Considerations in dementia care for Indigenous populations in Canada

2020 ◽  
pp. 241-264
Author(s):  
Kristen M. Jacklin ◽  
Jessica M. Chiovitte
Keyword(s):  
Health Equity ◽  
Indigenous Communities ◽  
Dementia Care ◽  
Cultural Safety ◽  
Indigenous Populations ◽  
Health Services Use ◽  
Care Needs ◽  
Cultural Frameworks ◽  
Age Related ◽  
Specific Care

Over the last decade age-related dementias emerged as a significant health concern for Indigenous populations in Canada. Current research suggest that Indigenous communities hold culturally grounded understandings of dementia that are important in determining health services use and needs. This chapter combines a cultural safety framework with a health equity lens to discuss Indigenous dementia care needs in rural and remote Indigenous communities. Based on qualitative ethnographic data from Canada supported by published accounts of Indigenous experiences with dementia and dementia care internationally, we discuss promising approaches grounded in cultural safety aimed at improving prevention, diagnosis and care practices. Developing Indigenous specific care tools and adapting best practice mainstream approaches to care to adequately address cultural frameworks for dementia and the impacts of colonial trauma are necessary steps in providing decolonized, culturally safe care for Indigenous patients and fundamental to health equity.

scholarly journals Developing the Canadian Indigenous Cognitive Assessment for Use With Indigenous Older Anishinaabe Adults in Ontario, Canada

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Kristen Jacklin ◽  
Karen Pitawanakwat ◽  
Melissa Blind ◽  
Megan E O’Connell ◽  
Jennifer Walker ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Indigenous Communities ◽  
Cultural Safety ◽  
Indigenous Populations ◽  
Face Validity ◽  
Advisory Council ◽  
Cognitive Test ◽  
Public Health Issue ◽  
Research Approach ◽  
Local Health

Abstract Background and Objectives Dementia is a growing public health issue for aging Indigenous populations. Current cognitive assessments present varying degrees of cultural, educational, and language bias, impairing their application in Indigenous communities. Our goal is to provide Anishinaabe communities in Canada with a brief cognitive test that can be administered within the community setting by community health workers or professionals. The purpose of this study was to adapt the Kimberly Indigenous Cognitive Assessment (KICA) for use as a brief cognitive test with Anishinaabe populations in Canada. Research Design and Methods We used a community-based participatory research approach coupled with two-eyed seeing to provide an equitable space for Indigenous knowledge. Adaptation of the KICA was accomplished over 22 months using an iterative cycle of monthly consultations between an 11-member expert Anishinaabe language group (EALG) and the investigators, with ad hoc consultations with an Indigenous Elder, a community advisory council, and the KICA authors. Face validity was established with two pilot studies using cognitive interviewing with Indigenous older adults (n = 15) and a focus group consultation with local health professionals (n = 7). Results Each question of the KICA was scrutinized by the EALG for cultural appropriateness, language and translation, and cultural safety. Every domain required adaptation to reflect cultural values, specificity of language, tone, and a culturally safe approach. Orientation, verbal comprehension and fluency, praxis, and naming domains required the most adaptations. The first pilot for face validity resulted in additional changes; the second confirmed satisfactory adaptation of all changes. Discussion and Implications The research resulted in the new Canadian Indigenous Cognitive Assessment. The findings reveal important cultural and linguistic considerations for cross-cultural cognitive assessment in Indigenous contexts. This new culturally appropriate and safe brief cognitive test may improve case finding accuracy and lead to earlier diagnosis and improved dementia care for Indigenous peoples.

Frankly, None of Us Know What Dementia Is: Dementia Caregiving Among Iranian Immigrants Living in Sweden

2015 ◽  
Vol 16 (2) ◽  
pp. 79-94 ◽  
Author(s):  
Eleonor Antelius ◽  
Mahin Kiwi
Keyword(s):  
Middle Eastern ◽  
Care Facility ◽  
Dementia Care ◽  
Rapid Expansion ◽  
Health Seeking ◽  
Care Needs ◽  
Health Maintenance ◽  
Formal Service ◽  
Age Related ◽  
Dementia Diseases

