On October 3, 2024, the Southern Stl’atl’imx Health Society hosted an event focused on end-of-life planning with the First Nation Health Authority and Vancouver Coastal Health. “Life’s Journey Coach” Anita Samuels attended the event to present on Advance Care Planning and her role supporting elders through this process. In this blog post, Anita reflects on her relationship with the communities, the event and shares many useful end-of-life resources for Indigenous Peoples.

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My name is Anita Samuels. I have been working with the Southern Stl’atl’imx Health Society (SSHS) as a community physiotherapist for twenty years. During that time, I had the opportunity to work with twenty elders to assist them in formulating their end-of-life planning, including completing the legal Advance Care Plan forms. These were submitted to the Pemberton Health Centre to become part of their medical record. The elders shared with me that they found completion of this planning gave them a great sense of peace, knowing their wishes were outlined and this would be clear to their families and health care providers. 

SSHS has been delivering culturally appropriate shared health services to the Indigenous people of N’quatqua, Samahquam, and Skatin for twenty-five years. Our office is based in Mount Currie, B.C., which is located two hours away from Vancouver. Travelling to these remote communities can take up to 1.5 hours while driving along a forest service road. Only the paved road is the one to N’quatqua. Various health services are offered to community members of all ages, ranging from babies to elders.  

I recently retired from my role as a community physiotherapist and was hired back as a “Life’s Journey Coach.” I am the team lead on offering a new program specifically focusing on End of Life/Advance Care Planning. Having worked for twenty years in these communities taught me a lot about how to offer culturally appropriate information. Having gained the trust of many community members facilitated a level of openness to the sensitive topic of death and dying. I was able to present many culturally sensitive resources that were supplied by the First Nations Health Authority.  

SSHS launched this new program by hosting a workshop on October 3 at the Big House in N’quatqua. The three communities were invited, along with our neighbours from the Lil’wat Nation. An elder did an opening and closing prayer, and songs were sung that welcomed us all to the Big House. We had various elders speak about cultural beliefs surrounding death and dying. It was emphasized that all Indigenous communities have their own protocols surrounding death and dying. I gave a presentation outlining the scope of end-of-life planning, including how being prepared for the unexpected can facilitate dying with dignity. We had two elders share their experiences of having their Advance Care Plans put in place. Labhrás Quigley, a volunteer from Dying With Dignity Canada, gave a presentation on medical assistance in dying (MAID). We had an open sharing session with the participants and closed the day by outlining what culturally sensitive resources are available on this topic. I also emphasized I was available to do 1:1 personalized sessions to provide guidance on Advance Care Planning. 

Forty community members attended the workshop. We received very positive feedback from the questionnaire we provided. A common theme was that people felt grateful and relieved that this topic was brought forward in such an open and respectful manner. Many people stated they did not know they had rights to express their wishes for medical care, and felt empowered that they can use their voices to outline how they wish to complete their final journey with dignity. Over twenty people indicated they were interested in the 1:1 personal sessions. 

Since the workshop, I have made four trips out to the three communities to facilitate 1:1 sessions, and have further trips already planned. The word seems to be spreading as people are telling their friends and family about what type of support is available through my role at SSHS. It is our hope at SSHS that as we bring this important work forward in our communities, other First Nations may follow suit with their community members.  

There are many end-of-life resources available that are specific to Indigenous Peoples.  

The First Nations Health Authority has a website dedicated to Advance Care Planning. It has a very powerful YouTube clip called “Honour Your Journey” that is well worth watching. It has a link to the booklet “Your Care, Your Choices” which provides an excellent culturally sensitive overview of Advance Care Planning.  It also includes the three potential legal forms that can be completed as a way to convey your wishes for care. 

Other resources include: 

Coming Full Circle:  Planning for your care:  An excellent guide with many thought-provoking questions to consider on end-of-life planning by FNHA 

Honour Your Journey: a tool to help you prepare for your future health care. It’s like preparing a basket of resources and supports that you can reach into when needed. 

When The Time Comes: A guide for end-of-life planning for Indigenous Peoples created by the Saskatoon Survivors’ Circle.