Health Care Needs of Elderly Métis Women in Remote Locations. Dr. Diane J. F. Martz SPHERU Director, Research Ethics Office

Transcription

1 Health Care Needs of Elderly Métis Women in Remote Locations Dr. Diane J. F. Martz SPHERU Director, Research Ethics Office

2 Issues Identified Fiscal restraint, health care restructuring and limited investment in home care infrastructure may save the health system money, but at the expense of both patients and caregivers; Family members are expected to provide home care support as an extension of their domestic and family work; A realization that when one member of a family requires care, the stress of care giving affects everyone in the family, but that women and men recognize and respond to stress differently; There is a lack of good quality long-term care available in the community of Buffalo Narrows to take the place of existing informal care giving.

3 Goals Create a vision of accessible, high quality health care that meets the needs of elderly Métis women care recipients and their caregivers.

4 Methodology Métis Women s Research Committee Partnered with PWHCE Adopted Ethical Guidelines for Aboriginal Women s Research Trained a community researcher who conducted and transcribed interviews. 12 qualitative interviews were analysed with Atlas-ti.

5 Framework - Access to Health Services Availability relationship between the volume and service provided and the users needs. Accessibility location of services, patient mobility, transportation resources and travel times Affordability ability of people to pay for the direct and indirect costs of services. Acceptability shared understandings between the attitudes and beliefs of the users and providers Accommodation relationship between service provision and the users perception of the appropriateness of the service

6 Availability Some services were not present. Some services couldn t meet the demand Some women had difficulties in making appointments and getting to the clinic

7 Accessibility Transportation availability Need for financial resources. External supports informal caregivers help with access Language barriers

8 Affordability Fixed incomes may not be enough to pay for services that cost. Costs associated with travel Some mentioned paying the costs for an escort if there was no family to travel with them. She doesn t have the money, I don t have the money, if [the hospital] was in our community we wouldn t have to travel. That s the big issue, that s the biggest issue of all. Because when she has an emergency or if she has a check up, we got to take her the day before, we got to get a room, we got to get her to the hospital. See that s already three days of travel, when she s done her check up in Saskatoon, we have to spend a night again because it s too late to come home

9 Acceptability Language Barriers Expressing symptoms Understanding diagnoses Asking for help Well for myself it is okay because I can speak English, but I imagine someone that only speaks Cree would have a hard time trying to get their message out to the doctors or else for them to understand what the doctors are trying to tell them Holistic vs Western Approaches

10 Accommodation Limited staffing restricts the ability to provide more flexibility to meet needs.

11 Accessibility Suggestions Reliable transportation to and from appointments Transportation services with escorts for out of town appointments Medical/ community van to support independent lifestyle ie., grocery delivery, prescription delivery Availability Increased on site health personnel Increased on site services including respite or a long term care facility so that elderly family members can stay in the community Pharmacy in the community Affordability Travel subsidies for out of town appointments Free transportation services in community or to neighbouring communities for health needs Drug coverage for necessary medications

12 Suggestions (Con t) Acceptability Services available in Cree, Dene or Michif. Mediator for appointments for translation Holistic medical response with community focus to health needs Social activities/ recreational activities for elderly residents Accommodation Emergency services Longer hours, after hours or 24 hour care Increased range of services provided by home care/ health care