Historic context of colonisation | It is critically important to recognise the role of colonialism in shaping policy and its impact on what services are available to Canada's First Nation peoples. Unlike other parts of the country, there has been no land surrender in Nova Scotia. |
Jurisdictional issues | Continuity of care may be lost as individuals require care outside their community and move between provincial and federal services. |
Cultural understanding | Values: lack of alignment between values implicit in Western medicine and those of the Mi'kmaq culture can be problematic. Using a holistic health approach can act as a bridge for understanding indigenous values such as the interconnectedness of the physical, social and spiritual dimensions of self and the impact this has on health decisions. Rather than being universal and unchanging, values differ, often subtly, by family and individual as well as from community to community. |
| Language: acknowledging culture as a part of an individual's healing process is vital to understanding health choices and preferences. The integration of spirit as a part of healing occurs through the inseparable interrelationships among self, family and community. Different world views, language and cultural contexts reflect the divide that needs to be bridged to attain cultural competency in the care of indigenous peoples at end of life. Complexity is inherent in gaining a deep understanding of language. |