Overview
Wholistic Integrated Continuum of Care (WICC) is focused on developing better systems and relationships for bringing care closer to home. Our vision comes directly from community engagement; we are listening and want to learn more from First Nations people in BC.
In 2022, the WICC team engaged with First Nations communities in BC on gaps in long-term and continuing care. The intention of the engagement was to learn if current community health systems are working and if not, what would improve the system.
The goal of engagement was to better understand future care needs and priorities across the lifespan. The documented learnings from this engagement were then validated across the province.
For more details on the engagement, see the news story and reports:
Listen to the message from cultural and language Knowledge Keepers Jo-Anne Gottfriedson of Tk̓emlúps te Secwépemc and Shirley David of Gitxsan and Wet’suwet’en as they explain what wholistic integrated continuum of care means to them and their families living in BC.
 | Grizzly Bear Calls a MeetingThe story, Grizzly Bear Calls a Meeting, is written by Dr. Garry Gottfriedson. It’s about building relationships with First Nation communities, preparing for the future and working together in a good way. |
Knowledge Keepers
Dr. Garry Gottfriedson, Secwépemc knowledge holder, poet, and cultural leader, advocates for language preservation, education and the arts. Speaker in Secwepemctsin and Cree languages, he combines land-based teaching with creative writing. Born into a ranching family in Kamloops, BC, Dr. Gottfriedson holds an MA in education from Simon Fraser University and has studied creative writing at the Naropa Institute. His works include Clinging to Bone (2019), Chaos Inside Thunderstorms (2014), Skin Like Mine (2010), Whiskey Bullets (2006), Glass Tepee (2002), In Honor of Our Grandmothers: Imprints of Cultural Survival (1994), 100 Years of Contact (1990), and the children’s book Painted Pony (2005). |
Bringing Care Closer to Home
There were four main findings we heard about bringing care closer to home.
Equity = Riverbed
The riverbed represents equity and is the foundation for health and wellness. The riverbed is essential to contain the river, the life within the river and the canoe. The riverbed represents basic human needs or social determinants of health. We heard that housing, food, money to pay bills and transportation were generally insufficient yet foundational to health and wellness.
Investment = Water
Water represents investment. The smaller the amount of water in the riverbed, the more restricted and difficult the journey. We heard that many communities are frustrated by the small, disconnected inaccessible puddles and that there is more opportunity in a river full of water.
Capacity = Canoe
The canoe, paddlers and paddles reflects the community strengths. The canoe is important to transform funding into positive outcomes. In the canoe, there is representation of life from womb to spirit. All members are valued on the wellness journey.
Paddles represent the mental, emotional, spiritual and physical aspects of the wellness journey. How members are able to move these paddles and canoe through the water is affected by the environment, wind and currents.
Connections = Environment, Wind, Rocks and Currents
The environment, wind, rocks and currents represent connections outside the community and how these impact the canoe to move forward easily or with challenges. Rocks represent racism within the health care system.
This component was added during validation (phase two) as many disturbing experiences were shared. Hitting a rock can stop the wellness journey in the same way that accessing unsafe care results in no care being accessed.
Where communities described strong connections with their regional health authority and other nonprofit organizations, the system supported pathways towards seamless, culturally safe and accessible care.
Community Inspired Strategies and Solutions
The inner circle depicts the individual / family on their wellness journey from womb to spirit wrapped in the strong value of care close to home. The second circle surrounds the individual / family with four guiding objectives to support care close to home. The outer ring of paddles indicate how partner collaboration is essential to provide appropriate and accessible health programs and services.
First Nations people and communities clearly expressed that wholistic care includes bringing care closer to home. During validation we heard more about:
- Anti-Indigenous racism in health care
- Greater financial costs for rural and remote communities
- Gaps in staff retention related to inequities of salaries across the health sectors
- No housing for health staff in isolated communities
The Path Forward
The path forward includes more discussions to determine what wholistic and inclusive care closer to home looks like in First Nations communities across BC, including Caregiver Support, Transitions in Care, home health policy, Wholistic Wellness Centres, and 2SLGBTQQIA support.
1. Family Caregivers in BC First Nations communities
Healthy family caregivers are necessary to keep people at home. How best to support family caregivers – emotionally, spiritually, financially, educationally, mentally and physically?
2. BC Ministry of Health draft Home Health policy
The Office of the Chief Nursing Officer at the First Nations Health Authority (FNHA) continues to collaborate with the BC Ministry of Health on resources to support the policy vision for home health services in First Nations communities. These resources are being designed to support relationship-building and respectful collaboration between regional health authority staff and First Nations communities, fostering cultural safety while addressing home health priorities.
With the government election, existing laws and standard practices guide how ministry staff support the transition of a new government. As a result, communication regarding the new policy and implementation sessions sharing resources and policy vision are paused during the election period. Once the new government is in place and the transition is complete, we will be able to plan the next steps.
3. Accessing safer care
Relationships and pathways are essential to support access and seamless care, so that when care is needed outside of the community, the length of time is as brief as possible. We need to hear what relationships and pathways would make the difference to get you home sooner and stay home longer.
4. Wholistic wellness centre
We heard the need for a multi-use building for short term support, no matter the age or reason. To meet this need, we seek to learn more about the services that would best support care closer to home. Most importantly, we need to understand how these services should be provided in this setting.
5. 2S/LGBTQQIA+ care
People who are two spirit, lesbian, gay, bisexual, transgender and/or gender expansive, queer and/or questioning, intersex and asexual are members of every community and have rights to access health services. How can we support inclusivity in accessing care closer to home for people who identify as 2S/LGBTQQIA+? How accessible is gender affirming care and what supports would keep people home?
First Nations Wellness Advisory
First Nations Wellness Advisory Bios
Jared Basil is a cultural Framework Educator with the Social Sector of the Ktunaxa Nation. His work consists of cultural safety and humility trainings, presentations, as well as continuous educational opportunities derived from the Nation’s Social Sectors Practice Framework. In conjunction with education, he continues to work with health partners to develop culturally safe spaces with the hope and intention of impacting and benefitting future generations. His work also reaches education institutions creating meaningful opportunities to learn about cultural safety, creating long lasting relationships that translate to strong, healthy conducive working partnerships moving forward.
Annette Loe is from northern BC and carries Northern Dené, Norwegian, and French roots. Though she has lived as a guest in the urban land of the sylix with her two adult sons for over 10 years due to medical needs, she remains grounded in her Indigenous ways and deep connection to the land. With a university degree and nearly 30 years in BC government, she now offers support where it’s needed through her broad knowledge and balanced experience. A proud mom, caregiver, mentor, artist, and more, Annette values family, strong relationships, and healing through Ancestral Ways of Being. She’s passionate about sharing Indigenous strengths and wisdom to foster unity and meaningful change.
Jean M Brown is a registered Splatsin member. Jean has two daughters and a son, six grandchildren and three great-grandchildren. Jean has been employed with Splatsin Health since 2019 as an Outreach & Mentor, and now as a Traditional Wellness Elder. Jean co-facilitates an Indigenous 12 Step Wellbriety program on a weekly basis and organizes harm reduction workshops. She also brings in resource people to provide information and support for grief and loss due to opioid overdoses and healing on-the-land programs, and helps organize National Aboriginal Addictions Awareness Week. Jean is a board member of Le7teMelamen Society which includes 16/17 Shuswap bands.
Nadine (Montah) McGee – Vancouver Island Region