Workshop - Aging and care

Session Nr.1: "Expanding the UN/conventional care service compass in Tribal Settings: context matters"

Indigenous peoples experience many barriers associated with accessing conventional care services in tribal settings.  These barriers contribute to Indigenous health and social disparities worldwide.  This qualitative study examines interrelated factors that impact access-to-care barriers in context of service delivery practices in tribal settings, specifically in Alaska.  Guided by a conceptual model based on relationship capital, this study incorporates relational and participatory action research principles with Alaska Native Elders.  It is comprised of twenty-two qualitative interviews with Alaska Native Elders in Alaska, which when combined represent all major Alaska Native cultural groups.  The interviews were collected as part of a larger ethnographic study and qualitatively analyzed using Atlas.ti.  Study findings are presented through ethnographic story narrative from Indigenous Elder voices in Alaska and show conventional service delivery practices are rooted in context: Language, Culture and History Matters.  Findings suggest expanding the un/conventional care service compass to incorporate a pathway of cultural triage based on context matters, particularly at the initial point of contact with service delivery systems.  In doing so, a fundamental paradigm shift occurs whereby the individual-institutional experience in service delivery systems relevant to Indigenous peoples is transformed: Voicing context matters.  This paradigm shift expands the un/conventional care service compass from one that is potentially re-traumatizing to one that is healing among Indigenous peoples.  These matters illuminate policy-practice connections relevant to Indigenous colonial histories and support a trauma-informed care approach

Session Nr.2: "Cared for by ourselves: A study of local organization and community day-care center"

Taiwan has been an aging society since 1993 and the issues of economic security and social care for older people have been widely discussed in recent decades. ‘Aging in Place’ is the key policy for developing long-term care services in Taiwan, and community day-care centers have received special emphasis from government in the past few years. So far, most community day-care centers have been run by foundations or social welfare organizations whilst indigenous community development associations operate the centers. This study aims to discover how tribal organizations have run their day-care centers and what local people think of the services provided. The research adopts a case study and community-based participatory action approach, and uses an action research team to investigate the experiences of tribal organization workers, service users and their families

Session Nr.3: "Aging and local perspectives on quality of life. findings from a Sámi-Norwegian study in Finnmark"

“Active ageing” is a topic that is currently much debated in the West. The activation model expressed in the term active ageing is constructed with a point of departure in an individualistic worldview, treasuring youthfulness, independence, autonomy and self-reliance. An important question, however, is if older people of indigenous and majority backgrounds themselves want to “age actively” in line with this ideology, especially when they become frail and experience an increasing loss of functional abilities. Based on analysis of in-depth interviews with five Sámi and six Norwegian women and men (aged 75-94) in Finnmark, we ask: What does the term active ageing mean in the daily life of frail older people? Our paper shows that the values inherent in the active ageing ideology are in contrast to interdependence and reciprocity highlighted as central values by several of our participants. Further, our findings indicate that, whereas some elderly socialize with family members or with other elders on the phone and in real-life, others prefer for various reasons to stay at home alone, not socializing too much and not going too much out of their house. They rather find meaning in activities such as reading books or magazines, watching TV, reminiscing old times, looking at the birds at the bird feeder and more. We conclude that “active ageing” as a paradigm risks marginalizing older people who do not want to or are not able to age in the ways favored in various policy papers. Thus, if ageing policies in the West aim to be more inclusive, the experiences of frail elders themselves, among both indigenous and non-indigenous populations, should be recognized.

Session Nr.4: "Experiences of being old and receiving home nursing care. Older south Sami narrations of their experience – An interview study"

The Sami people who are the natives of Scandinavia are not a homogeneous group. They consist of differ- ent groups of Sami populations of which the South Sami population are one small group. For the South Sami this means a problem; they have to struggle against a general ignorance about the Sami people and culture, which also may affect received home nursing care. The aim of this study is to describe individual South Sami experiences of being old and receiving home nursing care. A sample of 10 older per- sons with South Sami background was chosen for this study. Narrative interviews were conducted and qualitative content analysis was used to identify and categorize primary patterns in data. The experience of being an old person with South Sami background who receives home nursing care was understood through the use of the following four themes developed from the informants’ own narratives: “Experience of losses in life”; “Feelings of being less valued”; “Feelings of gratitude”; and “Experience of meaning in daily life as old”. The main finding is that the South Sami population still is exposed to an ongoing subtle colonisation. Therefore, it is important to pre- pare and teach nurses who work in the South Sami area in cultural care, traditional values and beliefs specific to the South Sami population