In quite a short amount of time, Sweden has gone from being a relatively homogeneous society to a multicultural one, with a rapid expansion of immigrants having culturally and linguistically diverse (CALD) backgrounds growing old in Sweden. This is particularly interesting in relation to studying age-related dementia diseases. Research shows that not only do CALD persons with dementia diseases tend to mix languages, have difficulties with separation of languages, or revert to speaking only their native tongue as the disease progresses, but they also show tendencies to experience that they live in the cultural environment in which they were brought up, rather than in the current Swedish one. In this article, we explore findings in relation to one such CALD group in Sweden, Iranians. The article is empirically driven and based on data gathered in 2 separate settings with specific ethnocultural profiles, offering dementia care with Middle Eastern, Arab, and/or Persian profile. Observations were carried out in combination with semistructured in-depth interviews (n = 66). By using a combination of content and ethnographic analysis, 4 main findings related to ethnocultural dementia care were elucidated. These include (a) a wider recognition of people from different CALD backgrounds possibly having different perceptions of what dementia is, (b) a possibility that such ascribed meaning of dementia has a bearing on health maintenance and health-seeking behavior as well as the inclination to use formal services or not, (c) choosing to use formal service in the forms of ethnoculturally profiled dementia care facility seems to relate to being able to “live up to ideals of Iranian culture,” and (d) “culture,” however ambiguous and hotly debated a concept it is, appears to be a relevant aspect of people’s lives, an aspect that is both acquired as well as ascribed to oneself and to others. As such, we argue that culture needs to be further addressed in relation to dementia care in multicultural societies because ascribing culture boxes people in as well as out. In addition, ethnocultural contextualization of dementia care needs to be understood in relation to this because it affects the care provided.

scholarly journals Frailty in Indigenous Populations: A Scoping Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Ebony T. Lewis ◽  
Leanne Howard ◽  
Magnolia Cardona ◽  
Kylie Radford ◽  
Adrienne Withall ◽  
...  
Keyword(s):  
Public Health ◽  
Scoping Review ◽  
English Language ◽  
Indigenous Communities ◽  
Indigenous Populations ◽  
Original Research ◽  
Public Health Priority ◽  
Definitive Evidence ◽  
Health Priority ◽  
Age Related

Background: Indigenous populations experience high rates of age-related illness when compared to their non-Indigenous counterparts. Frailty is a challenging expression of aging and an important public health priority. The purpose of this review was to map what the existing literature reports around frailty in Indigenous populations and to highlight the current gaps in frailty research within the Indigenous landscape.Method: Scoping review of English language original research articles focusing on frailty within Indigenous adult populations in settler colonial countries (Australia, Canada, New Zealand and USA). Ten electronic databases and eight relevant institutional websites were searched from inception to October 2020.Results: Nine articles met our inclusion criteria, finding this population having a higher prevalence of frailty and frailty occurring at younger ages when compared to their non-Indigenous counterparts, but two did not use a formal frailty tool. Females presented with higher levels of frailty. No culturally specific frailty tool was identified, and the included articles did not assess strategies or interventions to manage or prevent frailty in Indigenous peoples.Conclusions: There was little definitive evidence of the true frailty prevalence, approaches to frailty screening and of potential points of intervention to manage or prevent the onset of frailty. Improvements in the quality of evidence are urgently needed, along with further research to determine the factors contributing to higher rates of frailty within Indigenous populations. Incorporation of Indigenous views of frailty, and instruments and programs that are led and designed by Indigenous communities, are crucial to address this public health priority.

scholarly journals Barriers to Accessing Kidney Transplantation Among Populations Marginalized by Race and Ethnicity in Canada: A Scoping Review Part 1—Indigenous Communities in Canada

2021 ◽  
Vol 8 ◽  
pp. 205435812199683
Author(s):  
Noor El-Dassouki ◽  
Dorothy Wong ◽  
Deanna M. Toews ◽  
Jagbir Gill ◽  
Beth Edwards ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Health Beliefs ◽  
Scoping Review ◽  
Information Dissemination ◽  
Medical Information ◽  
Indigenous Communities ◽  
Indigenous Populations ◽  
Quality Data ◽  
Original Research ◽  
Gray Literature

Background: Kidney transplantation (KT), a treatment option for end-stage kidney disease (ESKD), is associated with longer survival and improved quality of life compared with dialysis. Inequities in access to KT, and specifically, living donor kidney transplantation (LDKT), have been documented in Canada along various demographic dimensions. In this article, we review existing evidence about inequitable access and barriers to KT and LDKT for patients from Indigenous communities in Canada. Objective: To characterize the current state of literature on access to KT and LDKT among Indigenous communities in Canada and to answer the research question, “what factors may influence inequitable access to KT among Indigenous communities in Canada.” Eligibility criteria: Databases and gray literature were searched in June and November 2020 for full-text original research articles or gray literature resources addressing KT access or barriers in Indigenous communities in Canada. A total of 26 articles were analyzed thematically. Sources of evidence: Gray literature and CINAHL, OVID Medline, OVID Embase, and Cochrane databases. Charting methods: Literature characteristics were recorded and findings which described rates of and factors that influence access to KT were summarized in a narrative account. Key themes were subsequently identified and synthesized thematically in the review. Results: Indigenous communities in Canada experience various barriers in accessing culturally safe medical information and care, resulting in inequitable access to KT. Barriers include insufficient incorporation of Indigenous ways of knowing and being in information dissemination and care for ESKD and KT, spiritual concerns, health beliefs, logistical hurdles to accessing care, and systemic mistrust resulting from colonialism and systemic racism. Limitations: This review included studies that used various methodologies and did not assess study quality. Data on Indigenous status were not reported or defined in a standardized manner. Indigenous communities are not homogeneous and views on organ donation and KT vary by individual. Conclusions: Our scoping review has identified potential barriers that Indigenous communities may face in accessing KT and LDKT. Further research is urgently needed to better understand barriers and support needs and to develop strategies to improve equitable access to KT and LDKT for Indigenous populations in Canada.

