Social isolation of seniors: A Focus on Indigenous Seniors in Canada

What is social isolation?

Social isolation is a situation in which someone has infrequent and/or poor-quality contact with other people. A person who is socially isolated typically has few social contacts or social roles, and few or no mutually rewarding relationships. (For information about how seniors can become socially isolated, see Social Isolation of Seniors, Volume I: Understanding the issue and finding solutions.)

Although social isolation is often associated with loneliness, the two are not the same. Loneliness is better described as “a feeling of distress that results from discrepancies between ideal and perceived social relationships.”^{Footnote 1} That is, loneliness happens when your social relationships do not live up to your expectations, so it can be experienced even when a person has adequate social networks. This document focuses on social isolation, not loneliness. Reaching out to Indigenous seniors who are at risk of being socially isolated may reduce their risk of poor health and poor quality of life.^{Footnote 2}

Using the ideas in this supplement

Before putting into practice the ideas set out in this report, it is important to have a sound understanding of the Indigenous seniors' local and regional contexts. This knowledge is needed to adapt the content of events, determine appropriate venues and provide open and inclusive spaces for dialogue.

Diverse groups of service providers, beyond those only in the medical and social services sectors, are encouraged to take part in such events. Reaching out to all occupational groups can have more far-reaching and significant impact than what might be achieved by only specialists and service providers. The companion document, Social Isolation of Seniors, Volume II: Ideas exchange event toolkit, provides guidance on hosting effective meetings to exchange ideas to address the social isolation of seniors. This document provides additional information and ideas for events focused on Indigenous seniors.

Social isolation among Indigenous seniors

Indigenous seniors are considered at high risk of experiencing social isolation due to factors such as racism, marginalized language, culture, poverty and historic negative experiences.

The oppression of Indigenous peoples and their cultures increases the risk that an Indigenous senior may experience social isolation. Although the extent of social isolation among Indigenous seniors has not been quantified, it is estimated that between 19%^{Footnote 5} and 24%^{Footnote 6} of seniors are socially isolated.

This document is intended to help Indigenous and non-Indigenous individuals, families, community groups, organizations, service providers, policy-makers and others prevent and address the social isolation of Indigenous seniors. More specifically, its purpose is to:

• Raise awareness of social isolation of Indigenous seniors. The risks and protective factors for social isolation are discussed in Part 1.
• Provide tools for engaging with Indigenous seniors, including examples of successful social innovation through community partnerships. Tools and examples are included in Part 2.

The information and tools contained in this supplement can be used to facilitate community conversations in a variety of settings: on reserves, in remote or rural areas, in small towns, or in larger cities. This document is a supplement that builds on the original toolkit by adding information that may be useful for better engaging and working with Indigenous populations specifically.

Diversity of the Indigenous community

Indigenous peoples in Canada are heterogeneous and have maintained a high degree of cultural diversity. The Canadian Constitution (the Constitution Act, 1982) recognizes three groups of Indigenous peoples: First Nation (or Indian), Métis and Inuit. Within each of these groups are many different communities. Although individual Indigenous persons may share common experiences, their communities would not necessarily have much in common culturally. There are more than 630 First Nation communities in Canada^{Footnote 8} and 54 Inuit communities across the northern regions of Canada.^{Footnote 9} While Métis persons are also dispersed across Canada, according to the 2016 Census, they were the most likely to live in a city, with 62.6% living in a metropolitan area.^{Footnote 10}

In addition to this cultural diversity, there is also a high degree of geographic diversity. Features of geographic diversity may heavily influence whether and how Indigenous seniors experience social isolation. For instance, for seniors who live in northern communities or remote areas, geographic isolation could pose a significant barrier to participation in social events. They may live several hours’ drive from a gathering place. This challenge could be amplified if it is compounded by situations such as lack of access to reliable transportation or living too far from friends and family to get help with mobility or transportation.

Indigenous seniors who live in rural areas and small towns, may also face social isolation due to a lack of supportive Indigenous organizations. While small towns may have general services for seniors, non-Indigenous organizations might not be as knowledgeable about the unique circumstances of Indigenous seniors. Seniors’ organizations or other non-Indigenous organizations may find it challenging to ensure that the small numbers of Indigenous seniors living in their communities are not socially isolated. Larger cities may have Indigenous organizations that host activities for Indigenous seniors and provide other services; however, the challenge may be identifying Indigenous seniors who experience social isolation and ensuring they are able to participate.

