In many instances, they fall into the cracks between federal and provincial/territorial jurisdiction and face bureaucratic slowdowns. Critics say that Aboriginal, Métis and Inuit Canadians over age 65 are paying for the lack of collaborative problem-solving between government departments and agencies. They point to poor communication and coordination at every level, including provincial/territorial ministries, the federal government and Indigenous communities. For example, some hospitals have sent frail patients home to their communities without checking if there are appropriate support services because historically Indigenous peoples have been viewed as a federal responsibility.
Funding can also be a problem. Some Indigenous seniors, particularly women, have never participated in the workforce, so they are not eligible for the Canada Pension Plan. While all Canadian seniors are eligible for Old Age Security pensions, some Indigenous seniors lack the necessary credentials, while others face literacy challenges.
First Nations and Inuit people are eligible to apply to the Non-Insured Health Benefits (NIHB) program for coverage for some drugs, dental care, vision, mental health counselling and other health-related items and services but Métis are excluded, and critics have pointed to the excessive amount of paperwork and chronic underfunding of the program.
Another federal program is the First Nations and Inuit Home and Community Care (FNIHCC) program, whose mission is to create “a continuum of home and community care services that are comprehensive, culturally safe, accessible, effective, and equitable to that of other Canadians.” However, critics contend that it is difficult to retain qualified nursing staff and that access to programs during evenings or on weekends is either limited or nonexistent.
Provincial/territorial programs also have problems. In some jurisdictions, on-reserve communities can access provincial/territorial services such as home and respite care, but in many places this type of care is not available.
Some provinces offer First Nations seniors the same access to home care as everyone else, while others provide access only for services through FNIHCC. Still others don’t provide any home care services at all because they maintain that on-reserve care is a federal government responsibility.
Overall, say critics of the system, jurisdictional disagreements have led to significant gaps in services for Indigenous seniors and a lack of long-term planning.
A national seniors strategy for all Canadians is long overdue. Please write to your government at http://www.demandaplan.ca/national-seniors-strategy