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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 (sara.finkelstein@gmail.com)
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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.

References

Assembly of First Nations. (2007). First Nations Regional Longitudinal Health Survey 2002/03: Results for Adults, Youth and Children Living in First Nations Communities. Ottawa, Ontario, Canada: Assembly of First Nations, First Nations Information Governance Committee.Google Scholar
Cattarinich, X., Gibson, N., & Cave, A.J. (2001). Assessing mental capacity in Canadian Aboriginal seniors. Social Science & Medicine, 53(11), 1469–1479.CrossRefGoogle ScholarPubMed
Charmaz, K. (2002). Qualitative interviewing and grounded theory analysis. In Gubrium, J. & Holstein, J. (Eds.), Handbook of Interview Research: Context and method. Thousand Oaks, CA: Sage.Google Scholar
Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Los Angeles, CA: Sage.Google Scholar
Craft, S. (2009). The role of metabolic disorders in Alzheimer’s disease and vascular dementia: Two roads converged. Archives of Neurology, 66(3), 300–305.CrossRefGoogle ScholarPubMed
Dunbar, C. Jr., Rodriguez, D., & Parker, L. (2002). Race, subjectivity, and the interview process. In Gubrium, J. & Holstein, J. (Eds.), Handbook of Interview Research: Context and method. Thousand Oaks, CA: Sage.Google Scholar
Durie, M.H. (2003). The health of indigenous peoples. BMJ, 326(7388), 510–511.CrossRefGoogle ScholarPubMed
Feldman, H.H., Jacova, C., Robillard, A., Garcia, A., Chow, T., Borrie, M., et al. . (2008). Diagnosis and treatment of dementia: 2. Diagnosis. Canadian Medical Association Journal, 178(7), 825–836.CrossRefGoogle ScholarPubMed
First Nations Centre (2005). First Nations Regional Longitudinal Health Survey (RHS) 2002/2003: Results for adults, youth and children living in First Nations communities. Ottawa, Ontario, Canada: First Nations Centre, National Aboriginal Health Organization.Google Scholar
First Nations Centre (2006). First Nations Regional Longitudinal Health Survey (RHS) 2002/03: Report on First Nations Seniors’ Health and Wellbeing. Ottawa, Ontario, Canada: National Aboriginal Health Organization.Google Scholar
Fletcher, C. (2003). Community-based participatory research in northern Canadian Aboriginal communities: An overview of context and process. Pimatziwin: A Journal of Aboriginal and Indigenous Community Health, 1(1), 27–62.Google Scholar
Forbes, D.A., Morgan, D., & Janzen, B.L. (2006). Rural and urban Canadians with dementia: Use of health care services. Canadian Journal on Aging, 25(3), 321–330.CrossRefGoogle Scholar
Griffin-Pierce, T., Silverberg, N., Connor, D., Jim, M., Peters, J., Kaszniak, A., et al. . (2008). Challenges to the recognition and assessment of Alzheimer’s disease in American Indians of the southwestern United States. Alzheimer’s & Dementia, 4(4), 291–299.CrossRefGoogle Scholar
Guba, E., & Lincoln, Y. (1994). Competing paradigms in qualitative research. In Denzin, N. & Lincoln, Y. (Eds.), Handbook of qualitative research. Thousand Oaks, CA: Sage.Google Scholar
Health Canada (2005). First Nations, Inuit and Aboriginal Health: Home and Community Program Care. Ottawa, Ontario, Canada: Health Canada [cited 2009 Aug. 1]. Retrieved fromhttp://www.hc-sc.gc.ca/fniah-spnia/pubs/services/_home-domicile/prog_crit/index-eng.php#appendix_a.Google Scholar
Henderson, J.N., & Henderson, L.C. (2002). Cultural construction of disease: A “supernormal” construct of dementia in an American Indian tribe. Journal of Cross-Cultural Gerontology, 17, 197–212.CrossRefGoogle Scholar
Hendrie, H.C., Hall, K.S., Pillay, N., Rodgers, D., Prince, C., Norton, J., et al. . (1993). Alzheimer’s disease is rare in Cree. International Psychogeriatrics, 5(1), 5–14.CrossRefGoogle ScholarPubMed
Hendrix, L.R., & Cloud-LeBeau, H.S. (2006). Working with American Indian families. In Yeo, G. & Gallagher-Thompson, D. (Eds.), Ethnicity and the Dementias, 2nd ed. New York: Routledge.Google Scholar