Language and culture

Indigenous seniors continue to play important roles in protecting and passing on their cultural identities and languages to their families and communities. Language plays a vital role in preserving cultural and traditional teachings among Indigenous communities while enhancing pride and identity. At the same time, language and culture have been noted as protective factors against health crises and social isolation in Indigenous communities.^{Footnote 11} Unfortunately, a contributing factor to social isolation among Indigenous seniors is a past characterized by suppressed Indigenous language and culture.

As a result, most Indigenous languages are now considered at risk, and the proportion of Indigenous people who speak Indigenous languages as a mother tongue is declining. “In 2016, 15.6% of the Aboriginal population reported being able to conduct a conversation in an Aboriginal language. This is compared with 21.4% in 2006.”^{Footnote 14}

Despite these declines in Indigenous languages as first languages, they have been experiencing a revival as second languages. In 2016, there were 260,550 Indigenous people who reported being able to speak an Indigenous language—which was more than the 208,720 Indigenous people who speak Indigenous languages as a mother tongue.^{Footnote 15} A closer analysis of different age groups seems to confirm the revitalization of Indigenous languages: the percentage of Inuit children under age 14 who could speak Inuktitut was 65.2%, compared with 61.3% of Inuit seniors.^{Footnote 16}

Despite past attempts to suppress Indigenous languages, some Indigenous seniors still speak their language primarily, may not be fluent in English or French, and may need a translator. Although finding a translator could prove challenging, there are persons who may speak the appropriate Indigenous language as a second language. Seniors’ families are often a good source. Indigenous persons on-reserve may also be able to provide some support. “In 2016, a higher percentage of First Nations people with Registered Indian status living on-reserve were able to speak an Aboriginal language (44.9%), compared with those living off-reserve (13.4%).”^{Footnote 17}

Social determinants of health and health inequities

Social determinants of health refer to the social, economic, cultural and political factors that impact a person’s health. They can include poverty, employment, working environments, education, geographic location, access to health services, housing, social status, social support networks, food security, language, gender and culture.^{Footnote 18}

Social isolation is associated with health inequities because many of the risk factors for social isolation are more prevalent among socially disadvantaged groups.^{Footnote 19}Social disadvantage describes the situation of not having the opportunity to participate fully in economic, social, political and cultural relationships, and has been associated with vulnerability to negative health outcomes.^{Footnote 20} Long-standing social disadvantage for Indigenous people in Canada is an offshoot of government policies created during colonization. According to historical accounts: “In the colonies of Upper and Lower Canada, the Indian Department became the vehicle for the expression of the new plan of "civilisation". Based upon the foundation that it was Britain's duty to bring Christianity and agriculture to the First Nations people, Indian agents shifted their roles from solidifying military alliances toward encouraging First Nations people to abandon their traditional ways of life and to adopt a more agricultural and sedentary, more British, life style. By doing so, First Nations people would become assimilated into the larger British and Christian agrarian society.”^{Footnote 21}

In a 2007 to 2010 report, Statistics Canada noted that urban First Nation, Métis and Inuit reported poorer health conditions compared with non-Indigenous people, including higher smoking rates (two times higher), higher obesity rates, and greater food insecurity.^{Footnote 22} According to Statistics Canada, “food insecurity occurs when food quality and/or quantity are compromised, typically associated with limited financial resources.”^{Footnote 23}

Demographic profile^{Footnote 24}: A growing population

The Indigenous population in Canada is growing. This is largely due to a combination of relatively high fertility rates, increased life expectancy, and more people newly identifying as Indigenous on the Census. Among Indigenous Canadians, a growing proportion are seniors: from 2006 to 2016, the percentage of the Indigenous population that was 65 years of age or older grew from 4.8% to 7.3%.^{Footnote 25}

According to population projections, the proportion of the First Nations, Métis and Inuit populations 65 years of age and older could more than double by 2036.^{Footnote 26} Here are some other interesting statistics:

• There were 65,025 Inuit in Canada in 2016, up 29.1% from 2006. Close to three-quarters (72.8%) of Inuit lived in Inuit Nunangat.^{Footnote 27}
• In 2016, there were eight metropolitan areas with a population of more than 10,000 Métis: Winnipeg, Edmonton, Vancouver, Calgary, Ottawa–Gatineau, Montréal, Toronto and Saskatoon. Combined, these areas accounted for just over one-third (34.0%) of the entire Métis population.
• While the First Nations population in the Atlantic Provinces is relatively small (73,655, or 7.5% of the total First Nations population), it more than doubled between 2006 and 2016. Much of the increase is most likely the result of changes in self-reported identification—that is, people newly identifying as First Nations on the Census.
• The First Nations population was concentrated in the Western provinces, with more than half of First Nations people living in British Columbia (17.7%), Alberta (14.0%), Manitoba (13.4%) and Saskatchewan (11.7%).
• Almost one-quarter (24.2%) of the First Nations population lived in Ontario—the largest share among the provinces—while 9.5% lived in Quebec.
• While First Nations people accounted for 2.8% of the total population of Canada, they accounted for 10% of the population in Saskatchewan and Manitoba (10.7% and 10.5%, respectively), and almost one-third of the population in the Northwest Territories (32.1%).^{Footnote 28}

