Cree family worries about 97-year-old elder, needing long-term care far from home and culture

Annie Bosum is worried that her 97-year-old mother might be sent far outside Eeyou Istchee and away from her language, culture, and everything she knows.

Bosum's mother, Eva Coon, ended up in hospital recently with COVID-19, but now needs 24-hour care as she also struggles with dementia, hypertension, osteoporosis and arthritis. 

"It's hard on me to imagine her being transferred out of town," said Bosum, who lives and works in Oujé-Bougoumou, a Cree community located 750 kilometers north of Montreal.

"I work full time, it is very hard and most times I am very tired," said Bosum.

Eva, like many Cree elders, only speaks Eastern Cree, the language spoken in Quebec Cree communities. For the last several weeks, she's needed to be in a non-Cree speaking environment in the Chibougamau hospital and could be sent even farther away.

"I just wish there was a place where she could be taken care of locally," said Bosum.

Right now, for elders with mobility challenges and more complex health needs, there is only one temporary assisted living elder's home in the whole territory, located in Chisasibi.

"It's really not enough because currently we have about 60 people on the waiting list for long-term care facilities," said Cheng Jung Lin, director of the Support Program for the Autonomy of Seniors (SAPA) with the Cree Board of Health and Social Services of James Bay. 

The Cree health board collaborates with out-of-town assisted living care facilities. Elders can be sent to these centres when options are not available locally, but it is far from ideal, said Lin. 

"Once we send the elders out, those elders are very, very isolated. A lot of them don't even speak English or French," she said. 

Moving to a better model

The Cree health board, with support from Quebec, is building three elders' facilities in Chisasibi, Mistissini and Waskaganish, that will act as hubs for surrounding Cree communities. 

Chisasibi will also cater to elders from Whapmagoostui and Wemindji and is expected to open in 2025. The second home in Mistissini will serve the communities of Waswanipi and Oujé-Bougamou and is slated to open in 2026. The last of the three planned long-term care facilities will be in Waskaganish, also serving elders from Nemaska and Eastmain. A completion date for this facility is not yet finalized.

Each new home will have 32 beds that offer respite care, long-term care and palliative care. 

The homes were shaped by community input to reflect Cree values and provide culturally tailored care for elders from every community. 

"They want us to focus on the spiritual and cultural aspects of health, in terms of the services we are going to provide in the elders home, other than the medical service, " said Lin. 

In the community consultation process, it was decided that the elders should remain active and contributing community members of society.

A generation of residential school survivors

"We are taking care of a generation that has gone through residential school" said Lin.

"It is very important for us not to pull people back into institutions," said Lin, adding the focus is on what the elders need.

The Cree health board staff also plans to encourage a connection between the younger generation to facilitate the transfer of knowledge. They will also have adapted transport to make sure the elders are able to easily get out in the community. 

That's good news for Annie Bosum, whose mother Eva has a deep connection with the land, the language and the culture. 

"She still knows how to speak well. She knows us, she knows where she is," said Bosum.

"She understands that they cannot find accommodations for her, she knows it, and she always speaks about spending her time out on the land."