I wish I knew. It's always an ongoing development, right?
For lack of a better word we looked at something called “blended caregiving”. We've overused the word “caregiving”, but blended care is when you work with the local health professionals on the reserve. I'm looking at other reserves or rural reserves because that's the area I've done a lot of research in and have experience in.
When you're looking at the situation at home and working with the families of the patients—the clients, the elders—and working with the professionals, at the end they often have to be placed, whether they go on respite for two weeks, whether they are being assessed for long-term care placement, especially if they have something like dementia, or whether they are no longer able to be looked after without medical risk at home. When they leave the reserve in that transition when they are placed, they can't just be plopped in a long-term care facility far away. We all know that.
What happens is that you have to work with those professionals within that facility—those nurses, those home health care aides, and all those people—so families also become a part of that continuum, so that blended care between at home health, the family, the patient, and the long-term care facility off reserve in the city, that kind of relationship building has to occur. That's a case management approach. It's a blended care approach.
What happens is that we always have common meetings. Usually a family—in my case we were always keeping the communication loop open, because you have to know what prescriptions that elder is taking, what doctors they have, all that medical history, and also their background. What background did they have? Are they Cree speakers only? Are they Dene speakers only? Language becomes an important part of it. Their cultural values as well as their beliefs also become important.
A lot of it is really training the health professionals. I was just talking to them a few weeks ago, and that's exactly what they said, “We need to be trained; we need to know the background of those elders who are coming in.” We, ourselves, don't even know, as first nations people, where the elders are in the province of Saskatchewan. Even in our own band we had to go looking for them, because right now they are being placed out.
The situation there becomes a matter of blended care and not leaving those people off their reserve and off their home list just because they are placed in a long-term care facility off reserve.
It's all a matter of linkages. I think that has worked in several key instances now, so we're continuing to work with it.