Increasingly urban

Indigenous people are increasingly urban, with more than half residing in towns and cities.^{Footnote 32} The cities with the largest Indigenous populations in 2016 were Winnipeg (92,810), Edmonton (76,205), Vancouver (61,460) and Toronto (46,315).^{Footnote 33}

Research estimates (2012) suggest that 52% of the 82,690 Indigenous seniors in Canada now live in off-reserve population centres^{Footnote 34}, ^{Footnote 35} and reported moving to these centres within the last 10 years after living in their home communities most of their lives. The composition of the urban Indigenous population was estimated to be 50% First Nations, 43% Métis and 3% Inuit.^{Footnote 36}, ^{Footnote 37}

Some Indigenous seniors leave their home communities to gain access to health services and supports. Non-insured^{Footnote 38} Indigenous First Nations seniors living on reserves may move to cities for access to long-term care facilities, to avoid frequent travel for services that are not available in their home communities, or to be closer to family. This is especially true for those in northern and more isolated communities, where some of the more vulnerable seniors are forced to relocate to urban centres to access the medical care they need.^{Footnote 39}

The move to off-reserve population centres increases the risk for social isolation, as these seniors are separated from the social and cultural supports they are familiar with. In 2012, most urban Indigenous seniors were living with family; among those who reported living alone, there were more women than men. An estimated 8% of urban Indigenous seniors reported lack of social supports and said they had no one to call upon in times of need.^{Footnote 40} Among all seniors in population centres, Indigenous seniors tended to be poorer, have more experiences with food insecurity, and face more chronic health problems (such as high blood pressure, arthritis, heart disease, diabetes and depression) than non-Indigenous seniors.^{Footnote 41}

Preventing social isolation: protective factors

Seniors with more risk factors face a greater likelihood of social isolation. Because the occurrence of risk factors is high for Indigenous seniors, it is important to find ways to create awareness of social isolation and protect against it. Protective factors could help them remain socially involved.^{Footnote 42} A 2007 Assembly of First Nations discussion paper on social determinants of health supports the World Health Organization’s acknowledgement that social support and good social relations are important to overall health^{Footnote 43}—an assertion that is also supported by many studies that have found a link between socio-economic status and health, well-being and longer life. To foster positive social inclusion and support, it is important to reach out to Indigenous Elders.

(Note: Social Isolation of Seniors, Volume I: Understanding the issue and finding solutions has additional general information about protecting seniors from social isolation.)

Awareness of traditional cultural values, languages and kinship systems

A study of Indigenous communities has found that Indigenous culture protects vulnerable communities in several ways. Among the protective factors are connection with the land, traditional medicine, spirituality, traditional foods, traditional activities and language.^{Footnote 44} These themes provide insight into the values held by Indigenous seniors.

Being aware of key protective factors for Indigenous seniors—such as the interconnected nature of the individual, the land, family and community in traditional cultures—is necessary to plan strategies that address their needs in a holistic fashion. Offering family-friendly events and providing safe and reliable transportation as needed are two examples. This can build confidence and social well-being. Activities and programs that provide practical social support to Indigenous seniors (whether in the form of practical help or friendship) can be important protective factors against social isolation. In health research, there is a growing awareness that social support (positive interaction, emotional support, affection) is a key determinant for thriving health, especially for Indigenous people, whose worldview is based on relationships with family, community, land, nature and Creator. Some ideas are described in the lists below.

Fostering good relationships and helping each other are traditional values that have long acted as protective factors to counter social isolation among Indigenous peoples. Indigenous families traditionally lived close to each other and cared for one another. Families and communities respected Elders for the wisdom and knowledge they had gained from life experience.

Acknowledging and respecting the importance of Indigenous languages to Indigenous seniors can help address social isolation, and can alert service providers and others that translation services and Indigenous staff may be needed to help the more vulnerable seniors. Supporting Indigenous languages through programs, policies and planned events can act as a protective factor for at-risk seniors who may only converse in their own language and may be anxious about engaging in broader social settings. Finding out about the main languages spoken in an area, utilizing translators when needed, and inviting seniors’ families and friends to social events can help make Indigenous seniors feel more comfortable and better able to communicate in social settings.