Session Nr.5: "Respecting and honoring Aboriginal and Torres Strait Islanders Elders in Social Work"

Accordingly social work theories and practices are based on the principles of Western non-Indigenous principles and ideas. Correspondingly Social Workers did not recognize or reference the Australian Aboriginal and Torres Strait Islander ways of knowing, being and doing within their scope of practice.

To understand the health and wellbeing of Aboriginal and Torres Strait Islander peoples in Australia one has to accept and understand that the historical, cultural, physiological, psychosocial, economic, environmental and political context faced by Indigenous peoples. The methodology needs to incorporate the specific cultural understandings and priorities of the Australian Aboriginal and Torres Strait Islander peoples. In-depth consultation and negotiation with the target communities ensured that their needs are understood.

In Aboriginal and Torres Strait Islander’s societies the role of the Elders is paramount. They are respected for their narrative historical value, where testimonies about the Dreaming and daily community life help others to understand the practical aspects of life and society The Elders hold and relay the stories and the wisdom of the past. In telling the stories the Elders make sense of people’s everyday lives. This presentation intends to provide an opportunity to discuss and formulate appropriate methodologies for social workers to develop when conversing with Aboriginal and Torres Strait Islander Elders.

Session Nr.6: "Decolonizing long-term care for the elderly: A case of Taiwan Indigenous peoples"

This paper has two aims to explore the notion of decolonizing long-term care. First, it aims to illustrate power relations between social welfare policies and Indigenous peoples through examining genealogy of long-term care for the elderly. Second, it aims to flesh out Indigenous peoples’ claims for self-determination and how it provides a critique for the formation of state’s long-term care project. For the former, Foucault’s genealogical analysis and Carol Bacchi’s ‘What’s the Problem Represented to be’ (WPR) approach are utilized as key resources for problematizing the apparatus of long-term care institutions. For the latter, critical ethnography is utilized as a key tool to open the institutional presence in Indigenous people’s everyday life.

The preliminary analysis from the first aim unravels Taiwan’s long-term care encompasses contingent conditions of what should be considered “good care”. Although Taiwan Indigenous peoples are recognized nationally, their voices in participating in producing the discourse are muffled and silenced. The underlying assumptions and norms of aging only concerns the medical professionals and other institutions of control. It leads to disruption of long-term care and Indigenous peoples as ‘ungrateful’ passive recipients of welfare. The results form the second aim shows that bringing self -determination to the discussion of long-term care is essential to end the disruption. Highlighting Indigenous peoples’ self-determination through practice exemplifies their agency and a more holistic conception of “good care”

Session Nr.7: ""Indigenous health promotion and cultural sovereignty in Taiwan"

Based on experiences at the Kaluluan elder’s physical rehabilitation center, this paper explores ways in which autonomy of indigenous senior health care is established through utilization of community collaboration, social relations and local knowledge, in connection to external medical professionals. Kaluluan is a rural community located on the east coast of Taiwan with Sakizaya, Pangcah, Kavalan and Bunun indigenous peoples. Members of this multi-ethnic community took the initiative to set up the rehab program, through collective efforts they went door-to-door to encourage elders’ participation, coordinated transportation, built rehabilitation equipment using recycled materials and contributed home-grown ingredients for the communal lunch. Given limited resources and the rural location, yet critical of the imposing responsibilities that may follow upon accepting external funding, Kaluluan responds to the divergent needs of community elders and avoids resource allocation conflicts and possible exclusions by allowing heterogeneous identities within the community to sprout organically. The center becomes a site of interactions of social relations and cross-cultural dialogues, which is in itself a concrete expression of local knowledge and claim to cultural sovereignty. Counter-intuitively, Kaluluan’s choice to prioritize the rehabilitation profession and local network as basis to develop health promotion initiatives, opens up space for its multi-ethnic participants to reveal their authentic cultural diversities, where indigenous cultural logic and local wisdom are vividly and fluidly present in daily practice