Sunday, November 28, 2010

Personal Care Homes for Indigenous Seniors with Dementia

              As a social work student who is both part Cree and taking a placement in a personal care home, I am interested in the accessibility of personal care homes for Indigenous seniors with dementia.  The personal care home where I am doing my placement consists of mainly French speaking residents, although there are many other different ethnic groups of seniors present. However,  out of all of the residents I have observed that there is a visibly low population of Indigenous people present. This made me question why there was such a minority of Indigenous seniors, and wonder where they receive care and who are their caregivers?

              When I researched the topic of Indigenous seniors with dementia I found some evidence that it is tradition for family members to take care of their seniors at home instead of placing them in a personal care home. According to Cox (2007), the most common traditional practice of North Dakota Indigenous peoples is to take the seniors into their homes and care for them. However, according to a study that was conducted in Manitoba, the Profile of Metis Health Status and Health Care Utilization in Manitoba (2010), it was found that home care use for the Metis is statistically higher than that for all other Winnipeggers. Perhaps this is due to Metis people choosing to take home care over entering into personal care homes.
           
Personally, I do feel it is good for Indigenous families to care for their own seniors at their homes but I do question the quality of care of Indigenous seniors with dementia are receiving. It is difficult to care for persons with Dementia; it requires 24 hour care and it is mentally and physically exhausting.  According to a study conducted by Swatsky & Fowler-Kerry (2003), a group of urban women who cared for seniors and disabled persons described their experience as being a 24 hour a day, 7 days a week job responsibility unless you have respite. Although this study involved the informal caregivers’ experience of long term care of seniors, seniors with dementia may also be included. The article outline that the responsibilities of  informal caregivers included: personal physical care special treatments, medication management, physical therapy, laundry, special meals; transportation, advocacy within the health care system, managing communication and memory problems, and dealing with emotional problems (p.279). This extensive list of potential duties may be too much for family member to have to do on a daily basis.

            Although Indigenous cultural practices have had an impact in the decision for families to care for seniors with dementia, there are families who choose to place their loved ones in personal care homes. What are the options of personal care homes that are available to them? Where are families sending their seniors with dementia?  Currently in Winnipeg there are no Aboriginal care personal homes but there is a need for people who are employed and are trained as caregivers; who are Indigenous, speak their language, and need to be familiar with culture and traditional practices.
           
In the fall of 2011, there is a 80 bed facility Indigenous Personal Care Home that will be opening (Winnipeg Free Press, 2009 September). This personal care home will be built on the south side of the city near the University of Manitoba. The province will be paying 19 million of the construction cost, and Southeast Resource Development Council will cover the remaining 2 million. According to Brokenhead Ojibway Nation Chief Debbie Chief, a board member of the Southeast Resource Development Council, “Our Elders are afraid to be in a place that may be so unfamiliar to them.”  So this development may or may not be a solution for Indigenous that require long term or intensive care, but it is still good to see that families will now have an option.
           
 I am glad that I am doing my practicum at a personal care home practicum, although it is not Indigenous, it does provide senior residents who are Indigenous with the opportunity to practice their cultural and traditional practices such as smudges, sharing circles and it recognizes that culture is important to residents.
           
 Although seniors with dementia may not be able to tell care givers and staff all their needs,     creating care homes that recognize indigenous cultural practices and traditions will benefit their quality of life as a resident.  According to Orrell et al. (2008), “There is little known about how people with dementia in residential homes view their own needs and whether these views agrees with the views of staff or family caregivers” (p. 942). 

By: Arlene

               

Tuesday, October 19, 2010

Aging Aboriginal People- Brief introduction to Health Status and Demographics


            I have struggled for weeks trying to decide what is the best way to introduce this blog, our topic and the people group we will be attempting to speak about. As a social work student I have been greatly impacted by the few courses I have taken on issues relating to Indigenous people and in turn the people I have been able to meet and learn from. Despite the great teaching I have received I still feel inadequate to speak on many of these issues because I recognize that as a non-Indigenous person I can never truly understand all the complexities of what it means to be First Nations, Inuit or Métis. Not only is there a rich culture present in the Indigenous communities in Canada but there is also a wealth of knowledge and experience. As I attempt to discuss current issues for aging Aboriginal people I look forward to learning from others, whether it be through literature or comments from other bloggers. While I realize I do not come from this perspective that I am studying, I will genuinely try to be as accurate and informed as possible.

