It's something many Canadians take for granted, but choosing to live out their last days at home is not an option for many First Nations people according to a university researcher studying the issue.

Mary Lou Kelley, a professor at Lakehead University in Thunder Bay, says that federal health care dollars that would help First Nations people receive end-of-life care at home have not kept up with the increasing demand.

"I think the federal government needs to step up and make their existing home care program more robust. The funding levels have not been increased since 1999 when the program was first developed," she said.

"All health services in the rest of the country have been increased since 1999, but not home and community care in First Nations. That's a problem."

Health care for First Nations is the responsibility of the federal government, and they do provide some home care services, Kelley said.

She says the problem is that the system was never designed to provide complex health care to people with chronic or advanced terminal diseases.

Jurisdictional issues

Kelley has been studying the issue for the past five years, and says there have been some improvements when it comes to delivering these services.

However, the biggest hurdles are jurisdictional ones. Although provinces feel an obligation to step in and provide adequate health services for other citizens — even those in rural and remote communities — she says they don't believe they have to do the same for First Nations people.

"The way forward is definitely partnerships between different levels of government," she said. "The provinces need to realize that First Nations citizens are citizens of the province too."

Kelley says her research has shown that local care providers along with experts provided by higher levels of government can provide very effective care plans that allow First Nations peoples to spend their last days at home.


To hear the full interview, click on the audio labelled: First Nations communities lack end of life care: researcher