Vulnerable and Forgotten the Colonial Way: Our Elders

During one of the Nishnawbe Aski Nation (NAN) Chiefs meetings a few years ago, one chief commented in the public forum, “When our elders leave our communities for care at urban Long Term Care facilities, the next time we see them come home is in a pine box.”

Elder care was one of my identified priorities when I was employed as Director of Health and Advocacy at NAN. To work on the elder care priority was short lived for two reasons: the government changed in Ontario, therefore approved planning funds for NAN may not have materialized; and secondly, -and especially, I can no longer advocate for elder care as I am no longer employed at NAN.

Elder care was and is a much-needed community service. I have witnessed this urgent need when I was chief of my home community of Kitchenuhmaykoosib Inninuwug. The matter continues to be magnified from the provincial territorial organizational perspective.

Currently, each First Nation is making an effort to ensure their elders are cared for by building facilities for seniors in their communities. However, accessing operational dollars needed to run an effective seniors centre in the semi-urban and remote First Nation communities is challenging:

  • There are no capital funds specific for elder care for First Nations communities
  • First Nations access capital funds as may be budgeted by successive governments to build senior/elder living facilities on reserves
  • First Nations cannot hire nurses to specifically work with elders and Personal Support Workers are mostly non-existent in northern remote communities

Elders are our last living knowledge holders in our communities. Yet, we do not do enough to ensure the survival of the elders’ knowledge. As educated professionals, we could be advocating for Long Term Care style of residences in northern remote settings. The First Nations political leadership, as well as NAN, need to all step up collectively, to use their political influence to fight for the elders’ rights to remain in their communities to the end of their natural lives. Elders need to be surrounded by family, friends, consume traditional foods, and hear their language being spoken to create a much happier ending of their days.

The urban institutionalization of First Nation elders needs to stop. In a lot of cases, we allow our elders to be removed from their familiar surroundings and sent to colonial institutional setting for care. Some elders are re-traumatized as they may have survived residential schools. I am familiar with this situation. My mother is an example of a residential school survivor and once again, she is battling trauma because my home community of KI, does not have sufficient human and financial resources and/or proper facilities to provide her care. Our elders are the most vulnerable, and usually forgotten, until they are returned for burial.

Like other First Nation Elders across our territories, my mother is one of many considered vulnerable and a forgotten member of our home community. It is especially sad today with the impact of COVID-19. I cannot visit my mother, even to celebrate her 90th birthday, and not until we have weathered the COVID-19 storm. I liken COVID-19 as the wave of colonialism when the Indian Act pass system was in effect, only everyone is affected. COVIDE-19 is isolating us from visiting our vulnerable family members locked in urban Long Term Care facilities. We have heard that nursing homes or Long Term Care facilities are being ravaged by COVIDE-19. It is particularly worrisome, and a feeling of helplessness, when you are self isolating and unable to help your family member.

The Long Term Care residences do not have dedicated Native language interpreters. This begs the question, are the health professional and care givers providing effective care to the elders coming from the north. The care that they receive can be similarly equated to the northern First Nations health service because of the language factor. Although, the residential staff have a rudimentary working vocabulary with their First Nation clients mostly related to bodily functions: directions –“sit up”, questions –“do you have to pee”, but no opportunity for our loved ones to share a meaningful exchange with a caregiver, and neither a way to communicate needs. I asked of the Director of Nursing where my mother resides, what was the percentage of First Nation clients living in the facility. The range was 45-60% at any given time. Most of the time, First Nations compose the majority of residents, yet still, there are no language provisions for our elders.

On June 2018, I wrote a short Standing Committee presentation for NAN’s Deputy Grand Chief carrying the Health portfolio and the Health Transformation Lead at the time. The title of the presentation was, “I Want to Go Home.” It is a lament that I hear almost every visit with my mom. Then she acknowledges that there is no one to take care of her if she returned to her community. In her declining years, when she needs to be surrounded by loved ones, by things familiar and treasured, she has no one there to provide her with the 24-hour care that she requires, and she has no home to return to.

The Standing Committee was informed that the care of elders usually falls on family members. Family members take turns caring for their elderly family members. There are no supports or formal training for the caregivers other than what they may observe. Additionally, there is no respite relief in the isolated communities. First Nations receive small formula driven home care support budgets. The funds received usually are designate for specified program reportable activities. Therefore, forward visioning and planning does not usually occur but rather priority is given to meeting the obligations of the day and fiscal year.
The federal and provincial governments normally provide parallel funding of the same program. The federal government tries to mirror provincial services for First Nations. This stems back to the parliamentary division of jurisdictional responsibilities. The federal government is responsible for “Indians and Lands Reserved for Indians” on-reserve and provinces are responsible for all other residents. The division of responsibilities blurs the line for First Nations and its like being sucked into the maelstrom of the blackhole.

The other challenge between the two governments is that each will have its own respective funding arrangement associated with their own reporting requirements. The two streams of funding are a major obstacle that First Nations encounter with government funded programs. The multiplicity of filing reporting requirements is an endless task.

Elders in urban care homes are lonely. Scared. Sad. Vulnerable. Forgotten. Unheard.

So what do we need to do?

All levels of First Nations political leadership must actively prioritize long term care homes in community for our elders. This is overdue. Most importantly, program leaders need to be more active to advocate, advise and support the political leadership to ensure the repatriation of those elders in urban care homes. And, a collective approach is essential to achieve economies of scale. The differences of First Nation individual autonomies need to be set aside to achieve the broader care of elders, at the very least, in familiar northern surroundings. The autonomy factor can resume once the goal is achieved. Acquiring the Long Term Care facilities is one component. Securing the financial and human supports are also essential factors to operate and maintain elder care in any setting or location. Community members are also accountable -hold your elected leaders to task, insist leaders establish measurable outcomes, and insist leaders establish timelines in which outcomes must be met! We can do better for our elders but we are not. Will we now?

Our elders, need to be repatriated to regain their dignity, a chance to return home. A last opportunity to spend the remainder of their lives in familiar surroundings, with family and friends, and hear their language being spoken. To repatriate the elders back to their northern setting is a challenge for the political and program leaders. A challenge, and also a humble honour, that can be achieved by leaders who possess, vision, focus and a steel resolve. Where are they?

For all they have endured, the institutionalization of the First Nations elderly is cruel. How tragic, for many who have suffered the residential school system, is the forced return to colonized settings, to be stripped again of their culture, their language and their loved ones in the final chapter of their life. Who is addressing this?