            So now, how can we begin to introduce issues related to aging Aboriginal people unless we first have a basis for how these particular people are viewed within their own culture and also the broader Canadian context? How does this population differ? How are they the same? How diverse is this population?
            Currently the aboriginal population is very young with 30% of its population being under 15 years old (Wilson, Rosenburg, & Lovelace, pp. 370, 2010). However there is now a significant increase in the aging population (Wilson, et al, 2010). Wilson, et al (2010) explains that, according to Statistics Canada, the Aboriginal population over 65 years old increased by 43% between 2001 and 2006 (p. 370). Even in light of this significant population increase it appears that there is little research on this population (Wilson et al, 2010).  Additionally, although the Canadian standard for “senior” or older person is those over 65 years some may suggest that due to differences in population distribution a definition of “senior” for Aboriginal people would be those over the age of 55 (Wilson, et al, 2010).  There are significant differences in quality of health between Aboriginal people 55+ and those in the non-aboriginal population. Wilson et al. (2010) states “Among those aged 55 to 64, 7 per cent of the Aboriginal population report three or more chronic conditions compared with 2 per cent of the non-Aboriginal population. Yet, among those aged 75 and older, 51 per cent of the Aboriginal population report three or more chronic conditions in comparison with 23 per cent of the non-Aboriginal population” (pp. 369). There is an obvious disparity in health status between Aboriginal and non-Aboriginal people. This disparity is further reflected in the life expectancy of Aboriginal People. The Statistics Canada website states “In 2000, life expectancy at birth for the Registered Indian population was estimated at 68.9 years for males and 76.6 years for females. This reflects differences of 8.1 years and 5.5 years, respectively, from the 2001 Canadian population's life expectancies” (2005). These statistics while alarming also raise some legitimate questions. What is the reason for these differences? Is it due to biological factors? Life style factors? Or a combination of both? What is the response to these disparities? How do we work with this population as social workers? Where is there room for improvement on the way we interact and respond to the issues these groups are facing? What other disparities could arise from these situations?
            A Health Canada report states it this way: “The hardships experienced by Aboriginal people in Canada are well documented. In the case of Aboriginal seniors, inadequate income, substandard housing conditions, and an elevated rate of disabilities are just some of the common factors that threaten health and well-being” (2002, p. 33). One could write a thesis or two on these issues but this is just a brief introduction to some very fundamental issues affecting the aging Aboriginal population.
            In our first class on aging, Sylvia explained to us that aging people are the most diverse group in Canada. In entering into a discussion on the broad category of aging Aboriginal people it is important for us to remember that even amongst aging Aboriginal people there is so much variation. Although there are many commonalities across Indigenous peoples there are also many differences in cultures and beliefs among these nations and this will provide a challenge in discussing issues related to this population. I will try to do justice to this reality as I research and write.

            Please note I have shared some links at the bottom of the articles I have cited and some interesting government programs.

-Meagan

Wilson, K., Rosenburg, S. A., Lovelace, R. (2010). Aging and health: an examination of differences between older aboriginal and non-aboriginal people. Canadian Journal on Aging, 29 (3), pp. 369-382. Retrieved October 14, 2010 from http://journals.cambridge.org.proxy2.lib.umanitoba.ca/action/displayAbstract?fromPage=online&aid=7878439


Health Canada (2005) First nations comparable health indicators. Retrieved October 19, 2010 from http://www.hc-sc.gc.ca/fniah-spnia/diseases-maladies/2005-01_health-sante_indicat-eng.php


Health Canada (2002) Canada’s aging population. Retrieved October 19 from http://www.phac-aspc.gc.ca/seniors-aines/publications/public/various-varies/papier-fed-paper/index-eng.php


Monday, September 20, 2010

WELCOME!!!

Hello and Welcome to Our Blog!

We are a group of social work students in our last year of bachelor studies. We are very excited to begin our blog for our Field Focus Class in aging. We are excited to begin reading and learning about our topic of Indigenous people in Aging. We are also looking forward to reading and learning from our fellow classmates blogs as well.
Our group consists of the following members:
Meagan: 3rd year regular BSW student in a hospital placement
Michelle: 3rd year regular BSW student in a long term care and rehab facility placement
Arlene: 4th year regular BSW student in a personal care home placement
Kendall: 2nd year concentrated BSW student in a hospital placement

We look forward to sharing comments and ideas over the course of the next 8 months

KAMM