CCBI News – Access to Palliative Care
April 14, 2023 Dear Friends of CCBI, Access to Palliative Care CCBI has always advocated…
March 14, 2022
Dear Friends of CCBI,
Editor’s Note: In CCBI’s Resources for COVID 19 Bulletins that preceded this CCBI News, we have been mindful to present information about the state of our First Nations peoples during the pandemic. (For example, see https://www.ccbi-utoronto.ca/category/covid-19/ August 14, 2020, The Chief of an Alberta First Nation, Chief Ouray Crowfoot of Siksika Nation, said that “the pandemic should be a wake-up call that drives long-term change.” Marlene Poitras, the Alberta Regional Chief for the Assembly of First Nations, said the federal government has been responsive during the pandemic, but agreed with Chief Crowfoot that there were long-standing problems before the pandemic that need long-term change “… in terms of the housing situations, the boil-water advisories, overall poor health conditions of our people.”) Moving forward, Bridget Campion, PhD, will now report regularly on Indigenous Issues for CCBI News. Here is her first commentary, followed by Dr McQueen’s on aging, the elderly, and Pope Francis.
COVID-19 and Indigenous Communities
On March 28, a delegation representing First Nations, Inuit and Métis people, along with representatives from the Canadian Conference of Catholic Bishops, will be in Rome to begin a series of meetings with Pope Francis. According to a Canadian Press report published by APTN News, the delegation will include “25-30 Indigenous people, including Elders, residential school survivors and youth.” The purpose of the meetings is to explore how healing and reconciliation may be possible in light of the still-unfolding tragedies caused by the residential school system. As Michael Swan notes in The Catholic Register, persons travelling with the delegation will include “two Indigenous mental health workers supporting survivors who will speak about their experiences in residential schools and the damage it caused in their families and communities.”
While the spotlight is necessarily on the trauma and grief caused by the residential schools, I think there is another aspect of this story that deserves attention. Originally the meetings with the Pope were to have occurred in December 2021 but were cancelled because of COVID-19. The omicron variant was making its appearance and so postponing the trip seemed simply to be a prudent decision. But, according to the Canadian Press report, Indigenous delegates and the CCCB felt that “The risks were too great … particularly for Elders who would have travelled, and for those who could potentially bring back the virus to their remote communities, where COVID-19 can pose a higher risk due to crowded housing and a lack of health care.” The delegation recognized not only that COVID-19 poses a higher risk to Indigenous communities but that it does so because of socio-economic and health-care inequities.
Amanda Carling and Insiya Mankani agree, writing in their article on the Human Rights Watch website, “because of the systemic inequities and discrimination … Indigenous people may suffer disproportionately from COVID-19.” As they point out, something as “simple” as hand-washing is not so “simple” in communities that lack clean water. Social distancing can be more than challenging when housing shortages lead to overcrowding. Accessing health care services in remote communities can be problematic because “many nursing stations are ill-equipped and understaffed.” COVID-based travel restrictions then make it even more difficult to be transported to larger health care centres. Moreover, as Carling and Mankani observe, “In urban settings, Indigenous people are also overrepresented in populations at heightened risk of COVID-19: populations experiencing homelessness, prison populations, and people living in poverty.”
In their June 2021 Sector Update on COVID-19, the Assembly of First Nations (AFN) report that many Indigenous communities were initially successful in keeping COVID-19 at bay. However, this did not last and “Once the virus got into communities, over-crowding, lack of isolation spaces, testing challenges and delays often caused the virus to spread quickly despite best efforts…. In January 2021, First Nations people living on-reserve had an active case rate that was five times that of the general Canadian population.”
Like everyone I will be following with deep interest events in Rome at the end of the month and I will be praying for the success of the meetings. But the heightened risk that COVID poses to Indigenous communities is further evidence that injustice did not end with the closing of the residential schools.
The Church and the Elderly
Pope Francis has embarked on a new catechetical theme for Wednesday papal Audiences: aging and the elderly. I mentioned that this is a theme dear to his heart, and he often warns against society’s dismissal of the elderly as if they are invisible, unimportant and burdensome, all of which is completely offensive to human dignity. In his opening Audience on this theme, the Pope said: “The wisdom of the long journey that accompanies old age to its close must be experienced as an offer of meaning to life, not consumed as the inertia of its survival. If old age is not restored to the dignity of a humanly worthy life, it is destined to close itself off in a despondency that robs everyone of love. This challenge of humanity and civilization requires our commitment and God’s help. Let us ask the Holy Spirit for this.”
In his audience on March 2, the Pope stressed the importance of what he called ‘intergenerational activity, urging to ensure that real connections with the elderly are made and kept. He is possibly reflecting on the more nuclear type of family that exists today, far from the former ‘extended family’ model where family ties were often more nurtured and maintained. Historically, people tended to live much closer together and in many ways were more interdependent. Different lifestyles have formed different family relationships and older people do not always have that type of immediate support. The Pope is not calling for a return to the ways of the past, but is inviting us to be creative in devising ways to ensure that the generations may still meet and share their news, views, time, wisdom and talents as usually happens in family and social relationships. Those links would keep everyone more aware of the dignity and worth of each other, and older people might not then find themselves feeling lonely, somewhat abandoned or even contemplating something as drastic as euthanasia. Loneliness can sometimes feel like a serious illness. The Pope constantly reminds us that the elderly are readily forgotten in our speed-obsessed culture and reminds: “A young person who is not bonded to his or her roots, which are the grandparents, does not receive strength — like a tree gets its strength from the roots — and grows up badly, grows up sick, grows up without points of reference. This is why it is necessary to seek a dialogue between the generations, as a human need. And this dialogue is important especially between grandparents and grandchildren, who are the two extremes.”
