Nunavut health minister responds to open letter decrying care of elders in the South

The care of elders from Nunavut who are living in the South is a "shared responsibility," said Health Minister John Main — at least, that is, until Nunavut is able to build its own care homes that would allow elders to remain in the North. 

Main was responding to an open letter published in March, in which the Iqaluit-based Pairijait Tigumivik Society presented a long list of concerns it wants addressed at the Embassy West Senior Living home in Ottawa, which it said was failing Inuit residents. Forty-three elders from Nunavut are currently living at Embassy West due to a lack of appropriate care homes in Nunavut. 

Allegations in the letter included a lack of Inuktitut interpretation and improper care from staff, including leaving people in their beds for days at a time.

The letter also alleged that Inuit at the care home are not given an Inuktitut-speaking interpreter when they are sent by ambulance to hospital. 

It also accused the facility of giving residents — many of whom are expert seamstresses — childlike projects like sewing paper hearts, and calling them "ataata," meaning father, or "anaana," meaning mother, instead of their names.

Main said many of the issues in the letter fall under the jurisdiction of regulators in Ontario.

"Given the serious nature of some of the allegations in that letter, it was, I believe, appropriate for the proper regulatory authorities to do that investigation," he said. 

CBC confirmed that the Retirement Homes Regulatory Authority in Ontario did an inspection of the home six days after receiving a report on March 15. The inspection "did not uncover any issues of non-compliance with the Retirement Homes Act and regulations," a spokesperson for the authority said in an email.

In terms of the cultural appropriateness of Embassy West for Nunavut elders, Main acknowledged that's a side effect of the fact that the only care available for the elders is in the South. 

"As a government we are focused on developing more capacity here in Nunavut so that we can deliver the services here in territory in the future," Main said, pointing to a long-term care facility now under construction in Rankin Inlet that's scheduled to open to residents in 2024. 

"That's the first of our, I'll call it the newer generation of facilities that we're planning to develop here in territory." 

Main said that facility would be able to accommodate higher needs patients like those currently in Ottawa. He said the government hopes to develop similar facilities in Cambridge Bay and in Iqaluit.

Cultural gap

Speaking about the March 7 letter, Rachel Qitsualik, the Pairijait Tigumivik Society's president, said on March 14 that problems at the home came to light earlier this year when families were allowed to travel there to help with care during a COVID-19 outbreak.

"The whole issue of elder care was in such contrast to what people expect culturally," she said. "It just blew people's minds that these things were happening."

Anne Crawford, an Iqaluit lawyer who works with the society, said on March 14 that Embassy West is not necessarily a "below standard" care home, but there is a great cultural gap.

"This is not an appropriate place for Inuit elders," she said. "The gap is so great in this context that people won't be receiving the care that they need.

"In Inuit culture, Inuit are the knowledge keepers, the people who pass knowledge to the next generation."

Main said current policy is to provide sponsored trips to Embassy West for family members twice a year, as well as potential other visits in "compassionate circumstances." 

He encouraged people with concerns to come directly to the government to help find solutions.

"There are healthy working relationships that exist between our staff and families and the elders themselves," Main said. 

Nunavut Premier P.J. Akeeagok has committed to creating an elder care strategy for the territory. Qitsualik and Crawford said that isn't enough.

"This is way too late in the game to say, 'OK, now we'll develop a strategy,'" Qitsualik said.

"It's essentially a deferral of an issue that needs immediate attention," Crawford said. 

The society wants to see the territory identify buildings in communities that could be renovated to accommodate elders and to hire nursing staff for home care. 

And, in the short term, it wants to see Embassy West hire more interpreters, offer traditional food and play Inuktitut radio and television programs. 

For Main, building room for more elders in the North is "a longer term project." 

"But I'm quite passionate about [it] and I believe that in the longer term, having a strategy in place will allow us to deliver more services, will allow us to meet the needs of our elders closer to home and make those big improvements that so many are looking for."