Needs of Elders addressed during CHR conference

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When Community Health Representatives (CHRs) met in Ottawa, June 12 to 14, they had a full agenda. The National Indian and Inuit Community Health Representatives Organization (NIICHRO) hosted a training session for them: Coming Full Circle: Healthy Living and the Aboriginal Frail Elderly. CHRs also participated in NIICHRO's 12th annual general meeting, and got an update on wage parity.

Currently the initial training of CHRs is three months. Their job description encompasses translation, dispensing medication, midwifery, home visits and treatment.

Richard Jock, executive director of the National Aboriginal Health Organization, delivered the keynote address, noting CHRs' vital role as providers of health information in their communities.

A panel of eight Elders shared their experiences as CHRs. Irene Lindsay, the Ottawa host Elder, originally from Saskatchewan, delivered the opening and closing prayers. The others were Walter Prince, Ont.; Eva Favel, Saddle Lake First Nation, Alta.; Amelia Frieda, Hopedale, Labrador; Alice Smith from Six Nations of the Grand River; Annie Evans, Makkovick, Labrador; Patsy Gray, Listuguj First Nation, Que.; Viola Christmas, Eskasoni First Nation, N.B.; and Bernie Delorme, Cowesses First Nation, Sask.

Arlene Vrtar-Hout, a Metis social worker and licensed practical nurse who now works in child protection and welfare services in Red Deer, Alta., spoke on the legacy of residential schools. Barbara Linkewich, on the Northwestern Ontario First Nations Palliative Care Committee, discussed palliative care.

Audrey Lawrence, of the information technology company Donna Cona. reminded delegates that those who care for others must also care for themselves. Her fast-paced presentation about humour in the workplace, Keeping Light When the Work Gets Heavy, brought many laughs.

On June 12, researchers from the University of Ottawa invited the CHRs and Elders to participate in two focus groups examining falls by the elderly.

For Viola Christmas, a CHR since 1981, working with Elders means home visits and home care, help with clothing and transportation to hospitals.

Alice Smith, a CHR since 1978, said health care needs of the elderly can become "a big burden to family members," but she advised "working situations out with family members, have meetings and discuss the health care of our elderly." Smith, whose father Charlie Hill turned 100 on Aug. 2, said, "to look at the person as a whole." She added, "They have been through a lot. They are very strong."

Patsy Gray, a CHR since 1980, offered: "There's nobody frail here. They're in their 80s, 90s, and they're very tough."

CHRs remembered the challenges they faced. Beatrice Morris of Moricetown First Nation, B.C. and a CHR since 1972, said that knowing your own language helps in the work. Morris received the NIICHRO 2003 CHR Award.

Eva Favel, a CHR since 1979, used to walk or use her father's tractor to get around. "Few roads were passable for cars. Few people had running water or power."

Walter Prince, a CHR since 1965, said, " When I first started, we had nothing. We used to see a nurse once a month."

The struggles faced by the CHRs mirror the struggles faced by many frail elderly in their everyday lives. The elderly may be isolated, lack transportation, and have difficulty accessing medical supplies and services.

NIICHRO's executive director, Margaret Horn, said motivation is key. "They think their lives are over," she said, and it's important "to get families involved."

The CHRs viewed the Coming Full Circle video. A team of ten facilitators led workshops looking at the issues affecting the Aboriginal frail elderly in the mind, the body, the social self and the spiritual self.

CHRs learned new activities to use with the elderly in their communities, such as safe body movements to encourage physical activity. Horn said, "We say 'movement,' not 'exercise,' because Elders don't like the word 'exercise'."

Linkewich talked about dealing wth pain and symptom management. "A lot of palliative care is listening to the stories." She pointed out that the prospect of addiction worries families. Elders also have thrown their morphine into the garbage because they believe it is not natural, Linkewich said, "but remember that aspirin comes from the bark of a tree." The frail elderly, she added, "will need to be supported and honoured in their choices."

Vrtar-Huot, Linkewich and Lindsay all attended residential schools, and said that legacy informs the Coming Full Circle training. Vrtar-Huot quoted from the Coming FullCircle training manual: "Many of today's seniors are those children who were taught that their culture was inferior, uncivilized and savage. The legacy of abuse, lack of self-esteem, ill-health, an inferior education... It is doubtless a contributing factor to the frail health of Aboriginal seniors today." Loss formed the basis of their life experience. "The value of children was well known," added Vrtar-Huot. But the children lost their parents; the adults lost the meaning in their lives; the Elders, who by tradition "were the keepers of the customs and traditions, lost their role.

Healing from the effects of residential schools is a vital process, and Vrtar-Huot implored the "sleeping Elders"- those who have not done this healing-to do so.

"The work we have to do is never a waste of time. If we don't deal with these issues, we are going to pass them down to our children."

Coming Full Circle looked back and looked ahead. Karen Keshane, president of NIICHRO and a CHR, band councilor and mother of eight (four foster children and four of her own), thanked the staff for its "commitment and hard work." Velma LeBillois, vice-president, focused on the development of national standards for CHRs, and the formal recognition of CHRs as health professionals. A year from now, she told delegates, Winnipeg will host the first national Aboriginal injury prevention conference.

NIICHRO received a Share Awar, funded by GlaxoSmithKline and administered by the University of Pennsylvania, which funded the Coming Full Circle training materials. Sponsors of the training session included Donna Cona, First Nations Centre des Premieres Nations, and Ajunnginiq Centre. Regional offices of Health Canada sponsored Elders to attend.