The following lists identify factors that can help to ensure that Indigenous seniors remain socially engaged.

Protective factors for all seniors

• Being in good physical and mental health
• Having sufficient income and safe housing
• Feeling and being safe in neighbourhood
• Having good literacy and communication skills
• Having satisfying relationships
• Having a supportive network
• Feeling valued
• Being able to access local services offered by community organizations, government programs and services, and health agencies
• Feeling productive in society
• Having access to transportation
• Having higher education

Additional protective factors for Indigenous seniors

• Participating in ceremonies
• Having social support (individual, family and community) that provides practical help, positive interaction, emotional support, and friendship
• Belonging to a community that promotes respect for the Indigenous way of life and cultural values as social norms
• Belonging to a community that promotes respect for Indigenous seniors for their wisdom and knowledge
• Belonging to a community that appreciates Indigenous resilience and the diverse narratives of Indigenous experience
• Having access to social events that respect Elders and experiencing positive interactions that make them feel comfortable
• Having translators when needed
• Having social contact in the form of phone calls, visits, excursions and/or other interactions
• Having access to culturally sensitive health care services within the community

Text description

The diagram is of four circles. The smallest circle represents the person, the next biggest circle contains the smallest circle and it represents the family and the spouse. The next circle contains the first two and it represents education, friends, ceremony, religious group, work, and traditional teachings. The biggest circle contains all of the smaller circles and it represents traditional ecological knowledge, history, laws, community, reconciliation, economy, norms, politics, government, neighbourhood and media.

Indigenous support systems were traditionally based on the values of individual wellness, shared responsibility, shared care, and kinship connections (family and friends). Each layer of the above diagram represents these different spheres of responsibilities that extend beyond the individual. The layers are interconnected and foster harmony by promoting responsibility and reciprocity. Although Indigenous cultures are diverse, they share a belief in the interconnectedness of all living things. The circles represent interaction and interdependence. Both within the circles and between the circles, there are reciprocal relationships; for example, individual to family, and family to community.

Social isolation risk factors

Seniors risk becoming socially isolated when they go through life transitions, such as losing a driver’s license or having their adult children move out, or live in social and environmental conditions associated with social isolation. Certain experiences are common risk factors for most Indigenous seniors, but many diverse experiences that are unique to individuals can also enhance risk.

Examples of common social and economic conditions that are considered risk factors are poverty and inadequate transportation. For example, low-income seniors may lack the funds to pay for memberships or activities; similarly, their budgets might be too restricted to allow them to dine out with family and friends or incur transportation costs to visit or attend events.

Life transitions that can trigger social isolation include retirement, illness, death of a spouse, loss of a key caregiver, moving to a different city, or losing a driver’s licence. Indigenous seniors and their families are often in the difficult position of leaving their home reserve and community to access health and social services. While any of these issues on their own could lead to social isolation, too many at once can be particularly challenging for a senior to address on his or her own.

Indigenous seniors are also at higher risk of social isolation than other seniors due to their generally poorer physical, social and economic conditions. Among Indigenous seniors in cities, 23% were found to have low income compared with 13% of non-Indigenous seniors. Low income was found to be more prevalent among Indigenous senior women than men: 26% of Indigenous senior women were considered to have a low income compared with 18% of Indigenous senior men. Illustrating the compounding effect of combined risk factors, higher percentages of Indigenous seniors who lived alone were part of the low-income population compared with those who lived with a spouse or partner. A relatively high percentage of Indigenous senior women (38%) live alone, almost half (49%) of whom are part of the low-income population.

Another risk factor associated with a lack of social support is food insecurity: 9% of Indigenous seniors reported food insecurity compared with 2% of non-Indigenous seniors. Those who experience food insecurity may be in that situation because they are in a less supportive social network and are unable to get help from friends or family. For others, food insecurity can contribute to social isolation because people who experience it may use alternatives for getting food that do not fit social norms.^{Footnote 45} For example, a person without enough food at home may have to visit a food bank. For an Indigenous person, not having access to traditional food has been described as an alienating experience. As mentioned earlier, health concerns can also lead to social isolation. Among Indigenous seniors, 88% of women and 86% of men report having at least one chronic condition,^{Footnote 46} whereas the percentage for Canadian seniors overall is 71%.^{Footnote 47}

Case studies

The following case studies describe common scenarios that illustrate both the risk factors and protective factors that Indigenous seniors face. These stories may help generate discussions as part of community “idea exchange” events described in Part Two of this document.

