Finding ways for Elders to spend final days at home
Holly Prince and Luanne Maki discussed end-of-life care in First Nations during a presentation about a $1.825 million Lakehead University Centre for Education and Research on Aging and Health project on palliative care.
Providing more options for dying at home is part of a Lakehead University Centre for Education and Research on Aging and Health (CERAH) project.
“It’s not about the quantity of life, but it’s improving the quality of what you have and respecting the people’s end of life care wishes,” said Holly Prince, project manager for the five-year, $1.825 million palliative care research project. “If their wish is to go home, how can we all work together as a community to make that happen — even if it’s not right up until the end.”
Prince said dying at home could be a milestone for some palliative care patients.
“Maybe they just want to be able to make it home to see the birth of their granddaughter,”
Prince said. “Or maybe they just want to make it home to be home for Christmas.”
While First Nation communities currently have federally-funded home and community care programs which provide eight essential services, Prince said palliative care is not considered an essential service so it is not funded.
“Within the provincially-funded health care system, there is funding for palliative care,” Prince said. “So once you step off the First Nation community and into a provincially-funded service, you have access to a lot more services.”
Luanne Maki, Fort William’s community health representative, said community members usually end up going across the bridge into Thunder Bay for palliative care.
“I don’t know if it’s family comfort or a fear of not being able to provide what’s necessary, personally, or not having the education to provide the services that are required, (but) our people end up going across the bridge into palliative care services,” Maki said. “The nurses are there; the doctors are there. The support is available, whereas at home it is very limited.”
Prince said infrastructure barriers in many communities also affect palliative care.
“We had an issue in our community over the weekend a couple of weeks ago,” Maki said. “An ambulance was called in, but they couldn’t get into the room with the stretcher. The doorframes were just not big enough. We had a community member in agony who had to walk to the stretcher.”
Funding for the palliative care research project was provided through an Aboriginal health intervention grant from the Canadian Institutes of Health Research.
Addressing the unmet need for accessible, culturally appropriate palliative care services for Aboriginal people in First Nations communities is a growing social obligation and an emerging Canadian policy priority, said Mary Lou Kelley, a CERAH research affiliate and a principal investigator in the project along with Kevin Brazil, director of St. Joseph’s Health System’s Research Network.
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