The key challenge in this research project was to understand or have a clear picture of the collective needs of Elsipogtog Elders and remain focused on this key challenge throughout our work. The right questions had to be asked in the right way to arrive at the emergent themes. In terms of program implementation, and making choices about how to make a difference, we had to prioritize the issues and started with food insecurity as this is a basic human need. We could not address all issues, but we could address the highest need areas and we know what the issues are and can work on other issues over time. Time also became a challenge in our work. Timeline adherence was something we watched closely. The planning and implementation processes were well established at the outset, and were adapted due to the pandemic. A six-month project extension was requested and granted. This allowed us to complete the aims and goals as planned. The goal of keeping Elders “home for life” is now better understood in terms of what it takes to do this on an ongoing basis. This knowledge means that planning for Elders is now evidence-based.

Older people in general, Older people with chronic health conditions or disability, Older people with vulnerabilities

Health, Other

Government, Academia, Health Care, Social Care, Private Sector

Older people were part of the process at multiple or all stages

Collaboration was an extremely important element in this project. Not only did we collaborate with the Elders of Elsipogtong First Nation by involving them on the research team, but we also collaborated with the Public Health Agency of Canada with the Government of Canada, the Government of New Brunswick's Department of Health and Department of Social Development, and the New Brunswick Institute for Research, Data and Training's, Monitoring, Evaluation, Knowledge Transfer Unit housed at the University of New Brunswick, as part of the $75 million dollar investment by the Government of Canada, Healthy Seniors Pilot Project. Additional collaborators included the Alzheimer Society of Canada-New Brunswick, Age Inc., Elsipogtog Band Council, Elsipogtog Health Managers, and Elsipogtog Businesses. We communicated with all collaborators on an as needed basis to ensure robust monitoring, evaluation and knowledge sharing and exchange at a local, provincial and national level. This involved rigorous reporting, knowledge translation strategies, Teams/Zoom and face-to-face meetings, community mail-outs, and posting project information on community websites.

Indigenous team members are now empowered by the knowledge we have surfaced. They conducted the interviews with their own people, in their own language, with education, support and guidance. There was co-production of the research and ownership of it by community researchers which was powerful in program planning. Our research has renewed the commitment of community leaders to the needs of their Elders. We have made sense of the complex questions of the needs of Elders to live Home for Life. A clear evidence-based picture of the needs of Elders has emerged. One example of this is the issue of food insecurity and the planning of a” meals to go” program in the community. Similarly, our research surfaced information about the mental wellness needs of Elders: loneliness, fear, safety, and security are prevalent among the Elders interviewed. This finding was discussed with the management team at the health center for ongoing monitoring. A final impact of our project on Elders was that listened to their message that Home for life also has the meaning of "home in my own community for the rest of my life". The Elders spoke about the need for an assisted-living lodge their own community. We are applying for funding to pursue this project under the Rapid Housing Initiative in 2023.

Our project began in March, 2020, and so did the COVID-19 pandemic. Our funders did not request a delay to the start of our project so we proceeded. We made the necessary adjustments: developing safety protocols involving temperature checks, hand sanitizer, masks, hand washing, meeting outside of the community when it was closed to visitors, and maintaining good record keeping. If we needed to pause for a period of time due to team members or close contacts having COVID-19, we did so and resumed working when it was safe to do so. We always asked permission before entering the First Nation Community to ensure we were following the rules established by Elsipogtog Health and Wellness Centre. We kept in close communication with our Planning Committee who were the Health Managers in the community. We also faced tragedies that occurred in the community, such as the sinking of the Tyhawk Fishing Boat on the first day of lobster season. Two men were lost in this accident, one of whom was the Captain and the son of a member of our research team. We went to visit her, attended the funeral, kept in close touch with her to talk and to listen. We continue to do so. We did draw on the connectedness already established among our team. We used several skills to get through this tragedy with the community members: empathy, agility, adaptability, flexibility, knowing what matters most in the moment, and when to ease back for proceed forward again.

1) We learned that you do not stop. You continue to find a path forward to implement the initiatives that have been planned. In this project, the Elders spoke. We respected their words by acting on them, even when it wasn't easy to do so as times. 2) We learned to listen closely to all issues raised by our community-based team members and address theses as they arose. The community members know their community best and knowing that we trusted their judgment. In regard to the Meals To Go program, we learned that volunteerism is not something that is embraced by the members of the community. Because of this, we pivoted from a Meals on Wheels type program to a Meals to Go curbside pick-up program which solved the problem of too few volunteer drivers. Elders or their family members picked up meals twice weekly at the restaurant that was preparing them in the community. 3) Most importantly, we learned that if you give Indigenous people the time they need to get to know you, when they decide you care, they will support you for the future. It is not important what we know. It is how we use what we know to complement the knowledge Indigenous people hold, from this flows mutual respect and endless opportunity to work together to reduce health inequities and facilitate healthy aging.

In Canada, we are in a time of reconciliation between Indigenous and non-Indigenous peoples. Practicing reconciliation through project such as ours is what is needed, rather than just talking about reconciliation. The National Centre for Truth and Reconciliation has published the 94 Calls to Action along with the 46 articles of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). Our work, presented in this Case Study, responds to some of the Calls to Action and articles of UNDRIP. Specifically, the Eimeg Tan Tleiaoltieg: HOME FOR LIFE project addressed the following Calls to Action: #19 availability of appropriate health services; #92 application of the principles, norms and standards of the United Nations Declaration on the Rights of Indigenous Peoples; article 8 and article 9 regarding the right to belong to a First Nation community and to not be assimilated elsewhere; article 22 regarding special attention to the needs of Indigenous Elders; and article 34 regarding the right to culturally appropriate processes and institutions. We have created respectful relationships and overcome cultural boundaries and differences to find a way of working together to create a more equitable and inclusive society. Advancing the process of Canadian reconciliation is possible, one project at a time. Any views and opinions expressed in this case study are solely those of the Recipient and may not reflect the views and opinions of the Government of Canada.