Creating opportunities for Indigenous seniors to engage

Recovery of Indigenous cultures, language, traditions and ways of knowing can improve Indigenous well-being.^{Footnote 52} These can be protective factors. Creating opportunities for Indigenous seniors to engage in social events that they can relate to—in settings where they feel comfortable, where they can understand the language and what is being communicated, and where they feel culturally safe sharing their stories and ideas (such as round dances and pow wows)—is crucial. Protective factors that reflect traditional values, such as helping frail Elders on a one-to-one basis, can strengthen Indigenous seniors so that they can participate in safe social activities with others and feel more included and valued.

It is also important to consider seniors who have had to leave their communities to live in long-term care homes. A history of colonization may contribute to a distrust of Western medicine and mainstream institutions. Indigenous seniors and their families may have concerns about non-Indigenous organizations. Indigenous seniors may fear that their families and friends might not be able to visit them, particularly if they are placed in a home far away from the community. Although this fear may not be unique to Indigenous seniors, their anxiety may be higher due to experiences of institutionalization and the residential school system. The protective factors of Indigenous culture and community can help Indigenous seniors who find themselves in long-term care. Although it may be difficult to find staff who are fluent in a given Indigenous language, it would be helpful to ensure that, at a minimum, staff understand Indigenous culture, values and attitudes; incorporate Indigenous recreation programs (such as crafts, games and music) into programming; and make traditions available by inviting the Indigenous community for traditional ceremonies,^{Footnote 53} offering traditional meals, and providing a space for family gatherings.

An illustrative example is provided below. This Elder is experiencing multiple risk factors of social isolation. In cases like this, the events coordinator(s) in the long-term care facility could arrange with community leaders to organize a visiting program. Support from the Elder’s family is also important to help recognize her vulnerability to social isolation and access collaborative solutions.

Consequences of social isolation for Indigenous seniors

The consequences of social isolation and neglect include greater health, social and economic risks which, in turn, are linked to deteriorating well-being and premature death.

For Indigenous seniors, poor health combined with losing kinship and community ties can be especially isolating. Inward fears and grief from the loss of a way of life can lead to depression and social isolation for those who lack social, economic, health and relational supports.

Other consequences of social isolation include:

• Increased vulnerability that could lead to neglect as well as physical, emotional and financial abuse by others^{Footnote 54}
• Mental health risks related to stress associated with economic issues, such as food insecurity and fears of homelessness
• Health risks, such as increased drinking, smoking, being physically inactive, and having a poor diet
• Loss of personal dignity, economic self-sufficiency and independence
• Inability to access available services

Social isolation of seniors also has consequences for the community, since Indigenous seniors play an important role in language and cultural preservation. Such cultural isolation can contribute to a loss of language and culture for Indigenous society as seniors begin to lose their role in cultural and language preservation.

For more information about the general consequences of isolation for all seniors, see Social Isolation of Seniors, Volume I: Understanding the issue and finding solutions.

Community-level success stories

Community-level success stories help provide important principles and ideas that can contribute to preventing and addressing the social isolation of Indigenous seniors. Here are a few to help illustrate rural reserve, northern reserve/community, and small town/city initiatives.

Core principles of Indigenous social innovation

Social innovation is defined as “community organizations, governments and public institutions, researchers, seniors and businesses working together and combining resources and ideas to make new plans and tools that address social problems in creative ways.”^{Footnote 61} The examples of social inclusion initiatives above demonstrate the core principles needed for social innovation that meets the needs of Indigenous seniors.

Practical strategies to engage Indigenous seniors

Indigenous people are diverse in terms of their experiences, languages, cultures and values. Strategies for engaging them will differ with each location or area. Principles and ideas gleaned from broader research on Indigenous engagement can inform local strategies to prevent the social isolation of Indigenous seniors.

Below are some examples of best practices and lessons learned from various groups engaging with Indigenous communities.

Why use the toolkit?

Many Indigenous seniors face exclusion and racism, both of which contribute to social isolation. For this reason, community initiatives benefit from acknowledging the history of colonialism and its present-day impacts. The aim is reconciliation and healing for past injustices with a focus on moving forward toward a better future for all.

As a first step to finding socially innovative solutions, consider informal conversations with the public, business, and community organizations to generate awareness about the social isolation of Indigenous seniors. Networking and connecting with people and agencies that work with Indigenous seniors in the community is important because of their experience with and knowledge of local Indigenous seniors, cultural considerations and specific protocols. These informal discussions could lead to the development of productive gatherings. More formal meetings will take time, and can vary in size and length depending on community readiness and willingness to participate.

