Culturally Safe Falls Prevention Programs for Inuvialuit Elders

Abstract

In Canada, falls are one of the leading causes of injury and deaths for seniors. These types of injuries can typically be avoided through falls prevention programs, and past studies suggest that these health services have significantly reduced seniors’ falls risk and rates in Canada. Despite the abundance of falls prevention research, practices and programs available in the country, Aboriginal Elders remain overrepresented in fall-related injury and fatality rates. The elevated rates of falls for Aboriginal Elders indicate that current falls prevention programs and standards may not be reaching those most vulnerable to fall hazards and injuries. My thesis is written in the publishable paper format and is comprised of two papers. Using an exploratory case study methodology in paper one, I investigated the social determinants of health that Inuvialuit Elders and LFPPs identify as factors that increase, decrease, or have no effect on the likelihood of an Inuvialuit Elder experiencing a fall. Together, we found that personal health status and conditions, personal health practices and coping skills, physical environments, social support networks, and access to health services increase Inuvialuit Elders likelihood of experiencing a fall, health practices and coping skills and access to health services decrease Inuvialuit Elders likelihood of experiencing a fall, and culture has no affect on the likelihood of Inuvialuit Elders experiencing a fall. In paper two, I used a participatory action research approach informed by postcolonial theory to examine what current falls prevention recommendations are offered by local falls prevention programmers (LFPPs) in order to reduce fall rates among Inuvialuit Elders in Inuvik, Northwest Territories, Canada; and to understand how falls prevention programs for Inuvialuit Elders can be co-created with participants to be culturally safe. In it, I provide the recommended strategies of developing and implementing a culturally safe falls prevention program for Inuvialuit Elders, as suggested by the LFPPs and Inuvialuit Elders who participated in the research. Taken together, the papers in this thesis make it apparent that research concerning falls prevention for Aboriginal Elders and falls prevention programs continues to be influenced by colonial practices. As a result, there is a demonstrated need for program development and research in this area to work towards reducing health disparities and challenging colonial practices.