Traditional healing and medicine in dementia care for Indigenous populations in North America, Australia, and New Zealand: a scoping review

Abstract

Access to culturally-safe dementia assessment, diagnosis, and care in Indigenous populations worldwide is an emerging challenge. In 2018, the World Health Organization recognized traditional healers as stakeholders in dementia care and prevention. Traditional healers contribute to dementia assessment, diagnosis, and care in unique ways, and play a catalytic role in the process of culturally-safe dementia care planning and assessment with health care providers at the community level. The purpose of this scoping review was to understand the roles and experiences of traditional healers, to evaluate strategies for integration between Indigenous traditional healing and western dementia care approaches, and to examine the policy barriers and research gaps in North America (Canada and United States), Australia, and New Zealand. The scoping review methodology used was the Joanna Briggs Institute (JBI) approach that included six steps: protocol development based on participants, content and context framework, development of a search strategy, selection of relevant studies, charting of relevant data, synthesis, and reporting of results, and conducting stakeholder consultation. We searched English literature in select bibliographic databases, including CINAHL, EMBASE, Medline and PsycINFO. The initial search identified 516 papers published between 2000 and 2020 that met the search criteria. After 164 duplicates were removed, we screened 352 titles and abstracts, excluding the 209 that did not meet the inclusion criteria. Our second stage review of 143 full text studies resulted in the further exclusion of 141 studies. Only two studies from Canada met all inclusion criteria for this scoping review and explored the potential integration of traditional healing in dementia care and the roles and perceptions of traditional healers. The two studies were conducted in Southwestern Ontario in an urban First Nations community and Saskatchewan with Cree, Salteaux, and Metis populations in rural and remote communities. The studies indicated that the inclusion of traditional healers, Elder knowledge-holders, Grandmother groups, and emerging Indigenous scholars and researchers can contribute to building an evidence-based dementia care decision-making process for Indigenous people with dementia. Hence, integrating Indigenous traditional healing and medicine in dementia care is a path to culturally-safe dementia care and social support systems for people with dementia.