To build strong relationships, it is important to be aware of and incorporate Indigenous protocols, cultural values and traditions into all planned events. Learning about the unique background of each community will increase your understanding of what is important to that community and what its members are proud of. Indigenous Elders and leaders are an invaluable resource in learning how to incorporate Indigenous oral cultures into events. This may also be achieved with help from interpreters, family and gifts, and with respect for Indigenous stories and cultural values. Indigenous cultural practices are diverse across the country, so it is important to find out what the local protocols are by asking Indigenous agencies and Elders in the area.

The tools that follow can help all facilitators to work with Indigenous communities, but getting facilitators who are Indigenous themselves (or who have prior Indigenous engagement experience) is best.

How to use the toolkit

Seniors (or any interested group) can lead conversations and strategies to find solutions. Gatherings can vary in length, group composition, number of participants and dialogue format. Social Isolation of Seniors, Volume II: Ideas exchange event toolkit provides detailed strategies for ideas exchange events that provide the foundation for this supplement, which is specific to the social isolation of Indigenous seniors.

The purpose of the ideas exchange gatherings is to build awareness, share information, build partnerships, and create opportunities to work together to address the social isolation of Indigenous seniors. The events can be organized for individual organizations or they can bring together organizations from different sectors to work together on community-wide solutions. The toolkit summarizes possible approaches to the dialogue and outlines specific questions for reflection to develop solutions.

How to conduct an event

Social Isolation of Seniors, Volume II: Ideas exchange event toolkit provides tools and techniques for to guide facilitators through three types of events: a partial-day event, a one-day event and a two-day event. Tools include sample agendas and suggested activities.

In hosting these events, a common, respectful practice in most Indigenous communities is to invite an Elder to offer opening and/or closing prayers and present him or her with a gift. In some Indigenous cultures, tobacco is an appropriate gift; however, this varies across cultural traditions. It is also respectful to acknowledge the traditional Indigenous territory of the area. For example, say, “We welcome you to Saskatoon, situated in Treaty 6 territory, traditional lands of First Nations and Métis people.” Such an acknowledgement is a reminder of the sharing spirit of the Indigenous people and the Creator. It is helpful to ensure that the Elder has transportation and that a translator is available if necessary.

As a courtesy, extend invitations to all levels of Indigenous government (such as First Nation bands, tribal/regional councils, and Indigenous political organizations), particularly for bigger events.

Some of the examples and approaches used in the Social Isolation of Seniors, Volume II: Ideas exchange event toolkit will need to be adapted to include content that specifically addresses Indigenous seniors, such as the sample invitation, PowerPoint presentations, case study scenarios, community assessment and event planning checklist. They could be adapted by including references to Indigenous culture and practices.

The Social Isolation of Seniors, Volume II: Ideas exchange event toolkit includes a SWOT (strengths, weaknesses, opportunities and threats) analysis and the Theory of Change exercise; note that these may not work effectively for small Indigenous events. You may find it helpful to set aside some time to allow participants to share their experiences and challenges instead. The facilitator should be prepared to be flexible and should have the skills to address difficult topics or conversations should they arise during the event.

To help with organizing the event, this document includes the following resources:

• How to Adapt the Event Planning Checklist (Appendix A)
• Sample Invitation (Appendix B)

Other resources that could be helpful in ensuring an event specifically addresses Indigenous seniors are:

• Presentation Slides (Appendix C)
• Case Study (Appendix D)
• Handouts: Additional Considerations for Indigenous Seniors (Appendix E)
• Protocol for Indigenous Elders (Appendix F)
• Indigenous Peoples of Canada: Demographic Profile (Appendix G)
• Additional Resources for Organizers and Facilitators (Appendix H)

Slide 1

Indigenous seniors and social isolation

• Indigenous seniors profile
• What is social isolation?
• Key risk factors
• Preventing social isolation
• Social innovation—Key principles

Slide 2

Indigenous seniors profile

• An estimated 6% of the 1.4 million Indigenous people in Canada are seniors (aged 65+ years)
• More than half live in towns and cities with their families and those living alone tend to be women. It is unclear how many reside in long-term care facilities
• They tend to be poorer, have more chronic health problems, older seniors are less fluent in English, and many lack social supports and face housing and food insecurities.
• Many seniors were affected by residential schools and the Sixties Scoop (intergenerational trauma).
• Lack of local medical and support services may continue to push more seniors into the towns and cities which has serious implications for finding solutions to prevent social isolation