scholarly journals Traditional forest-related knowledge and agrobiodiversity preservation: the case of the chagras in the Indigenous Reserve of Monochoa (Colombia)

2021 ◽  
Author(s):  
Maria Alejandra Hernandez Marentes ◽  
Martina Venturi ◽  
Silvia Scaramuzzi ◽  
Marco Focacci ◽  
Antonio Santoro
Keyword(s):  
Biodiversity Conservation ◽  
Traditional Knowledge ◽  
Indigenous Communities ◽  
Agroforestry Systems ◽  
Local Communities ◽  
Indigenous Populations ◽  
Governance System ◽  
Nature Protection ◽  
Wild Fruits ◽  
Deep Relationship

AbstractChagras are complex agroforestry systems developed by indigenous populations of the Amazon region based on shifting agriculture, as part of a system that includes harvesting of wild fruits and plants, hunting and fishing. During the centuries, thanks to their traditional knowledge, indigenous populations have developed a deep relationship with the surrounding environment, as, living in remote places, they must be self-sufficient. The result is the chagra, a system whose cycle is based on seven basic steps to establish a successful and sustainable system, starting from place selection and ending with the abandonment of the plot after harvesting of the products. After the abandonment, the forest starts to grow again to allow the agroecosystem to recover and to take advantage of the residual vegetal material to avoid erosion. The paper takes into consideration the Indigenous Reserve of Monochoa in Colombia as an example of how traditional knowledge can support a rich biodiversity conservation. Moreover, differently from other parts of the world where there is a growing contrast between indigenous communities and protected areas, in the Indigenous Reserve of Monochoa local communities have been recognized as the owners of the land. Results highlighted the crucial role of the indigenous communities for biodiversity conservation. The preservation and adaptation of traditional knowledge and practices, a decentralized autonomous governance system demonstrates that local communities not only can be part of ecosystems with unique biodiversity, but that they can represent the main actors for an active conservation of biodiversity. Agroforestry systems based on traditional forest-related knowledge can therefore be an effective alternative to biodiversity and ecosystem services conservation based on strict nature protection where humans are perceived as a negative factor.

Barriers and Enablers to Older Indigenous People Engaging in Physical Activity—A Qualitative Systematic Review

2021 ◽  
pp. 1-13
Author(s):  
Margaret J.R. Gidgup ◽  
Marion Kickett ◽  
Tammy Weselman ◽  
Keith Hill ◽  
Julieann Coombes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Indigenous Peoples ◽  
Indigenous Communities ◽  
Cultural Safety ◽  
Barriers And Enablers ◽  
Qualitative Systematic Review ◽  
Physical Activity Programs ◽  
Key Barrier ◽  
Appraisal Tool

The objective of this qualitative systematic review was to synthesize all evidence to understand the barriers and enablers to older Indigenous peoples (aged 40 years and older) engaging in physical activity. Four databases were searched. Study quality was assessed from an Indigenous perspective, using an Aboriginal and Torres Strait Islander quality appraisal tool. Data were analyzed using thematic synthesis. There were 4,246 articles screened with 23 articles and one report included from over 30 Indigenous communities across four countries. Cultural Safety and Security was a key enabler, including developing physical activity programs which are led by Indigenous communities and preference Indigenous values. Colonization was a key barrier that created mistrust and uncertainty. Social Determinants of Health, including cost, were supported by successful programs, but if not addressed, were demotivators of engagement. Older Indigenous peoples identified barriers and enablers that can direct the development of sustainable, culturally appropriate physical activity programs.

