The key issue here is addressing long-term care on reserve. I come to this presentation through both research and experience.
I grew up on a northern reserve. I still have a home on the northern reserve and I do a long commute to where I work.
I've done my Ph.D. on health care services and looking at first nations' health care services and its development. When we took over health transfer, back in the early nineties, we saw there were a lot of elderly people. When I speak of the term elderly, we know that the pension age of 65-plus is considered senior and people normally look at it as 65. Some now, due to the generally poor health status on the reserves, use 55 years or some even younger.
What we were finding was that there were a lot of elderly people. I like to use the term elderly or elder. They are mostly in their seventies, but particularly in their eighties is when they become the most frail.
At that time, we were on the development edge of developing home and continuing care services and what that would entail. My experience was that, in developing that, I never dreamed that I would one day come to use those very same services for my own parents. You just never think of those things, but I did. Over the past 10 years, both parents have gone and passed away in their eighties, along with my aunts and my uncles. What I have found, with my own community and having worked with the provincial first nations health organization as well, is that a lot of the same issues that my parents faced and I faced in our care of them were the same experiences that first nations families all over had. Also, there were other non-indigenous families as well, who experienced similar types of challenges, particularly when their loved one ended up with dementia and things like that. This is a common thing for all of us in Canada.
I am speaking to you from the Treaty No. 6 territory, which is in Saskatoon. My own band, the Peter Ballantyne Cree Nation, also come from a Treaty No. 6 territory. It's the treaty with the medicine chest clause that we have interpreted as the holistic comprehensive health care. We are looking at the care of the person—before they're even born, to the time they pass on. We talk about the seasons of life and those are the necessary seasons that we all have to go through. However, as citizens of this country, we should all expect to be cared for, to go in dignity, and to be treated with respect.
Those are the end goals that I'm looking at. I'm just going to go through this presentation, particularly to promote the need to build long-term care homes on reserves that are properly subsidized, that can be maintained and sustained, and to ensure that the elders we have can access sustainable long-term care facilities in, or at least near, their homes and families.
We just have to look at the media to look at the stories with elders who have been placed in Ottawa from Nunavut, for example. People are placed from my own isolated northern communities into the urban centres and whether it's people who don't understand their culture.... Even with well-meaning health professionals, they just don't understand and can't relate and communicate and work with families in a way that is respectful and is also most effective in terms of care.
In placing our first nations elderly, one of the things we have to consider is that the demographics are growing. The indigenous population is growing overall. Certainly what we've found now as well is that the seniors population is growing. In 2011, the estimates through Statistics Canada suggested that there is about 6% of seniors in the 1.4 million aboriginal population. By 2016, that had grown to 7.3% of the total 1.7 million. It's continuing to grow. Some projections estimate that, by 2036, the seniors population is going to double or more than double.
Obviously, the situation is not going to improve unless there are some dedicated resource investments and dedicated strategies to address that continuum of care on and off reserve, because basically you're trying to address that person, that individual, and that individual is not ever alone. They come in a package, a family package, and they also come in a first nations community package. With that, there are a lot of traditional values that are unique and distinctive. There are regions across Canada; we're not all the same. That's one of the things when you're dealing with culturally appropriate programs and services and their development.
Sometimes people assume that everybody is the same, but they have different backgrounds. They have different languages and they come from different areas. Their experiences as children are also the same, although they might have had experiences with.... This is, I guess, the tragedy of it. A lot of these elders that even go into dementia may have gone through the residential schools system or they might have gone through the TB sanatorium system that we're finding out about now. They also might have gone through some of these Indian hospitals that they recall. There are a lot of areas where, as children or adults, they might have experienced trauma that comes back along with other things through the years of life.
These are the things that we have to consider even as families looking after our loved ones. I know that the one question that was asked.... I have done a lot of studies in long-term care research and program development research as well as caregiving research. I go to these research things not because I'm asking a question, as most researchers would do, but because it's been placed before me by the communities and people whom I work with and it's become a need that needs to be addressed. We're just trying to find out as much information as possible about it, which is what research is, being informed to be able to make the most balanced and cost-effective and quality type of decisions.
Some of the common themes I looked at, one of the questions that came out, especially with the seniors, concerned the frail elderly when they're feeling vulnerable. I talk to the most vulnerable population, not just the elderly who go into long-term care facilities but also disabled youth sometimes. Nonetheless, they're vulnerable populations and they have things, as somebody mentioned—loneliness, isolation, abandonment. One of the questions that comes out over and over again, and I've heard in visiting elderly and my loved ones as well, was “Who will take care of us when we get old, when we're no longer able to help ourselves?”.
It's a question all of us ask, I suppose, but when you're at a vulnerable season, that becomes a time then to gather the resources and bolster the foundation that will help provide for them, so that they're well cared for until they go on.
This is one of the reasons I wanted to come here, the current status of continuing care services. Typically in Canada we refer to them as a basket of services. We know them to include home care, long-term care, respite, palliative, but for reserves, that basket is particularly small. The current stats show long-term care on reserves is fragmented. Some first nations are very fortunate to have long-term care facilities. It's not a common thing. I know in Saskatchewan we have maybe three for a population of over 90,000 indigenous people. You have to look at that.
The current status of long-term care in the western provinces is much the same. There's no dedicated funding for the development of these facilities on reserve. There are no subsidy programs, like the provincial and the territorial programs might have, that ensure sustainability and maintenance of these facilities. That all has to do with jurisdiction and the policy directions that government has taken.
One of the other things is the whole affordability issue, with provincial facilities based on various income-testing formulas. Pensions are the most common form of income for first nations. For example, in our case, Standing Buffalo First Nation in southern Saskatchewan is really struggling at the moment. It houses a 22-bed facility, and it also deals with disabled youth in that same facility, so there are a lot of issues there. We've been working to try to address that.
The long and short of it is that with the rising issues involving first nations seniors care, a national strategic plan is definitely needed, one that envisions long-term care on reserve as part of a compassionate and seamless health care continuum of services that places the seniors and their needs first.
That is it.