad et al, 2020). Indigenous caregivers report poor access to support and respite services, geographic distance, racism and discrimination, creating distrust with mainstream health care professionals (Decourtney et al, 2010; Finkelstein et al, 2012; Forbes et al, 2013; Jacklin et al, 2015; Webkamigad, Cote‐Meek, et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

“…If there is mutual awareness and understanding of cultural differences, the quality of care is likely to improve (Cooper et al, 2020; Forbes et al, 2013; Hanssen, 2013). Owing to the heterogeneity of Indigenous communities, the delivery of culturally and linguistically sensitive and safe care needs to be context‐dependent, comprehensive, community‐based, diverse and adaptable (Forbes et al, 2013; Radford et al, 2019; Smith et al, 2011; de Souza‐Talarico et al, 2016; Webkamigad, Cote‐Meek, et al, 2020; Webkamigad, Warry, et al, 2020). Finally, acknowledging historical traumas and engaging with culturally sensitive training is a much‐needed process to support Indigenous informal caregivers (Alcock, 2019; Smith et al, 2011).…”

Section: Resultsmentioning

confidence: 99%

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An integrative review of Indigenous informal caregiving in the context of dementia care

Racine

Ford

Johnson

et al. 2021

Journal of Advanced Nursing

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Aims To appraise the empirical literature on the needs of Indigenous informal caregivers caring for people living with dementia in Indigenous communities. Design Whittemore and Knafl's updated approach to integrative reviews, PRISMA guidelines, and CASP checklists for narrative analysis were followed. Data sources A systematic search of published empirical literature from January 2010 to August 2020 was undertaken in six databases. Review methods Fifty‐one studies met the research question and the inclusion criteria. Results Five themes describe the findings: Decolonizing Western perspectives on dementia, the centrality of cultural safety, caregivers’ experiences, pre‐dementia community education and family and community‐centred care emerged from the thematic analysis. Most of the studies used quantitative methodologies, and few studies were conducted using community‐based approaches. Conclusion This review shows that Indigenous caregiving represents an emerging field in nursing and health sciences in a context of a global crisis. Researchers need to focus on Indigenous values and voices to adapt care and support informal caregivers. Our review emphasizes that working with Indigenous communities will likely translate into new care delivery models, policies and practices to support Indigenous informal caregivers and address the specific social determinants impacting caregivers’ roles and tasks. Impact This review highlights the necessity of having community and family‐based discussions on enhancing the delivery of dementia care for Indigenous peoples in Canada and worldwide. Decolonizing Western perspectives of dementia translate into culturally safe approaches that aim to integrate Indigenous cultural perspectives of holism, reciprocity, wisdom, respect of older people and relationality into nursing practice. The support of Indigenous informal caregivers requires future studies to address the stigmatizing Western views of dementia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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An integrative review of Indigenous informal caregiving in the context of dementia care

Racine

Ford

Johnson

et al. 2021

Journal of Advanced Nursing

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“…Cultural safety is achieved when the person receiving care perceives that the care was appropriate to their culture, that the practitioner is respectful and understanding of them as an Indigenous person, and when systemic barriers to appropriate care are absent ( Webkamigad et al, 2019 ). With the help of the CAC, EALG, and Elder Otowadjiwan, the research team came to understand that ethical practice in test development demands that we work to ensure assessment tools are culturally safe and trauma informed.…”

Section: Discussionmentioning

confidence: 99%

Developing the Canadian Indigenous Cognitive Assessment for Use With Indigenous Older Anishinaabe Adults in Ontario, Canada

Jacklin

Pitawanakwat²,

Blind

et al. 2020

Innovation in Aging

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Background and Objectives Dementia is a growing public health issue for aging Indigenous populations. Current cognitive assessments present varying degrees of cultural, educational, and language bias, impairing their application in Indigenous communities. Our goal is to provide Anishinaabe communities in Canada with a brief cognitive test that can be administered within the community setting by community health workers or professionals. The purpose of this project was to adapt the Kimberly Indigenous Cognitive Assessment (KICA) for use as a brief cognitive test with Anishinaabe populations in Canada. Research Design We used a community-based participatory research approach coupled with two-eyed seeing to provide an equitable space for Indigenous knowledge. Adaptation of the KICA was accomplished over 22 months using an iterative cycle of monthly consultations between an 11-member expert Anishinaabe language group (EALG) and the investigators, with ad hoc consultations with an Elder, a community advisory council, and the KICA authors. Face validity was established with two pilot studies using cognitive interviewing with Indigenous older adults (n=15) and a focus group consultation with local health professionals (n=7). Results Each question of the KICA was scrutinized by the EALG for cultural appropriateness, language and translation, and cultural safety. Every domain required adaptation to reflect cultural values, specificity of language, tone, and a culturally safe approach. Orientation, verbal comprehension and fluency, praxis and naming domains required the most adaptations. The first pilot for face validity resulted in additional changes; the second confirmed satisfactory adaptation of all changes. Discussion and Implications The research resulted in the new Canadian Indigenous Cognitive Assessment. The findings reveal important cultural and linguistic considerations for cross-cultural cognitive assessment in Indigenous contexts. This new culturally appropriate and safe brief cognitive test may improve case finding accuracy and lead to earlier diagnosis and improved dementia care for Indigenous peoples.

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“…We also did not specifically recruit Indigenous persons for this work. Meaningful engagement with Indigenous communities regarding dementia care requires dedicated and culturally appropriate efforts, as has been demonstrated by Webkamigad, Cote-Meek, Pianosi, and Jacklin (2019), and Jacklin and Walker ( 2019).…”

Section: Limitationsmentioning

confidence: 97%

Whole Person, Whole Journey: Developing a Person-Centred Regional Dementia Strategy

et al. 2020

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ABSTRACT We present the development of a regional dementia strategy in Southwestern Ontario, Canada. We worked with stakeholders in a regional health authority to develop a dementia strategy. We conducted interviews with persons with dementia and their care partners (n = 26) and health care administrators and policy makers (n = 33); and administered a priority-setting survey (n = 64). Both participant groups identified provider compassion, professionalism, and care in the early stages of dementia as system strengths. Both groups also highlighted a need for more integration and coordination, a need for more person-centred care, support for care partners, and more flexibility in the provision and receipt of services. The highest-ranked priorities were improving care partner support, improving access to care, and improving system-wide quality. We integrate these strengths, needs, and priorities in a strategic framework, “Whole Person, Whole Journey”. Organizations developing a dementia strategy may use this framework as a springboard for their own work.

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Exploring the Appropriateness of Culturally Safe Dementia Information with Indigenous People in an Urban Northern Ontario Community

Cited by 7 publications

References 12 publications

An integrative review of Indigenous informal caregiving in the context of dementia care

An integrative review of Indigenous informal caregiving in the context of dementia care

Developing the Canadian Indigenous Cognitive Assessment for Use With Indigenous Older Anishinaabe Adults in Ontario, Canada

Whole Person, Whole Journey: Developing a Person-Centred Regional Dementia Strategy

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