Caregiving for elders in first nations communities: social system perspective on barriers and challenges

This research examined the perspectives and experiences of First Nations community members regarding health and social support for elderly people living in 13 First Nations communities in northwestern Ontario. Surveys (n = 216) and focus groups (n = 70) were conducted in 2005 and 2006 with elderly Aboriginal people and their formal and informal caregivers. Results indicated a strong preference (69%) for helping people to age and die at home; however, barriers and challenges existed at the family, community, health system, and social policy levels. Barriers included a lack of family caregivers and shortage of health care providers and programs; changing community values; and limited access to provincial health services and culturally relevant and safe care, all of which hindered social policy and community empowerment. Enabling elderly people to age within First Nations communities will require multi-level and multi-sectoral system changes.