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e-book First Nations, Identity, and Reserve Life: The Mikmaq of Nova Scotia

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Quotes "The Mi'kmaq Education Agreement is a clear demonstration that self-determination leads to better outcomes. Minister of Crown-Indigenous Relations "Signing the agreement is a fundamental step towards the ongoing recognition of Mi'kmaw leadership taking control of education and ensuring children and youth continue to succeed and be guided by the strengths of Mi'kmaw language and culture.

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Land & Sea: The Mi'kmaq journey

Information is missing. Information is outdated or wrong. Scared fires and pipe ceremonies are also traditions that communities may partake in collectively during this transition. End of life is not so much its own period but a continuation of the realities that there are many levels of existence. Combined with the importance of family and community, the perception of spirit is linked to a strong sense of faith in both the life and death process. As a result of this perspective, healthcare providers should not restrict the number of visitors, as family means more than immediate family members.

Prohibiting visitors from bringing sacred objects or prohibiting ceremonies that enable an individual to travel to the spirit world is also problematic. Respect for handling sacred objects or personal belongings and knowing who can handle certain objects is important. A woman who is on her moon time menses should not touch sacred objects because women are believed to be very powerful during this time.

Culturally competent advocacy on the part of healthcare providers is fundamental to providing care that is grounded in the understanding of this journey to the spirit world. Healthcare providers can play a critical role in providing an environment that positively affects the individual and those in attendance at end of life by learning the values and beliefs of the individuals and families who are willing to accept their care. Historically, coping with illness, bereavement and pain is considered acceptable when met with even-temperedness and suppression of grief rather than public displays of despair and inconsolable grief.

This was perceived as a survival mechanism or a way of being stoic in the face of disaster or illness. However, Mi'kmaq people do not view the English term stoic as being an adequate description of their cultural teaching and socialisation. Historically, Mi'kmaq suffered without showing the effect of misfortune and to do the contrary was believed to be the height of immaturity or a means of drawing attention, even causing harm. Complaining was perceived as being selfish and was considered to have the effect of making others depressed. Special respect and deference for elders is a fundamental given in Mi'kmaq communities.

Some respected elders are known for their knowledge and wisdom of oral traditions and this may not necessarily be related to age. Elders are well known and play a significant role in the community.

Healthcare providers must build relations with respected elders in the community as the relationship is seen as a partnership for addressing culturally competent care for community members. Historically, care giving was defined within the context of reciprocity, and was often experienced throughout the lifespan. Today, there are differences in the availability of supports that exist on and off reserve which has led to changes in care, particularly around the role of the community in providing assistance and the role of family in providing respite care.

A sense of family, community and traditional views of spirituality frame the view of health among Mi'kmaq. There is a rooted belief in the strength of prayer and faith in its ability to cure as much as any intervention. More value may be placed on quality of life rather than on pursuit of a cure when life balance and wellness are a part of the holism that is ethically equated with mental, physical, emotional and spiritual health.

Aboriginal worldviews see health as more than a lack of disease. Health is linked to the economy, the land, community and culture. Non-Mi'kmaq healthcare providers should not assume that someone in their care is following treatment measures prescribed by Western medicine and should openly discuss this with clients in a non-judgemental manner. It is important for non-Mi'kmaq healthcare providers to understand and appreciate the worldview, spirituality, role of family and community, and communication norms of Mi'kmaw individuals with whom they are working, and to strive for an alignment of values in the provision of care.

The words that are used and a lack of common understanding of terms can lead to miscommunication and misinterpretation of needs and services. For example, terms such as home care, supportive care and palliative care are sometimes used interchangeably by federal and provincial service providers even though they may imply different ideas. Language barriers also affect the understanding of care plans. Even if interpretation services are available, they may not be accessed because persons are not identified as having this need since the Mi'kmaq generally have some level of understanding of English, some Mi'kmaq may not speak Mi'kmaq or because interpreters may not be readily available.

Furthermore, interpretation services may not adequately handle the nuances of Mi'kmaq terms and the wording used by non-Mi'kmaw healthcare providers. Mi'kmaq terms, which are not well understood by non-Mi'kmaq care providers, are very relevant. Three of these apiksiktatulti, nemu'ltus and salite are introduced in table 1.

Mi'kmaq traditions associated with the journey to the spirit world are culture-specific and individually determined. Beyond access to publicly-funded health services and historic Mi'kmaq ways of caring for each other, there can be an additional dimension. Jesuit priests introduced the Mi'kmaq to Roman Catholicism which remains important to varying degrees among the Mi'kmaq in terms of both values and language; for example, heaven may be the term used for the spirit world by some Mi'kmaq.

By separating and reflecting on the issues of jurisdiction and cultural understanding, progress can be made toward greater cultural competency. Inclusion of indigenous ways of knowing about health is critically important for ensuring cultural competency. Non-Aboriginal healthcare providers often discuss and provide supportive and palliative care from a Eurocentric approach 24 either due to lack of knowledge or lack of system support to provide culturally competent supportive and palliative care.

Cultural competency transcends cultural understanding. It includes ensuring that the healthcare system is inclusive of different worldviews in the planning, implementation and evaluation of healthcare services. The authors recommend that indigenous leaders undertake a more indepth study of supportive and palliative care needs in their communities by using an integrative framework to guide this research.

The authors recommend that consideration be given to having palliative care researchers work with the Mi'kmaq using research processes that respect the community. The purpose would be to explore how current perspectives on palliative and supportive care might be enhanced or reconstructed through a greater understanding of the Mi'kmaq ways. The identification of both jurisdictional issues and cultural understanding in the historic context of the Mi'kmaq is important for enhancing the cultural competency of non-Mi'kmaq care providers.