Hendrix, L.R., & Fee, C. (2004). American Indian. In Yeo, G. (Ed.), Mental health aspects of diabetes in elders from diverse ethnic backgrounds. Palo Alto, CA: Stanford Geriatric Education Center.Google Scholar
Hotson, K.E., Macdonald, S.M., & Martin, B.D. (2004). Understanding death and dying in select first nations communities in northern Manitoba: issues of culture and remote service delivery in palliative care. International Journal of Circumpolar Health, 63(1), 25–38.Google ScholarPubMed
Hunter, L.M., Logan, J., Goulet, J.G., & Barton, S. (2006). Aboriginal healing: Regaining balance and culture. Journal of Transcultural Nursing, 17(1), 13–22.CrossRefGoogle ScholarPubMed
Indian and Northern Affairs Canada. (2008). Aboriginal demography: Population, household and family projections, 2001–2026. Ottawa, Ontario, Canada: Indian and Northern Affairs Canada/Canada Mortgage and Housing Corporation (CMHC).Google Scholar
Israel, B., Schulz, A., Parker, E., & Becker, A. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health, 19, 173–202.CrossRefGoogle ScholarPubMed
Jervis, L.L., Cullum, C.M., & Manson, S.M. (2006). American Indians, Cognitive Assessment, and Dementia. In Yeo, G. & Gallagher-Thompson, D. (Eds.), Ethnicity and the Dementias, 2nd ed. New York: Routledge.Google Scholar
Kaufert, J.M., & Shapiro, E. (1996). Cultural, Linguistic and Contextual Factors in Validating the Mental Status Questionnaire: The Experience of Aboriginal Elders in Manitoba. Transcultural Psychiatric Review, 33(3), 277–296.CrossRefGoogle Scholar
Kelly, L., & Brown, J.B. (2002). Listening to native patients. Changes in physicians’ understanding and behaviour. Canadian Family Physician, 48, 1645–1652.Google ScholarPubMed
Kirby, M.J.L., & LeBreton, M. (2002). The Health of Canadians: The Federal Role. Interim Report. Volume Two: Current Trends and Future Challenges. Ottawa, Ontario, Canada: The Standing Senate Committee on Social Affairs, Science and Technology.Google Scholar
Li, T.K. (2008). Quantifying the risk for alcohol-use and alcohol-attributed health disorders: Present findings and future research needs. Journal of Gastroenterology and Hepatology, 23(Suppl.1), S2–S8.CrossRefGoogle Scholar
Lofland, J., Snow, D., Anderson, L., & Lofland, L.H. (2006). Analyzing social settings: A guide to qualitative observation and analysis. 4th ed. Toronto, Ontario, Canada: Wadsworth.Google Scholar
Morgan, D.G., Semchuk, K.M., Stewart, N.J., & D’Arcy, C. (2002). Rural families caring for a relative with dementia: Barriers to use of formal services. Social Science and Medicine, 55(7), 1129–1142.CrossRefGoogle ScholarPubMed
Patterson, C., Feightner, J.W., Garcia, A., Hsiung, G.Y., MacKnight, C., & Sadovnick, A.D. (2008). Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease. Canadian Medical Association Journal, 178(5), 548–556.CrossRefGoogle ScholarPubMed
Roberts, R.A. (2006). Stories about cancer from the Woodland Cree of Northern Saskatchewan [PhD]. Saskatoon, SK: University of Saskatchewan.Google Scholar
Steward, B. (2006). Strategic choices in research planning. In Findlay, L. & Ballinger, C. (Eds.), Qualitative Research for Allied Health Professionals: Challenging choices. West Sussex, UK: John Wiley & Sons, Ltd.Google Scholar
Waldram, J.B., Herring, D.A., & Young, T.K. (2006). Aboriginal Health in Canada: Historical, cultural, and epidemiological perspectives. 2nd ed. Toronto, Ontario: University of Toronto Press.Google Scholar
Weiner, M.F., Rosenberg, R.N., Svetlik, D., Hynan, L.S., Womack, K.B., White, C. 3rd, et al. . (2003). Comparison of Alzheimer’s disease in Native Americans and Whites. International Psychogeriatrics, 15(4), 367–375.CrossRefGoogle ScholarPubMed
Wentworth, J., & Gibbons, A. (2000). Health Transition Fund Project NA108, First Nations and Inuit Home Care: Final Report. Ottawa, Ontario, Canada: Health Canada.Google Scholar
Wilson, K. (2003). Therapeutic landscapes and First Nations peoples: an exploration of culture, health and place. Health & Place, 9(2), 83–93.CrossRefGoogle ScholarPubMed