Indigenous views on Dementia and Memory Loss in Older Age

            Dementia, everyday in my placement I see the effects of this “disease” “stage of life” “natural part of life” on families and individuals. Dementia has many different forms but manifests in some common ways. No matter what sort of dementia a person many experience it marks a drastic life change for both individuals and their families. I would like to share with you the findings of a study done in BC about Elders’ views on Memory loss.

Traditionally dementia was seen as a “natural part of the life cycle” however colonization has influenced the degree to which Indigenous people continue to ascribe to these beliefs (Hulko et al, 2010). It is important to recognize that there is much diversity with in the term “Indigenous”. There are many different nations who all have unique understandings and practices. Additionally some Indigenous people do not ascribe to traditional belief and practices and may even belong to other religious organizations. Therefore it is important to remember that although there is a “traditional Indigenous view” of dementia, this view may not be assumed by the particular client or family you may work with.

In the past dementia has been seen as “not a concern” for Indigenous people because of its rarity with in the population (Hulko et al,  2010).  However this is no longer the case, Indigenous people are living longer and coupled with multiple risk factors for dementia (diabetes, obesity, poverty etc.) are actually at a greater risk (Hulko et al, 2010). Research by Hulko et al (2010) has begun to address the topic of Indigenous people and dementia. They state that services especially in the North are not adequate or appropriate for the population’s needs and are not congruent with Traditional Indigenous practices.

The study by Hulko et al, (2010) outlines a number of different view about dementia and memory loss as explained by Indigenous Elders from BC:

-Memory loss was seen as a natural part of life by the broader community but was not necessarily welcomed by the Elders who were experiencing it for themselves. (p. 327)

-Many believed that changes from eating natural foods to store bought foods has made memory loss more common. (p. 327).

-Others stated that “accidents, age, alcohol and drugs, loss of oral care, medication, pollution and trauma (including residential schools)” were all cause for greater occurrences of memory loss. (p.327).

-Prevention strategies put forth by Elders were “talking, eating healthy, getting sleep, being chemical-free, avoid gambling and exercising the mind, body and spirit”. (p 327). These prevention methods were commonly called “mind always going”. (p.327).

-Interestingly the Elders in this study viewed memory loss as environmentally caused contrary to a westernized view that labels it as “brain disease” (Hulko et al, 2010, p.238).

Traditionally dementia was seen as a natural process or part of the family circle (Hulko et al, 2010, p.329).  They explained that as we age we become more independent and then we begin to return back to a child like state. This child like state is considered “closest to the creator” and is highly valued (This is very different from a westernized view of “child-like” which in reference to an Older Adult would be considered infantilizing of them) (Hulko et al, 2010, p.330). At times this closeness to the creator can also be considered an ability to communicate with the spiritual realm (Hulko et al, 2010).

            One part of this study that particularly struck me was that the researchers found that although they spoke with Indigenous Elders in sharing circles that they found that many of them expressed views that were more often congruent with a “shémá way” or  “white way” emphasizing "your dementia" rather than the traditional views discussed above (Hulko et al, 2010, p.330). This served as a reminder of the strong effects that residential schools had on the survivors (Hulko et al, 2010).

So what can we learn from this information? I believe that as social workers we have a duty to become culturally competent and to become aware of our own positions and viewpoint and how they may differ from those we are working with. Too much hurt has been inflicted on Indigenous peoples because we have not taken the time to listen and to understand their needs. Self reflection and a listening ear I believe can go far in trying to be culturally competent. Remembering that simply because someone is a member of one group does not necessarily mean that they will ascribe to all the particular values and practices. Dementia in particular is a difficult part of life for anyone to experience. There are many losses involved and changes in roles and responsibilities within families and communities. As social workers I think that it is important that we recognize this struggle but also be open to seeing the beauty in the life cycle.

I recently worked with a family who was in the process of placing their parent in a personal care home. This family had attempted everything they could think of to care for this family member at home but it had become too dangerous for her to live in her community as the dementia progressed. I saw the love that this family had for this patient and that they did not want to place her in a PCH.  There were over 10 people in the room, more than I had seen before in similar meetings with other families.    Some had travelled for hours to be at this half-hour meeting. This woman was truly loved and respected. I was touched by the care and concern the family paid to this woman and her best interests.

            I always find that my own views are challenged when I learn different perspectives on life. This is one of them. As I prepare to graduate I look forward to learning more as I work with others and hear their stories. I look forward to learning more from people themselves rather than from a textbook or journal articles. I hope that the knowledge I have gained as a student will help me as I take the next steps as a social worker.

Hulko W., Camille, E., Antifeau, E., Arnouse, M., Bachynski, N., & Taylor, D. (2010). View of first nation elders on memory loss and memory care in later life.  J Cross Cult Gerontol. 25(4). 317-342. doi: 10.1007/s10823-010-9123-9. http://www.ncbi.nlm.nih.gov/pubmed/20593232