Filling in the Gap - Indigenous Caregivers of People Living with Dementia in 21st Century Canada: A Literature Review

Abstract

Dementia is a neurodegenerative medical disorder of adulthood that causes a deterioration of memory and interferes with the ability to perform activities of daily living. Although many causes of dementia are not modifiable, Indigenous peoples are likely subject to modifiable risk factors, and many social determinants of health (like culture, racism and ableism) that could impact their risk of developing dementia (Alzheimer Society of Canada, 2024). Indigenous people (First Nations, Inuit, and Métis) living with dementia and their caregivers within the geographical regions of Canada face challenges that are similar to those of non-Indigenous Canadians. However, they also have unique challenges that can be examined using a Critical Disability Studies framework, which include a review of the intersections of dementia (disability), identity, culture, and systemic barriers in dementia caregiving. Thereafter, Decolonizing Theory can be used to analyze the intersections of dementia, caregiving for people who live with dementia and Indigenous identity to understand the different coping mechanisms that help Indigenous people living with dementia and their caregivers manage stress. Just as Critical Disability Studies aim to combat the marginalization and stigmatization of people with disabilities, Decolonization can oppose the ableist beliefs that colonial processes have ingrained (Roy, 2024). Furthermore, understanding how colonialism, marginalization and systemic inequities create stress for Indigenous people living with dementia and their caregivers can be achieved through Postcolonial Theory. Postcolonial Theory provides the basis for much cultural safety training and is an explanatory framework for Canadian healthcare providers practicing with Indigenous peoples. It proposes that providing healthcare to Indigenous peoples requires an understanding of the postcolonial relationship between Indigenous peoples and the Canadian settlers (Wilmot, 2021). The framework of Two-Eyed Seeing or Etuaptmumk, can then explain how there are many ways of understanding the healthcare world, including the Western biomedical model, and the various knowledge systems used by Indigenous peoples in the development of caregiving support models.