Side 3

• What is social isolation?
• Low quantity of and quality of contact with others that is long-term
• It is different from loneliness which can happen periodically to everyone
• It affects health & wellbeing
• It can lead to early death

Slide 4

Key risk factors

• Living alone in unsafe community areas
• Older seniors become more vulnerable
• Senior caregivers without adequate help
• Poor health, chronic illnesses, mobility issues
• Social and cultural changes

Slide 5

Preventing social isolation

• Key protective factors for Indigenous seniors: individual and family supports; awareness of and access to community/government programs and services.
• Cultural awareness, language needs and culturally respectful opportunities for Indigenous seniors to engage.
• Community social supports are important for both the seniors and their families

Slide 6

Social innovation-key principles

• Cultural awareness and respect for diversity
• Respectfully engage seniors, families and leaders
• Engage widely and broadly across all levels of community agencies, groups, governments
• Volunteer and other programs are vital, like transportation, translators, flexible and informal opportunities for participation (visiting/lunches/berry picking, crafts)

Questions for groups

Risk factors

Social isolation happens when a senior’s social participation or social contact drops. Seniors risk becoming socially isolated when they go through life transitions or when they live in social and environmental conditions associated with social isolation.

Protecting against social isolation

While many factors can increase seniors’ risk of becoming socially isolated, there are others that can help ensure they remain socially engaged. A study of Indigenous language and culture has found that it protects vulnerable communities. Below are factors that can be helpful in maintaining social inclusion for seniors and Indigenous seniors.

Protective factors for all seniors

• Being in good physical and mental health
• Having sufficient income and safe housing
• Feeling and being safe in neighbourhood
• Having good literacy and communication skills
• Having satisfying relationships
• Having a supportive network
• Feeling valued
• Being able to access local services offered by community organizations, government programs and services, and health agencies
• Feeling productive in society
• Having access to transportation
• Having higher education

Additional protective factors for Indigenous seniors

• Participating in ceremonies
• Having social support (individual, family and community) that provides practical help, positive interaction, emotional support, and friendship
• Belonging to a community that promotes respect for the Indigenous way of life and cultural values as social norms
• Belonging to a community that promotes respect for Indigenous seniors for their wisdom and knowledge
• Belonging to a community that appreciates Indigenous resilience and the diverse narratives of Indigenous experience
• Having access to social events that respect Elders and experiencing positive interactions that make them feel comfortable
• Having translators when needed
• Having social contact in the form of phone calls, visits, excursions and/or other interactions
• Having access to culturally sensitive health care services within the community

Principles of social innovation

Social innovation combines the resources and ideas of community organizations, governments and public institutions, researchers, seniors and businesses to make new plans and tools that address social problems in creative ways. Experience in Indigenous communities has identified additional best practices to help prevent and address the social isolation of Indigenous seniors.

Core principles of social innovation

• Committing to work together to address the needs of the community
• Welcoming new partners
• Adjusting new activities, services and programs to new audiences
• Drawing on expertise and resources from partners
• Being open to taking risks to address issues
• Relating solutions to changing attitudes and behaviours and to structural institutional and systemic change
• Adjusting new technologies

Additional core principles of social innovation for Indigenous seniors

• Connecting solutions to changing attitudes and systemic changes
• Respecting the diversity of Indigenous seniors
• Identifying the needs of Indigenous seniors through engagement opportunities
• Engaging all levels of government (federal, provincial/territorial, municipal, Chief and Council, Indigenous, First Nation administration) and community agencies
• Recognizing the importance of volunteers and volunteer programs that provide services, for example, transportation, translation
• Engaging and working with Indigenous community organizations
• Working on programs and services that target the needs of Indigenous seniors

How to make a request

• Invitation in person (preferred): For First Nations or Métis Elders, it is customary to offer tobacco. Tobacco is one of the four sacred medicines, and is offered when making a request. The offering can be in the form of a tobacco pouch or tobacco tie (loose tobacco wrapped in a small cloth). (Inuit Elders do not expect tobacco offerings, because it is not part of their traditional customs. A small gift may be offered in the same spirit with which one would make a request to a First Nations or Métis Elder.) Place the tobacco/gift in front of you and state your request. The Elder indicates acceptance of your request by taking the gift in their hands. The exchange of tobacco/gift is similar to a contract or agreement between two parties. Ask the Elder if there is anything they need for the event.
• Invitation by phone or email: It is preferable to make requests to Elders in person, as tobacco can then be offered. However, many Elders will also accept requests by phone (or by email if you cannot reach them by any other means). If you are making a request to an Elder by phone or email, let the Elder know you will have tobacco or a gift to offer when you see them, then make your request.
• Follow-up: It is a good practice to make the initial request well in advance of the meeting. If the Elder agrees to accept the request, you must follow-up with a call a few days before the event to ensure they are still available.

