Jacklin Kristen, Pace Jessica E, Warry Wayne
Care Manag J. 2015;16(2):106-20. doi: 10.1891/1521-0987.16.2.106.
Recent studies suggest dementia is an emerging health issue for Indigenous peoples in Canada. In this article, we explore findings concerning informal dementia caregiving in Indigenous communities. Our research has been carried out in partnership with Indigenous communities in Ontario, Canada, over the past 4 years. Semistructured in-depth interviews were carried out with informal Indigenous caregivers (primarily family) to Indigenous people with dementia at 7 geographically and culturally diverse research sites (n = 34). We use a critical interpretive and postcolonial lens to explore common caregiving experiences and patterns to gain insight into Indigenous models of care and better understand how to appropriately support Indigenous families dealing with a dementia diagnosis. Themes from the interview data are explored through a storyline beginning with why and how participants came to the caregiving role; the challenges, struggles, and decisions along the way; and reflections on the rewards and benefits of caring for a loved one with dementia. The findings suggest that underlying Indigenous values created a consistent family caregiving model across the Indigenous cultures and geographic contexts included in the study. Family caregiving was found to facilitate cultural continuity through intergenerational contact and the transmission of cultural knowledge. Diverse community contexts presented significant challenges most immediately attributable to the nature of relations between Indigenous and non-Indigenous Canadians and the continued colonial policies governing access to services.
最近的研究表明,痴呆症是加拿大原住民中一个新出现的健康问题。在本文中,我们探讨了有关原住民社区非正式痴呆症护理的研究结果。在过去4年里,我们与加拿大安大略省的原住民社区合作开展了研究。在7个地理位置和文化背景各异的研究地点(n = 34),对患有痴呆症的原住民的非正式护理人员(主要是家庭成员)进行了半结构化深度访谈。我们运用批判性解释和后殖民视角来探究常见的护理经历和模式,以深入了解原住民的护理模式,并更好地理解如何适当地支持面对痴呆症诊断的原住民家庭。通过一个故事情节来探讨访谈数据中的主题,这个故事情节从参与者为何以及如何承担护理角色开始;讲述一路上的挑战、挣扎和决定;以及对照顾患有痴呆症的亲人的回报和益处的反思。研究结果表明,原住民的基本价值观在本研究涵盖的原住民文化和地理背景中创造了一种一致的家庭护理模式。研究发现,家庭护理通过代际接触和文化知识的传承促进了文化延续。不同的社区背景带来了重大挑战,这些挑战最直接归因于加拿大原住民与非原住民之间的关系性质以及持续存在的关于获得服务的殖民政策。