Completing the Circle: Elders Speak about End-Of-Life Care with Aboriginal Families in Canada

Abstract

In this article, we share words spoken by Aboriginal elders from Saskatchewan, Canada, in response to the research question, “What would you like non-Aboriginal health care providers to know when providing end-of-life care for Aboriginal families?” Our purpose in publishing these results in a written format is to place information shared by oral tradition in an academic context and to make the information accessible to other researchers. Recent theoretical work in the areas of death and dying suggests that cultural beliefs and practices are particularly influential at the end of life; however, little work describing the traditional beliefs and practices of Aboriginal peoples in Canada exists to guide culturally appropriate end-of-life care delivery. Purposive sampling procedures were used to recruit five elders from culturally diverse First Nations in southern Saskatchewan. Key informant Aboriginal elder participants were videotaped by two Aboriginal research assistants, who approached the elders at powwows. Narrative analysis of the key informant interview transcripts was conducted to identify key concepts and emerging narrative themes describing culturally appropriate end-of-life health care for Aboriginal families. Six themes were identified to organize the data into a coherent narrative: realization; gathering of community; care and comfort/transition; moments after death; grief, wake, funeral; and messages to health care providers. These themes told the story of the dying person's journey and highlighted important messages from elders to non-Aboriginal health care providers.

End-of-Life Culture Care Practices among Yup’ik Eskimo

“…Nurses must be prepared for the environments in which they will interact with patients, families, and communities. Advocating for the examination of ethical dilemmas, biases, and prejudices was supported in previous works (Crawley, 2005;Hampton et al, 2010;Higginson, 2005). This study further supports study findings that explored the contextual experiences at end of life.…”

Key features of palliative care service delivery to Indigenous peoples in Australia, New Zealand, Canada and the United States: a comprehensive review

“…Furthermore, the need for more education and training for both the Indigenous communities and the health care staff in palliative care was identified repeatedly [ 2 , 6 , 14 , 22 – 27 , 30 , 32 , 35 – 40 ]. Health service providers (HSPs) need to be committed and spend sufficient time to gain the confidence of Indigenous patients and their families.…”

“…There was a strong preference for living with family and within the community at EOL [ 23 , 29 , 31 , 33 , 35 – 37 , 39 , 41 – 43 ]. Family members generally wanted to be with their loved ones and to fulfil their wishes, including finding ways of enabling care and support to die at home.…”

“…EOL care was regarded as a process that should involve the entire family, with several studies reporting that families should be at the centre of any decision-making process [ 24 , 26 , 27 , 30 , 31 , 44 ]. Community and/or extended family members gathering was regarded as significant and part of the process for how a dying person is prepared for death [ 35 ].…”

Developing palliative care programs in Indigenous communities using participatory action research: a Canadian application of the public health approach to palliative care

“…Given the issues described for First Nations people, it is increasingly recognized that PC should be developed at the local level. Program models need to be locally relevant and accessible (6,17), and need to be developed in conjunction with community leaders, Indigenous health care providers and the Indigenous community (3,27,28,29,30,31,32). While the challenges are similar, the solutions need to be community specific (14).…”