Aboriginal Experiences of Aging and Dementia in a Context of Sociocultural Change: Qualitative Analysis of Key Informant Group Interviews with Aboriginal Seniors

Abstract

Examining the role of culture and cultural perceptions of aging and dementia in the recognition, diagnosis, and treatment of age-related cognitive impairment remains an understudied area of clinical neuropsychology. This paper describes a qualitative study based on a series of key informant group interviews with an Aboriginal Grandmothers Group in the province of Saskatchewan. Thematic analysis was employed in an exploration of Aboriginal perceptions of normal aging and dementia and an investigation of issues related to the development of culturally appropriate assessment techniques. Three related themes were identified that highlighted Aboriginal experiences of aging, caregiving, and dementia within the healthcare system: (1) cognitive and behavioural changes were perceived as a normal expectation of the aging process and a circular conception of the lifespan was identified, with aging seen as going back "back to the baby stage", (2) a "big change in culture" was linked by Grandmothers to Aboriginal health, illness (including dementia), and changes in the normal aging process, and (3) the importance of culturally grounded healthcare both related to review of assessment tools, but also within the context of a more general discussion of experiences with the healthcare system. Themes of sociocultural changes leading to lifestyle changes and disruption of the family unit and community caregiving practices, and viewing memory loss and behavioural changes as a normal part of the aging process were consistent with previous work with ethnic minorities. This research points to the need to understand Aboriginal perceptions of aging and dementia in informing appropriate assessment and treatment of age-related cognitive impairment and dementia in Aboriginal seniors.

Evolution of a Community-Based Participatory Approach in a Rural and Remote Dementia Care Research Program

“…To ensure their voice was represented, the Grandmothers reviewed all transcripts and participated in an iterative process of thematic analysis. 39 Based on the Grandmothers' recommendations, existing screening instruments and neuropsychological testing protocols were modified to increase their cultural appropriateness for Cree-speaking Aboriginal older adults 39,40 and a new screening tool, the Northern Cultural Assessment of Memory, was developed for use by front-line healthcare providers. 41 Multiple trips were made to northern Saskatchewan to foster collaborative relationships, conduct home-based visits to pilot test assessment protocols, and collect normative data for Aboriginal adults.…”

Social cognition in a case of amnesia with neurodevelopmental mechanisms

“…“The Grasshoppers and Geese Prospective Memory Test” (Lanting et al, 2010, 2011), which was developed for ethnically diverse individuals, comprises a task instruction that is embedded semantically. The test requests that the patient reminds the examiner to perform a task when an external (verbal) cue is delivered.…”

The Path of Creating Co-Researchers in the File Hills Qu'Appelle Tribal Council

“…This view is shared by many Canadian seniors, which can lead to a failure to access necessary and appropriate health care services (Cammer, 2006). For example, when talking to aging Indigenous women, Lanting, Crossley, Morgan, and Cammer (2011) discovered that many seniors viewed dementia as part of the circle of life, where aging and its effects on the brain and body are seen as a transition before passing to the spirit world. This viewpoint may run counter to the information provided by doctors and health care professionals who view dementia as a disease, which can lead to misunderstandings or patient distrust.…”