A younger onset dementia toolkit: Innovative practice

Dementia ◽  
2018 ◽  
Vol 19 (4) ◽  
pp. 1299-1307
Author(s):  
Caroline Vafeas ◽  
Elisabeth Jacob ◽  
Alycia Jacob
Keyword(s):  
Expert Panel ◽  
Aged Care ◽  
Dementia Care ◽  
Care Providers ◽  
Community Environment ◽  
Innovative Practice ◽  
Care Workers ◽  
The Family ◽  
Specific Care ◽  
The Individual

A diagnosis of younger onset dementia requires specific care tailored to the individual and the family. Dementia care workers often do not have the skills and experience necessary to offer this care within the residential and community environment. This article reports the development of an interactive resource to educate those employed to care for people living with younger onset dementia. Prescription for Life, a talking e-Flipbook was developed and piloted in two states of Australia. Feedback from the pilots was incorporated in the resource prior to a national rollout. The project was supported by an expert panel, including experts from national aged care providers.

scholarly journals Informing patterns of health and social care utilisation in Irish older people according to the Clinical Frailty Scale

2021 ◽  
Vol 4 ◽  
pp. 54
Author(s):  
Aisling M. O'Halloran ◽  
Peter Hartley ◽  
David Moloney ◽  
Christine McGarrigle ◽  
Rose Anne Kenny ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Markov Models ◽  
Classification Tree ◽  
Community Health Services ◽  
Health Services Use ◽  
Care Needs ◽  
Clinical Frailty Scale ◽  
Care Utilisation ◽  
Health And Social Care

Background: There is increasing policy interest in the consideration of frailty measures (rather than chronological age alone) to inform more equitable allocation of health and social care resources. In this study the Clinical Frailty Scale (CFS) classification tree was applied to data from The Irish Longitudinal Study on Ageing (TILDA) and correlated with health and social care utilisation. CFS transitions over time were also explored. Methods: Applying the CFS classification tree algorithm, secondary analyses of TILDA data were performed to examine distributions of health and social care by CFS categories using descriptive statistics weighted to the population of Ireland aged ≥65 years at Wave 5 (n=3,441; mean age 74.5 (SD ±7.0) years, 54.7% female). CFS transitions over 8 years and (Waves 1-5) were investigated using multi-state Markov models and alluvial charts. Results: The prevalence of CFS categories at Wave 5 were: 6% ‘very fit’, 36% ‘fit’, 31% ‘managing well’, 16% ‘vulnerable’, 6% ‘mildly frail’, 4% ‘moderately frail’ and 1% ‘severely frail’. No participants were ‘very severely frail’ or ‘terminally ill’. Increasing CFS categories were associated with increasing hospital and community health services use and increasing hours of formal and informal social care provision. The transitions analyses suggested CFS transitions are dynamic, with 2-year probability of transitioning from ‘fit’ (CFS1-3) to ‘vulnerable’ (CFS4), and ‘fit’ to ‘frail’ (CFS5+) at 34% and 6%, respectively. ‘Vulnerable’ and ‘frail’ had a 22% and 17% probability of reversal to ‘fit’ and ‘vulnerable’, respectively. Conclusions: Our results suggest that the CFS classification tree stratified the TILDA population aged ≥65 years into subgroups with increasing health and social care needs. The CFS could be used to aid the allocation of health and social care resources in older people in Ireland. We recommend that CFS status in individuals is reviewed at least every 2 years.

scholarly journals Indigenous economies in the Arctic

Elem Sci Anth ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Elena Gladun ◽  
Soili Nysten-Haarala ◽  
Svetlana Tulaeva
Keyword(s):  
Industrial Development ◽  
Indigenous Communities ◽  
Well Being ◽  
The United States ◽  
Indigenous Populations ◽  
The Arctic ◽  
Young Generation ◽  
Way Of Life ◽  
Economic Activities ◽  
The One

There is a growing global interest in Arctic natural resources that have a strong influence on the local economies. The Arctic economy is a rather unique phenomenon encompassing Indigenous practices, local economic activities, and industrial development. Indigenous economies vary across the Arctic states and exhibit divergent economic mixtures. In globalizing societies and full market economies, traditional Indigenous economies are changing and perceived especially by the non-Indigenous to be a tribute to old customs rather than a way of life that is being followed by the young generation. However, certain groups of the contemporary Indigenous populations in the Arctic continue to preserve their culture and ensure the continuation of Indigenous ways of life. The development of Indigenous communities is closely linked to their economic well-being, on the one hand, and to their culture and traditions, on the other. Our article contributes to the discussion on the significance of Indigenous economies in providing sustainability in terms of Indigenous communities, their culture, and traditions. The research objective is to identify strategies and tools that sustain Indigenous economies as well as the goals of various stakeholders in encouraging and supporting the traditional economic activities of Indigenous peoples. We contrast three countries—Russia, Finland, and the United States (Alaska)—and discuss some governmental strategies that can be employed for preserving unique Indigenous economies. The research methods consist of a content analysis of state and regional legislation and strategies, social studies of stakeholders’ opinions, case studies describing market infrastructure, and economic activities as well as features of traditional lifestyles and Indigenous knowledge typical of these regions.

Sign in / Sign up

Export Citation Format

Share Document