Greetings to the chair and members of the Standing Committee on Indigenous and Northern Affairs. Thank you for the invitation to speak with you today.
I have been asked to share some experience of working in long-term care in a facility that is one of very few situated in an indigenous community. As a supervisor in a 50-bed long-term care facility, my role over the past 17 years has varied from that of ward clerk-receptionist to admin assistant to activity aide, to my role now as rec and leisure supervisor.
If you asked for the one decisive factor that I have learned from my experience, it would be this. Time is the one feature that residents in long-term care have an overabundance of during their stay, whereas in contrast, staff members do not have enough time to provide the quality care that residents deserve.
Time as a concept is organic to indigenous peoples around the world. They survived in a natural environment now commonly known as Mother Earth. As well, there are plenty of published anthropological papers and textbooks that indicate how the original peoples survived and appreciated the land they lived on.
Consider in contrast your own concept of time. Do you put a value to it, do you use it wisely, or is it something to be conquered, with a winner and a loser in the end?
While I cannot speak for other indigenous peoples and communities, my insight is gleaned from a retired RPN, whose career started in southern Ontario, then moved to Sioux Lookout, and ended up in British Columbia where she retired on Vancouver Island, who happens to be my mother.
The Thanksgiving address, or the Ohen:ton Karihwatehkwen, is the central prayer and invocation for the Haudenosaunee, also known as the Iroquois Confederacy or Six Nations—Mohawk, Oneida, Cayuga, Onondaga, Seneca, and Tuscarora. It reflects the relationship of giving thanks for life and the world around them. The Haudenosaunee start and close every social and spiritual meeting with this address, sending greetings to the natural world and asking for everyone to use a good mind while business is conducted. In one Mohawk community, an individual was known and recognized to recite this Thanksgiving address every sunrise, to ensure that everyone would see another day.
Indigenous peoples are credited with being the first scientists: geneticists creating hearty seed, my ancestors; physicists, quantum theories abound everywhere now; and mathematicians. The activities of the family evolved around the changing seasons. Faith keepers and knowledge keepers continue to educate and encourage their people today.
Included in the teachings are the rituals or community practices that occur at various times of the year. It is the time of expressing thanks to the natural world, the spirit world, and the Creator, with an appeal to maintain the health and prosperity of the nations. Depending on how the indigenous culture lived on the land—as hunter-gatherers, fishermen, agriculturalists—their calendar of activities was centred in the natural world in order to survive.
I was a participant in a fish study project years ago. Our funding came from Quebec. We were interrupted because, when the geese arrived, our researchers and our goal in the project—everything—stopped. The village said, “You know, nothing is going to happen for the next two weeks, because everyone has gone hunting.”
Community and family was everything to indigenous peoples. Unfortunately, this very important cycle of tradition and teachings has been broken by residential schools, beginning in the early 20th century, and by the sixties scoop, during which children were taken from their families and placed with non-native foster families, to various degrees of failure.
Historically, when nursing homes were first established in western culture the residents played an active part in the operation of the home by working at various jobs in order to pay their way. The residents did chores common to every household, which required everyone to pitch in and share the workload to ensure survival, to have a sense of self-worth, and to contribute to their community. Later, these facilities became dreary places, identified as places where you go to die, until the restorative care incentive was introduced in 2010.
Recently, residents were interviewed and participated in a food service satisfaction survey in the home where I work. A lifelong farmer asked, “What happens to the food I don't eat? Where does it go?” When he learned that the food was thrown away, he remarked, “We should have pigs. Feed them the leftovers and then slaughter them in the fall.” Does this sound like a person just waiting to die?
Anyone over 18 years of age can be admitted into a long-term care facility. Taking care of indigenous residents is not limited to the frail elders. With the breakdown of the family unit, poor lifestyle choices are made by individuals who would benefit from a holistic treatment. Most traditional medicine ceremonies and teachings consider the whole person when trying to help. This includes the social, physical, emotional, spiritual, and intellectual parts of the person. When their minds and bodies have not had the opportunity to deal with the trauma inflicted by generations of abuse, they may be diagnosed with diseases that are directly related. Unfortunately, some health services are geared to preventive measures for community members, and requests for residents living in long-term care can be ignored.
Growing up and being told “what happens in this house stays in this house and no one else needs to know” leaves caregivers and family members struggling to keep their loved ones at home. It is a shame to ask for help. It is admitting defeat.
The health care team in long-term care homes involves the health professionals and the family members working together to educate and provide the resident with the care and treatment he or she desires. For example, in my experience, an elder female resident was not feeling well and asked for a cup of hot water. In reality, she wanted to make a cup of cedar tea, but did not have the resources, ability, or autonomy to ask for what she wanted. Her mother was a well-known, respected herbalist and healer. This was a lost opportunity to learn about herbal medicines.
Fifty years ago, as part of a church youth group, I took part in a Christmas visit to a nursing home in an indigenous community. My mother had learned that a childhood friend and neighbour was now living there, and she tasked me with finding him and reading a letter to him. Because I was 11 years old, this was not something that I wanted to do. I remember being taken to a dimly lit ward with two rows of metal frame beds lined against both walls. As I approached the sleeping individual lying in bed, the staff member called out, “Percy John, you have a visitor”, and promptly left. Not knowing if he was asleep or not, I read the letter out loud, never taking my eyes off the pages. In the letter, my mother reminded Percy who she was, indicated who I was, shared some childhood reminiscences, and ended with wishing him a merry Christmas. Relieved to have accomplished this task, I looked up finally to see great tears rolling down wrinkled, withered cheeks. Not knowing what to say, I left the letter on his bed and left.
That same experience could have happened last week, as the residents I now care for exhibit the same signs of loneliness: sitting near the front doors, waiting for someone to come to talk to them.
The newly formed Ontario Caring Advisory Circle on indigenous long-term care was created in April this year at the birthing centre in Toronto, Ontario. The individuals who came together for this session have made their own two- or three-year commitment to the group. Nine individuals started a journey at the beginning of that day. By the end of the day, a team—including the two absent members being “voluntold”—agreed to work together and made a schedule to meet in the coming months.
Indigenous culture celebrates a new life with family and friends. An individual who chooses to die in his own bed is surrounded by family, and they are supported spiritually by community. When a cycle of life reaches its end, this time is also marked with what society is now calling a celebration of life, where family and friends come together one more time to honour the deceased.
For the nursing professionals, who are basically scientists, death is considered a failure. The gap between the generations in indigenous families now has an opportunity to close with information and guidance. Instead of young people being afraid of the frail elders, especially when the elder no longer lives in his or her own home, generations are encouraged to share stories and eat a meal together, a universal expression of love. The communal celebrations could be hosted by the indigenous residents in the long-term care residence to accommodate those family members and community.
The backgrounds of the OCAC members are varied by their geography, nationhood, and experiences. However, their goal is the same: to demonstrate leadership by guiding the identification and development of culturally appropriate resources, to ensure that indigenous culture is recognized as a valuable aspect of health care in long-term care, and that the tools and resources are identified to the health care provider.
Is it okay to end with a Bible quote?
I would like you to consider this, and don't forget I'm from the seventies:
To every thing there is a season, and a time to every purpose under the heaven:
A time to be born, and a time to die;