Appropriate protocol

You should coordinate a host or escort for the Elder. The host or escort is responsible for:

• ensuring appropriate transportation to and from event
• greeting and meeting the Elder upon arrival
• taking care of the Elder until their departure (in other words, ensuring the Elder is served first where appropriate, offer and assist with getting drinks, food, etc.)

Photographs, audio and/or video recordings are often not acceptable when an Elder is conducting a spiritual ceremony. Try to obtain explicit consent from the Elder before beginning any recording. Out of respect for the Elder, always ask permission and seek clarification if there is something you do not understand.

Honoraria and compensation

• Honoraria: Historically, Elders were given food, clothing and other necessities in exchange for their help and guidance. If an Elder accepts your tobacco/gift, it is customary to also provide a monetary gift in the form of an honorarium in exchange for their assistance. The protocol is to offer tobacco/gift before any honorarium. The intention of offering an honorarium is to give what you can while showing your respect for the value of what the Elder is offering. It is not appropriate to ask the Elder what amount is appropriate. Always keep in mind that you are asking to impose a monetary value on a sacred ceremony.
• Compensation for additional costs: It is recommended that you make travel arrangements with the Elder or someone working on their behalf in scheduling their activities. Additional costs incurred by the Elder, such as parking, mileage, meals and accommodations, should be reimbursed.

The Indigenous population in Canada

• Indigenous peoples are the fastest-growing segment of the Canadian population.
• Indigenous populations are increasingly urban.
• There were 65,025 Inuit in Canada in 2016, up 29.1% from 2006. Close to three-quarters (72.8%) of Inuit lived in Inuit Nunangat.
• In 2016, there were eight metropolitan areas with a population of more than 10,000 Métis: Winnipeg, Edmonton, Vancouver, Calgary, Ottawa–Gatineau, Montréal, Toronto and Saskatoon. Combined, these areas accounted for just over one-third (34.0%) of the entire Métis population.
• While the First Nations population in the Atlantic Provinces is relatively small (73,655, or 7.5% of the total First Nations population), it more than doubled (+101.6%) from 2006 to 2016. A significant part of this increase most likely stemmed from changes in self-reported identification—that is, people newly identifying as First Nations on the Census.
• The First Nations population was concentrated in the Western provinces, with more than half of First Nations people living in British Columbia (17.7%), Alberta (14.0%), Manitoba (13.4%) and Saskatchewan (11.7%). Almost one-quarter (24.2%) of the First Nations population lived in Ontario, the largest share among the provinces, while 9.5% lived in Quebec. A further 7.5% of the First Nations population lived in the Atlantic Provinces and 2.1% lived in the territories. While First Nations people accounted for 2.8% of the total population of Canada, they accounted for one-tenth of the populations of Saskatchewan (10.7%) and Manitoba (10.5%), and almost one-third of the population in the Northwest Territories (32.1%).

Indigenous seniors

• Indigenous seniors (aged 65+ years) are estimated to account for 6% of the 1.4 million Indigenous people in Canada. In comparison, among non-Indigenous Canadians, seniors comprise 16% of the population.
• Estimates project that by 2031, the Indigenous population could surpass 2 million; Indigenous seniors could represent as much as 14.5% of the total Indigenous population by then.
• 52% of the 82,690 Indigenous seniors in Canada live in off-reserve population centres. The majority (52%) of Indigenous seniors have reported moving to off-reserve population centres within the last 10 years after having lived in their home communities most of their lives.
• The projected life expectancy for Indigenous populations is generally lower (74 years) than for the non-Indigenous population (81 years).^{Footnote 72} (This fact, together with the generally poorer socio-economic environment and health status of Indigenous populations, has led some to suggest the Indigenous “seniors” age group should be lowered from age 65+ (pensioners) to age 50^{Footnote 73} or 55+^{Footnote 74} for matters of social policy and public programs and services.)
• An estimated 8% of urban Indigenous seniors report a lack of social supports and say they have no one to call upon in times of need. Among seniors in population centres, compared with non-Indigenous seniors, Indigenous seniors tended to be poorer, were more likely to have had experiences with food insecurity, and faced more chronic health problems (such as high blood pressure, arthritis, heart disease and diabetes).