Formal Dementia Care among First Nations in Southwestern Ontario

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.

Dementia Care Knowledge Sharing within a First Nations Community

“…Commonalities between the fi ndings of this study and other research on knowledge sharing within dementia care networks include the importance of developing trusting relationships among PWDs, their care partners, and HCPs (e.g., Finkelstein et al, 2012 ). Trusting relationships were developed through the use of strategies such as (a) having a supportive network of PWDs, care partners, and neighbours; (b) HCPs' approaches that were culturally sensitive and client and familycentred; (c) resolving confl ict; (d) continuity of care; and (e) sustaining community programs.…”

An Approach to Improve Dementia Health Literacy in Indigenous Communities

“…Improving health literacy is thought to benefit both the individual and health system, in that it can improve selfmanagement, allowing Indigenous people to make sound health decisions and reduce the use of health services (Mitic and Rootman 2012). Research suggests that older Indigenous people may be accessing services quite late in their dementia journey and are not benefiting from early detection and intervention (Buchignani and Armstrong-Esther 1999;Finkelstein et al 2012;Henderson and Henderson 2002). The resultant fact sheets can serve to support those initial conversations between health care providers and Indigenous older adults and families concerned about memory loss and confusion; or, as a tool for individuals and families outside of the health system.…”

“…Research shows a lack of basic dementia care resources in Canada, especially Indigenousspecific dementia care literature (Finkelstein et al 2012). Caregivers, older adults, nurses, personal support workers, and researchers often request Alzheimer's and age-related dementias health promotion materials targeted to the Indigenous peoples in Canada but none exist (Jacklin et al 2014b;2014cPace et al 2013.…”

Cultural Understandings of Dementia in Indigenous Peoples: A Qualitative Evidence Synthesis

“…Our knowledge of how Indigenous peoples experience dementia is limited (Boss et al, 1995; Finkelstein, Forbes, & Richmond, 2012; Jacklin, Warry, Blind, Webkamigad, & Jones, 2017b). Most research with Indigenous peoples to date has found that the biomedical construct of dementia, in which dementia is perceived as a disease, is not well understood, and that often the illness is not viewed as problematic.…”