By Richard Dagenais
Matiusi Tukalak sincerely and emphatically insists he has no recollection of how he arrived at the Saint Margaret Residential Centre in 2019.
Nor does he remember past confrontations with fellow residents.
The arrival of the former Inuit rock’n roll songwriter and guitarist, confined to a wheelchair, posed some immediate challenges for caregivers.
He was a desperately long way from Puvirnituq, his Inuit home in northern Quebec.
Culturally isolated at Saint Margaret, he chose to isolate himself socially.
For two or three years, Mr. Tukalak would not get into the elevator, refused medical consultations and he spent much of his time staring out the third-floor solarium window.
Head nurse Elizabeth Lopez believes Mr. Tukalak and fellow residents were fearful of one another and, as a result, he wouldn’t allow others to share space with him, because alone, he felt safe.
Ms. Lopez describes reports of disruptive behaviour as “mutual misunderstanding”.
Hoping to build a trusting relationship with the 63-year-old Inuit resident, staff members struggled to break through, trying unsuccessfully to get Indigenous volunteers to interact with Mr. Tukalak, and offering him a traditional dish from Inuit culture.
There was a lot of trial and error and through it all, Mr. Tukalak kept everyone at a distance.
About nineteen months ago, after locating Tukalak with the help of a volunteer, Shirley Fender, a human relations agent with Inuulitsivik Health and Social Service based at CLSC Hudson Bay, contacted Saint Margaret Social Worker Louise Solloway to offer resources.
Ms. Fender and CIUSSS West-Central Montreal Indigenous Liaison Officer Lucie-Maude Grégoire suggested connecting Mr. Tukalak with the Southern Quebec Inuit Association (SQIA).
That has made all the difference.
The connection with his culture, his Inuktitut language and community have led to more harmony and openness between Mr. Tukalak, residents and staff.
Now, Mr. Tukalak attends an SQIA gathering to share coffee and conversation, a weekly event he describes as his “number one favourite thing.”
Ms. Solloway says Mr. Tukalak is also very grateful. “My door is always open, and he always comes to say, ‘thank you’. He goes out to his group and afterward, he always says, ‘thank you, I had a good time.’”
Ms. Fender explains that many of the Inuit long-term care residents and patients scattered across Quebec face the same trauma of isolation, “It’s very difficult when you come from a community where you’ve known everyone all your life and where everyone speaks Inuktituq to end up in a strange facility where it’s never the same person twice who cares for you and where they don’t speak your first language or your second language, which is English.”
Ms. Fender praises CIUSSS West-Central Montreal and the team at Saint Margaret for their care-based approach to Indigenous residents and patients.
Jennifer Pépin, Indigenous Affairs Officer at CIUSSS West-Central Montreal, explains, “Ensuring the cultural safety of CHSLD residents, and in particular residents from Indigenous communities, is a priority and a part of our standard processes. At admission, and then on an ongoing basis, the clinical team evaluates the resident’s specific needs and develops a care plan in response.”
As much as possible, the goal is always to encourage a growing sense of security within all Indigenous residents of long-term care in CIUSSS West-Central Montreal through the maximization of cultural safety, which is all about the respect and integration of Indigenous perspectives and preferences.
Ms. Pépin points out health care staff must guard against unconscious biases by “reflecting critically on their beliefs, behaviours, attitudes and knowledge with respect to Indigenous realities.”
When asked whether he has advice to offer management at long-term care residences, or the Indigenous residents who live there, Mr. Tukalak responds, “I don’t have advice,” then, after a moment, he reconsiders and quietly adds, “Just be good all the time.”
Admits Ms. Lopez, “I’m very emotional about this case because I’ve seen both sides; I’ve seen the clinical progression, and I’ve dealt with a lot of administrative work stemming from complaints. I’m very proud of the outcome, this could have gone either way.”
Ms. Lopez also expresses pride in the team at Saint Margaret and believes Mr. Tukalak’s case clearly illustrates that long-term care residences cannot truly care for their residents without input from everybody.
Ms. Solloway maintains, “We have got to keep working and working, and trying and trying, until we finally get to where we want to be and where the resident wants to be; and when we get there, then we see in them that we’ve made a difference.”