Best practice indigenous supportive and palliative care may be contrary to conventional Western healthcare assumptions and practice. Through reflection on the situation of Nova Scotia's Mi'kmaq, non-indigenous healthcare providers can assess how they might critique and increase their cultural competency. This paper will hopefully raise awareness of the need to more broadly understand and incorporate an indigenous cultural context when providing supportive and palliative care. Contributors: GJ was responsible for overall conceptualisation of the paper and guidance especially in relation to palliative and end of life care for vulnerable populations as well as critical reflection, interpretation and editing.

AV advised on Mi'kmaq information sources, conceptualisation and design, and assisted with the critical review, understanding of the Mi'kmaq culture, liaison with Mi'kmaq consultants and editing of the manuscript. SP carried out the initial literature review and meetings with strategic informants, prepared the first draft of this paper and contributed to revisions. All authors contributed to the literature review and have read and approved this final manuscript.

GJ and AV jointly are the guarantors for the content of this paper based on their respective areas of expertise and through ongoing consultation with two Mi'kmaq consultants. Competing interests: None. Provenance and peer review: Not commissioned; externally peer reviewed.

National Center for Biotechnology Information , U. Published online May 3. Author information Article notes Copyright and License information Disclaimer. Accepted Feb This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

This article has been cited by other articles in PMC. Abstract Objectives The provision of supportive and palliative care for an indigenous people in Nova Scotia, Canada, was examined to further our understanding and thereby improve cultural competency. Methods Themes were identified in the literature and through discussion with seven experts who have Mi'kmaq health and cultural research expertise. Results The themes identified focused on jurisdictional issues and cultural understanding.

Conclusion Through reflection on the situation of Nova Scotia's Mi'kmaq, non-indigenous healthcare providers can assess how they might increase their cultural understanding in the provision of supportive and palliative care. Methods This paper was developed from a review of literature and discussions of one author SP with four non-Mi'kmaw informants intricately involved with research and Mi'kmaq peoples and the second author AV who shared this paper with two Mi'kmaw consultants Theresa Meuse, advisor and educator on Mi'kmaq ways, and Sister Veronica Matthews, Elder.

Table 1 Descriptions of terms related to providing Mi'kmaq supportive and palliative care. Term Description Aboriginal peoples Indigenous people who have lived in Canada for thousands of years. Oral tradition is important in the relational nature of the Mi'kmaq language. Apiksiktatultimk pronounced abiksikdadldimk A Mi'kmaq term used to describe when a person is thought to be dying, family and friends go to the bedside to partake in this act of mutually being present with each other which may include forgiveness or reconciliation.

This has the intent of ensuring that the dying person will go to the spirit world without any burden while also preparing all involved for the inevitable. The implication here is that death is not final. Life and death are events. Death is understood to be a verb since if it were a noun, it would be final. Life is also a verb as it is a process of living and of being alive. Salite Mi'kmaq feast after a person leaves this world.

About the Book

Feasts are common for First Nations peoples for closure after events. Usually the Elders are the first to begin the meal. This is a community event with everyone bringing goods for an auction. In the past, the Salite auctioned the belongings of the person who has gone to the spirit world. Today, community members bring goods to auction to help raise funds to pay for the wake and other expenses and debts the person may have had. Salite is an important aspect of care. It acknowledges the interconnectedness of the person who has moved on to the spirit world and the community.

Cultural competency As a continuum, cultural competency encompasses sensitivity, awareness, knowledge, skills and competency. Cultural competency depends on provider efforts to understand unique aspects of individual cultures and is based on the premise that knowledge of cultural characteristics equips professionals to build trusting relationships and provide holistic care. Palliative care Palliative care aims to improve the quality of life and care of patients and their families facing life-threatening illness through the prevention and relief of suffering by early intervention and treatment of pain and other physical, psychosocial and spiritual problems.


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In Canada, palliative care and palliative medicine are typically hospital-based and provincially organised. Palliative care developed in Canada during a time period when federal-provincial agreements provided public funding for hospital and physician care, and patchwork funding at best for community-based care.

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The role of the voluntary sector and the federal government is minimal in the delivery of palliative care in Canada. Supportive care Supportive care relates primarily to cancer services that help patients and families with their experience during the diagnostic, treatment, follow-up and palliative phases. It includes physical and symptom support as well as information, psychological and spiritual support. Indian and Northern affairs INAC is the Canadian federal government department with a mandate to fulfil constitutional responsibilities in First Nations affairs regarding the Indian Act which was established in To see what your friends thought of this book, please sign up.

Lists with This Book. This book is not yet featured on Listopia. Community Reviews. Showing Rating details. More filters. Sort order. Oct 23, Peter rated it liked it Shelves: history , first-nations. An in depth look at the current life of the Mi'kmaq First Nation focusing primarily on Identity and the varying factors that effect it. I was struck by how many of these factors cause a tension within the people as they seek to define themselves today. Traditionalism contrasted to Catholicism, the ability to speak Mi'kmaq or not, wealth and poverty, inside or outside the reserve, etc.

The Mi'kmaq seem constantly torn about who they are today as the past has been largely taken away but outside inf An in depth look at the current life of the Mi'kmaq First Nation focusing primarily on Identity and the varying factors that effect it.

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The Mi'kmaq seem constantly torn about who they are today as the past has been largely taken away but outside influences. I'm encouraged to see a resurgence of First Nation pride and perhaps a more sensitive National environment seeking reconciliation and the founding of a new identity for the future. Bianca Beland marked it as to-read Aug 25,