Aging in Place
One of the most frequently heard pleas by the elderly or people with disabilities and their families is to be able to stay in the comfort of their own homes as they age unless or until they reach the stage where more intensive care and supervision is needed. We frequently refer to the problems in long-term care homes brought to light by the pandemic, but there are other systemic issues that affect the quality of the care residents receive as they live out their last days. Care of the elderly involves looking at those needs as well, and our multi-cultural society should help us recognize the importance of language, food preferences, cultural preferences around activities for residents, and so on. An interesting video from TVO makes us think more deeply about such cultural differences and how they can be accommodated. The focus is on dementia, but the suggestions from the panel also could be applied more generally to the elderly in all cultures. One panelist pointed out how a PSW who spoke his mother’s language was able to coax her into eating where others could not do so. This seems so simple, but for residents and their families this is the sort of concern that makes them anxious and troubled about their loved one in a home, as well as feeling as if they, too, are not doing enough. It’s an all too familiar experience in many families and is one that could be partly remedied with proper concentration on cultural needs.
In the video, Dr Samir Sinha made the startling comment that there are only 180 specialist geriatricians in Ontario. I had to listen again to make sure that’s what he said. Caring for the medical needs of the elderly as well as trying to direct patients to homes best suited to their situation must be strained, given these limitations. Partly because of the pandemic, more money has been poured into long-term care and that is a start, but, as Dr Sinha points out, one in three residents in these homes could be looked after at home, given better government support. While governments’ budgets can only stretch as far as the tax-paying population of the country or province allows, the ‘dying in place’ movement deserves our attention, first, and most importantly to the elderly, that is what they want. Second, families would be able to support their loved one in the comfort and safety of their own home for much longer, and models for this from other countries speak to that possibility. Third, it costs less to maintain people in their own homes! This is surely a win-win situation for a significant percentage of the elderly, while budget savings could then be further applied to providing cultural needs in long-term care homes, so important for the quality of life of our elderly citizens at this stage of their lives where they deserve the best care possible.
Pope’s Intention for March
We pray for Christians facing new bioethical challenges; may they continue to defend the dignity of all human life with prayer and action.
St Pope John Paul’s Prayer to Our Lady For Ukraine
John Paul II’s prayer to Our Lady for Ukraine (aleteia.org)
Moira, Bambi, Bridget
Here are links to sources and additional articles that you may find helpful:
Indigenous
APTN News “Indigenous delegation to meet Pope Francis at the Vatican at the end of March” (The Canadian Press) Feb 01 22 https://www.aptnnews.ca/national-news/indigenous-delegation-to-meet-pope-francis-at-the-vatican-at-end-of-march/ ;
Michael Swan “Vatican delegation is taking shape” in The Catholic Register Nov 17, 2021 https://www.catholicregister.org/item/33731-vatican-delegation-is-taking-shape ;
Amanda Carling and Insiya Mankani “Systemic Inequities Increase COVID-19 Risk for Indigenous People in Canada. Challenges Include Barriers to Healthcare, Adequate Housing and Resources” June 9, 2020 on Human Rights Watch website https://www.hrw.org/news/2020/06/09/systemic-inequities-increase-covid-19-risk-indigenous-people-canada ;
Assembly of First Nations “Sector Update/Compte rendu de secteur HEALTH: COVID 19 June 2021 https://www.afn.ca/wp-content/uploads/2021/07/Sector-Update-COVID-19-June-2021-EN.pdf ;
Ainsley Hawthorn CBC N.L. “Why have Indigenous communities been hit harder by the pandemic than the population at large?” https://www.cbc.ca/news/canada/newfoundland-labrador/apocalypse-then-indigenous-covid-1.5997774 ;
AFN News “Canadian Bishops, Assembly of First Nations, Métis National Council, and Inuit Tapiriit Kanatami Provide an Update on Delegation to Rome” Dec. 7, 2021 https://www.afn.ca/news-media/page/2/
St John Paul II, Prayer to Our Lady for Ukraine
St. John Paul II used this prayer to ask for Our Lady’s mantle to be spread over all the people of Ukraine. https://aleteia.org/2022/02/25/john-paul-iis-prayer-to-our-lady-for-ukraine/
General Audience of 23 February 2022 – Catechesis on Old Age | Francis
Catechesis on Old Age. Dear brothers and sisters, good morning! We have finished the catecheses on Saint Joseph. Today we begin a catechetical journey that seeks inspiration in the Word of God on the meaning and value of old age. https://www.vatican.va/content/francesco/en/audiences/2022/documents/20220223-udienza-generale.html
General Audience of 2 March 2022 – Catechesis on Old Age – 2. Longevity: symbol and opportunity | Francis (vatican.va)
Speaker: Dear Brothers and Sisters: In our continuing catechesis on the meaning and value of old age, viewed in the light of God’s word, we now consider the contribution that the elderly can make to the development of a truly humane society, one in which every age group has something to offer. https://www.vatican.va/content/francesco/en/audiences/2022/documents/20220302-udienza-generale.html
Church must do better at valuing elderly, Vatican official says https://cruxnow.com/vatican/2022/02/church-must-do-better-at-valuing-elderly-vatican-official-says
TVO: Why Culture Matters in Dementia Care https://www.tvo.org/video/why-culture-matters-in-dementia-care