Some First Nations in northwestern Ontario are looking at home-grown options for long-term care.
Every year, elderly aboriginal people — many of whom come from remote communities — are admitted to nursing homes in Thunder Bay.
They come to be cared for in their old age, but when they arrive, they often find a culture that is different from what they've known for most of their lives.
Florence Twance moved to Dawson Court in Thunder Bay from her home of Pic River First Nation near Marathon, Ont.
"At first I didn't like it," she said. "I cried for the first two weeks."
Twance said she wasn't mistreated at the home — just lonely. She said the language, food and activities she experienced were unfamiliar to her.
"My son said, 'Mom, why are you so lonely?'" Twance said. "'You got to get out of your room. You have to move around and see who you can find for friends.'"
'Huge culture shock'
Twance isn't alone in her struggle — Thunder Bay's Local Health Integration Network (LHIN) doesn't know exactly how many aboriginal seniors are living in Thunder Bay nursing homes, but most estimates place the number between 60 and 80.
'They feel out of place because they're not home. They're not among their people.' - Shannon Gustafson, Anishnawbe Mushkiki clinic
Workers at Dawson Court say about 10 aboriginal residents live there, with most coming from remote communities such as Eabametoong (Fort Hope) First Nation.
"I see it being a huge culture shock for them," said Shannon Gustafson, health promotion co-ordinator with the Anishnawbe Mushkiki clinic in Thunder Bay, which focuses on aboriginal health.
"They feel out of place because they're not home," she said. "They're not among their people."
Gustafson visits two long-term care homes in Thunder Bay each month to do traditional crafts with the residents.
The Anishnawbe Mushkiki clinic has been running the program, called Kichewyajig, for the past eight years.
"It's about making them feel comfortable and wanted and needed," she said. "Showing them that we care for them and that they're not forgotten because to me, it seems like they are forgotten because of the lack of ... services."
Gustafson said she wishes she could visit more homes more often, but she doesn't have the funding.
'It's like I've opened up a shell'
One home in the region that is doing more to make nursing home care culturally appropriate is William George Extended Care in Sioux Lookout, where June Wynn acts as a translator.
Wynn, who is the mother-in-law of CBC Thunder Bay's Elliott Doxtater-Wynn, said an incredible change comes over the residents when they learn she speaks their language.
"It's like I've opened up a shell," she said. "They just open themselves up and say, 'Oh! This lady can talk in both languages, so I'll just say whatever I want to say.'"
But the William George home is small, with only 20 beds, and a five-year waiting list.
CEO David Murray said most people on the list will die before they get into the home.
One way to shorten that list would be to provide service in remote communities, but right now there is little home care — and no long-term care — in any of the northern First Nations.
Janet Gordon, health director for the Sioux Lookout First Nations Health Authority,. is trying to do something about that.
In September, First Nations in the region asked the health authority to look into other long-term care options, citing concerns about the care seniors get in places like Thunder Bay.
"Most people from our communities, they would like to see their elders stay in the community, if at all possible," said Gordon.
She said she hopes to have a detailed list of recommendations by the end of the year.
This is the first in a CBC News series examining long-term care in remote First Nations. Tuesday's story looks at long-term care in Eabametoong (Fort Hope) First Nation.